Recommendation is for CD residential treatment. Patient is currently inpatient.
17 year old female admitted from the ED. Pt was having increased panic attacks and engaging in self-injurious behaviors by hitting themselves. Patient has been having suicidal ideations. Patient has been using marijuana as a coping strategy. Patient has a history of numerous psychiatric hospitalizations. At this time mother feels the patient can not return home as the family has been staying at a motel.
Pt insured by BCBS PMAP and Medicaid.
Pt has the following outpatient supports:
Individual therapy
Psychiatry/medication management
Primary care
Recommendation is for dual diagnosis residential programming (ASAM 3.5)
Patient arrived at Inpatient from ED due to increased suicidal ideation. This is his 5th psychiatric inpatient hospitalization in the past few years. He has done RTC through Northwest Passages, PC PHP, and began programming at Options day tx before it closed. He does have a history of aggression towards school peers although aggression has not been a concern while in programming or hospitalized.
Discharge Plan:
Dual Diagnosis RTC:
Dual Diagnosis RTC:
-Newport (patient declined due to impulsivity and aggression concerns)
-MHealth Fairview, Maplewood (declined due to acuity of MH and aggression)
-Hazelden (in network benefits approved – initial phone screen complete, awaiting decision for setting up next assessment)
-Wings (pt declined due to physical aggression in previous six months)
-Rogers BH (Referral sent – guardian to complete phone screening and then pt screening will be scheduled)
-Lakeside Academy (Christian based program – patient declines referral due to this)
-Bar None Omegon (unable to refer – only accepts biological males)
-Anthony Louis Center (unable to refer – will not accept those needing dimension 3 ratings or above)
Update 4/26/24: Patient discharged from inpatient on 4/26/24 and admitted to VOA Bar None Shelter Plus.
Update 4/24/24: Patient has been accepted to VOA Bar None ShelterPlus Program with admission scheduled for Friday 4/26.
Update 4/17/24: Updated clinical/referral resubmitted to Anthony Lewis Center for acceptance consideration.
Update 4/4/24 – County is working towards referrals to group home settings at North Crow Group Home – Cokato and Annadale – Village Ranch while awaiting appropriate RTC placement. Anthony Lewis Center tentatively reconsidering the referral if patient does not need a medical setting.
16-year-old female presenting to PrairieCare Inpatient Hospital. Patient is diagnosed with RAD, depression, anxiety, ADHD, PTSD, polysubstance use emerging personality traits. Patient has had multiple hospitalizations, utilizes outpatient resources and completed DBT, one RTC placement, been in a group home, and is currently in foster placement. Patient’s current foster placement is unwilling to have patient return. Patient is currently under guardianship of Wright County.
Discharge Plan:
Dual Diagnosis RTC:
– MHealth Fairview-Maplewood (Referrals submitted: Update 3.13.24 – Cannot be approved until housing is confirmed)
– Wings (Referrals submitted Denied 3.15.24 due to mental health needs exceeded current program capabilities)
Current Providers:
– Individual Therapy
– Chemical Dependency Counseling
– Medication Management
– CMHCM with Wright County
Patient presented to the ER with her mom for concerns of suicidal ideation though patient denies this. She has had several presentations to the ER due to aggressive behaviors and kicked out of group home for aggression towards peers and staff. She has been in and out of crisis centers and alternative housing verses being at home along with several inpatient hospitalizations.
**Full details of patient history is unknown to writer as I am not currently following her***
Patient presented to the ER via law enforcement for aggressive behaviors at shelter care resulting in property destruction. Patient is not able to return to the shelter and does not have any safe disposition options.
Update 3/29- Pt discharge home while waiting potential tx
16-year-old male presenting to PrairieCare Inpatient Hospital. Patient has a known past psychiatric history significant for Depression, Anxiety, Polysubstance abuse. Patient has had multiple psychiatric hospitalizations.
Discharge Plan:
-Dual Diagnosis RTC:
– MHealth Fairview – declined due to behaviors at previous placements
– Rogers Behavioral Health – cannot accept pts insurance
– Hazelden – cannot accept pts insurance
– MN Adult & Teen Challenge Lakeside Academy – declined due to behaviors at previous placements
– Wings – referral sent, pt denied in past
– Anthony Louis Center – CD only – declined due to dimension 3 score
– VOA Omegon Pathways – referral sent, will make determination week of 3/25/24, earliest availability mid-late Apr
Continue with currently established providers:
-Probation Officer: Swift County
Update: 1/19/24 Pt. still looking for placement.
15-year-old male looking for a group home and residential program. Children’s Mental Health Case Manager has tried everything, and doors are being shut. Client has a physical aggression, verbal aggression, history of PTSD and sexual abuse. Client has experienced abuse from biological father who is in still in the home, and sexual assault that happened possibility of more than one with an older cousin sister. Client mother is giving up on hope on trying to help her child. Client is struggling at home, school, and community. Children’s Mental Health Case Manager has been trying everything to find a placement for him. He’s been going in and out of the ER like every two months now. Children’s Mental Health Case Manager still trying to offer support the way she can by being there every hospital stay, seeing client like twice a month, and having mom keep her on speed dial to talk to client.
Because of experiences, client is chemical dependent on marijuana, perks, and opioids.
Patient presented to the ER after 3 other ER visits from outside ER for physical concerns that were determined to be panic symptoms verses a physical abnormality. Patient has a chronic history of mood and behavioral dysregulation, self-harm, multiple suicide attempts, truancy, and parent child relationship difficulties. She has a history of trauma in the form of witnessing domestic abuse, physical abuse, possible sexual abuse, and the death of her dad due to an OD 4-5 years ago. She has had 2 inpatient hospitalizations along with 2 PHP admissions with little benefit and participation. Mom struggles with following through on recommendations and struggles with alcohol/substance use. A child protection report was filed last year and she moved in to her neighbors though this is no longer an option. She denies any passive or active suicide ideation, plan, or intent. Inpatient hospitalization is not recommended. Mom is not willing to bring her back home at this time due to disruption in the home.
Update: DC’d to Anthony Lewis 11/20.
16 y/o F with a significant opioid use disorder and passive SI. Self-presented to APS wanting CD tx. Hx of 3 serious overdoses.While in APS, She has been calm, cooperative, and engaged. Suboxone was started and is tolerating it well.
This child was previously on the HUB as MCR-M17-2128. Originally admitted 10/12/23, and discharged 11/17/22 to CD group home and eloped within 24hours. Brought back to ED after being found ODing on 12/4/22. Eloped on 12/30 and returned 1/6; attempted to elope again on 2/4 but successfully stopped.
Chemical dependency (fentanyl and meth), suicidal statements when intoxicated. On MI/CD Civil Commitment. Needs locked CD or dual diagnosis residential treatment. County Attorney pressing charges, which may help with JDC placement options.
