Risk Factor: Substance use/abuse

Substance use/abuse is the misuse or problematic use of drugs or alcohol, which can lead to negative consequences in a person’s life.

PH-M16-6335

Recommending level 5 RTC
16-year-old male who presented to PrairieCare Inpatient Hospital as a step up from PHP. When home for the weekend, he had increased emotional and behavioral dysregulation with symptoms of psychosis and was brought to the ED by his mother.
He has a psychiatric history of disruptive mood dysregulation disorder, autism spectrum disorder with accompanying intellectual impairment, intellectual developmental disorder, mild, fetal alcohol syndrome, and ADHD.
This is his second psychiatric inpatient hospitalization; he was attending PHP prior to this hospitalization and has a history of psychiatric outpatient services.

SMCF-F17-6289

Pt was brought to the Sanford ED for concerns for “erratic behavior.” Long history of residential services, outpatient case management, Juvenile Detention in North Dakota and in Minnesota. Patient has been running away, increase in drug use. Mom is concerned about patient being trafficked. Reports have been made. No active probation at this time. Patient could benefit from an inpatient psychiatric hospitalization for stabilization. Concern facilities will take her with history of chemical dependency and aggression. Additional concern for a plan for patient upon discharge.

PH-M12-6065

Recommending RTC. Will need county funding.
12-year-old male presenting to PrairieCare Inpatient Hospital due to an altercation with his mother after not wanting to go to school. Following this altercation, his mother found a suicide note. He is a history of depression, anxiety, PTSD, mood/dysregulation resulting in intrusive SI. This is his 2nd psychiatric inpatient hospitalization. He has engaged in PHP and outpatient psychiatric services.

Discharge Plan as of 9/9/25:
– PrairieCare
– North Homes
– Gerard

MHF-F17-5573

Youth came to our ED 4/17 from group home, who are not allowing her to return. Stearns County has custody currently and there is a CPS worker as well as ICWA advocate. No waiver currently. Had a SUD assessment that recommends residential treatment and she was agreeable to that, however no acceptance at programs yet and wait lists for those also. CPS is exploring shelter and kinship options. Was denied by Red Lake shelter and Ain Duh Yung.

PH-F15-5562

Patient is a 15-year-old female, currently at PrairieCare Inpatient Hospital.
Recommendation is for level 6 PRTF.
Patient has had five previous inpatient hospitalizations through Abbott Northwestern and PrairieCare since April of 2022. Patient has had two admissions to PrairieCare partial hospitalization programming, and one admission to Anthony Louis Center RTC.

Establish PRTF:
-Nexus East Bethel (CMHCM sent referral, PC also sent a referral, declined for admission 04/16 due to believing PT needs a higher level of care- CABHH)
-Northwoods (Not a viable option due to insurance and 2 year waitlist)
-Grafton (Not a viable option due to patient not meeting admission criteria)
-Leo Hoffmann Center (Not a viable option due to patient not meeting admission criteria- only accept biological males)

MFIUP-F13-5535

Pt presented to the FV Riverside ED on 3/17/25 from school for agitation and aggression in the context of being questioned by school security about misusing her medications (which was reported to school by her guardian). She has remained in the ED boarding awaiting placement at a residential facility as guardian/aunt has not felt safe to have her return home. In the ED, she has had multiple behavioral codes, has been aggressive to staff, and has self injured. Given her out of control behaviors and the ED’s inability to manage her, she was admitted to UMMC unit 7ITC on 4/11/25 as a boarder while she awaits placement. Significant symptoms on the initial presentation include irritability, aggression, out of control behaviors, impulsivity, and SIB. Was previously admitted to Nexus-East Bethel but assaulted staff so unable to return.

MHF-M16-5515

Came to our ED on 4/10 only because the County had no where else to bring him. Mille Lacs County has custody. He just left the lino lakes juvenile detention center. Has been to many juvenile detention placements, but is no longer required to be there. Has some history of substance use, but most SUD treatments have denied him due to aggression. Has been sober for 2 months now as he was at JDC and now the hospital. County is exploring out of state MH treatment facilities, as well as in state MH group homes, shelters, evaluation programs. Working on getting a recommendation for PRTF through a psychologist who had seen him for civil commitment. Working on SMRT and MNchoices for waiver placement options.

GC8S-F14-863

14-year-old adolescent female with a history of ADHD, witnessed verbal and physical abuse, multi-substance use with significant behavioral issues at school. Pt was admitted to Gillette Children’s on 4-30-2023 with an acute hypoxic ischemic brain injury secondary to hanging herself in a suicide attempt. Pt has made significant improvements in her cognitive and motor functioning since her initial presentation. Pt does not have a previous history of suicide attempts but does have a history of non-lethal cutting behaviors. She has been involved with various mental health providers on an outpatient basis over the past several years. She has never been hospitalized for mental health issues. Pt is currently not suicidal. Pt currently presents with a flat affect and difficulty comprehending the gravity of her suicide attempt. Pt will be ready for discharge from a medical standpoint mid-next week and is expected to be independent in mobility and self-cares, although she will require supervision in the home setting. Pt has the endurance to complete a full day of activity. Please consider Pt for intensive mental health services and parental support as she transitions back to her home setting.

Update 5/18/23 from Mallory at PrairieCare: Amy and I messaged, this pt will DC from RU 5/24/23 and has not had any SI or SIB plans, means, or intent. Likely initially declined for Inpatient due to medical condition. Once medically cleared, discussed referral for PHP due to needing intensive therapeutic intervention, but not imminent danger to self. Amy plans to refer for PHP.