Patient is presenting to the ED for the following concerns: self-harm. Patient has a history of self-harm, through primarily biting his arm, punching other things or scraping himself with a tack. Mom reported that today was the first time he self-harmed with a blade. Mom reporting increased aggression in the home and at school and feels that patient needs inpatient. Mom explained the patient is in a level 4 school setting. He recently did PHP at Prairie Care and was discharged after three days due to concerns about aggression and inappropriate sexual comments. Mom shared the patient has made comments about wanting to strangle others.
Mom explained that patient may already be on the waitlist for the Village Ranch residential treatment in Cokato. They are also exploring North Home in Bemidji. Mom reported that patient has been diagnosed with ADHD, ODD, PTSD and ASD. She also wonders about FASD due to his biological mothers, drug and alcohol use. Patient was adopted at age 7 by his adopted mom and adopted dad. Mom was his PCA in his last foster home for one year before adoption.
Risk Factor: Self harm
This term refers to instances of isolated, non-repetitive aggressive behavior, such as a single incident of physical aggression or verbal aggression.
MHF-M7-2180
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression. Patient currently lives with foster mom and dad, mother will soon be entering IRTS but intends to take son back afterward. Patient has been not been taking his medications and engaging in behavior that puts himself and others around him in danger. Patient has high sensory needs that if not attuned to will begin to hurt self and others. Patient was last admitted on 10/20/23 and was inpatient until stabilization. Patient has been attempting to “scratch out” his eyes and turn off devices of his fellow foster care children. Pt is diagnosed with Autism Spectrum Disorder and significant early childhood trauma. Collateral reports that when pt takes meds, he can calm down. Patient is non-verbal.
MCR-F17-2173
Ingesting items. Several ED trips to have items removed. Was at Gerard, couldn’t keep her safe. Significant sexual abuse history. Several referrals with denials due to the ingesting. looking at Group homes. takes responsibility for her actions. Parental rights terminated. Barriers are not being able to keep her safe (ingesting). medical issue with pancreas – very specific diet, ex. places don’t have medical staff on site. Turns 18 in May
MCR-F13-2165
Was at SERCC, brought to ED for ingestion of metallic items there. Had been in ED > 24hrs now admitted to inpatient unit to monitor his GI. Was in Fernbrook Day treatment. Transitioning to male. ED more related to PICA ingesting nonfood items regularly – batteries, tacks, chargers, etc. 1:1 support for keeping from self-harm. is at home with mom when not in day treatment program. Needs more than day tx support, needs 24 hr. Concern for medication mgt. Absence of psychiatric support. Has been in Prairie Care twice summer 2022 – dc’d for noncompliance. He describes a strong compulsion for ingesting things. He doesn’t claim it to be self-harm. when he goes to Mayo, he claims that it’s a suicidal attempt. Was at Gerard in May and struggled, then inpatient at Children’s in summer. Then came back to Fernbrook. over 30 presentations to ED at Mayo and Metro for self-harm and ingestion. Some are SI. Ingested batteries, screws, chargers, needing med tx/attn. Spent 12 ays at Gerard in May, 3 ingestions and elopements while there, they had to dc him as couldn’t meet his needs. Just gotten a CADII waiver to help mom supervise at home. Case conf. yesterday – the hope would be that he could be in a residential settings with the understanding that he will ingest things. Licensure issues. He has been declined as he fits everyone’s exclusion criteria. When he is out of crisis, he’s lovely. bright, intelligent.
AH-F16-2120
trauma. Bio female, id’s as male. On inpatient unit. Rec residential tx. 1:1 staffing due to safely concerns for self and others.
AH-F16-2111
Diabetic, trauma and self harm
AH-M15-2095
depression, dissociation, SIB, Ids as female. County is not involved. Health Partners is payor.
PH-F15-1621
Updated 10/23/23: DC home to in home therapy through CIBS. Still no county funding for QRTP
Updated 10/19/23: Still no county funding for QRTP. Discharge home 10/23 or 10/24 with in home therapy through CIBS.
Update 10/12/23: Still no county funding. Likely moving forward with CIBS at Gerard, will likely discharge next week home.
Update 10/5/23: Gerard admission pending 10/11 now. County funding remains pending. Pt declined from CD RTC noting Mental Health long term RTC.
Update: 9/7/2/3 Gerard admission tentative 9/20, pending county funding.
Update: 8/31/23 Approved for Gerard admission week of 9/18, pending county funding. Also accepted at NorthHomes, 3-6 month waitlist.
SI since the 4th grade, history of trauma, living in cars/shelters, history of CD use.
Discharge Plan:
Primary DC recommendation is RTC*:
Gerard (accepted; pt is next on list for placement; openings week of September 18th)
North Homes (accepted; 3-6m waitlist)
CRTC (referral placed; admissions paused due to staffing)
Avanti (referral not placed; facility not accepting referrals)
*QRTP/RTC County Funding needed as pt has a UCARE PMAP Plan:
Dakota County CMHCM: Referral Placed
-Mother lives in Dakota County and father lives in Rice County (pt will reside with mother following hospitalization, mother provided consents)
-Le Suer County and Scott County CMHCM previously referred to: Cancelled Referral due to Family Moving
MHF-F16-1061
Patient arrived via EMS due to her mother calling 911 after the patient made suicidal comments at home and conflict with her mother. Patient was engaging in sexual behavior with a strange, in exchange for drugs. Patient went home and told her mother what she did, passively stating she wanted to kill herself.
The patient has a history of risky sexual behavior, self-harm, and suicidal ideation. Patient also has a history of physical and verbal altercations with others including family and EMS / hospital / treatment staff, and has a history of 3 suicide attempts, most recent attempt was 1 year ago by ingesting bleach.
Patient has a past psychiatric history of ASD, ADHD, MDD, GAD, and Cannabis Use disorder.
MHF-F13-1289
Update 9/28/23: Has potential placement. Awaiting.
Patient was brought in by medics after she was physically aggressive with a staff member at The Aspen House, where she has been living for two months.
Patient has adoptive parents and adoptive siblings. She was adopted when she was two years old, and has recently reconnected with bio-dad.
Patient had prior diagnoses of depression, ADHD combined type, anxiety, neurocognitive disorder related to maternal meth abuse while patient was in utero, and learning disability. She’s been in M Health FV IOP, since she’s been there. She does not participate in groups or other activities much. She’s been in an inpatient mental health unit, mostly at M Health FV, at least four times. The last admit was 4/21-4/27/2022 at FV. She’s had the following RTC placements: Eau Claire Academy, 4-8/2022, CRTC 8/2022-1/2023, and Avanti 1-4/2023. She receives Psychiatry and Therapy services through the group home.
She has had two prior suicide attempts by choking herself.