Patient is currently inpatient and are unable to move further with discharge planning due to not having a County of Financial Responsibility. Stearns County and Wadena County have both been consulted and neither have accepted responsibility at this time.
Discharge Plan:
Establish PRTF; referral made to Nexus East Bethel, accepted, on waitlist
Establish Level 6 Program; referral made to Bar None Haven
Establish County Support/Funding; SW navigating with Stearns Co/Wadena Co/VOA
Continue with established outpatient providers:
-PCP: Lakewood Health System
-MM: Lakewood Health System
-Therapy: Lakewood Health System
Psychiatric history of Major Depressive Disorder, Generalized Anxiety Disorder, and Oppositional Defiance Disorder. Patient has two prior inpatient psychiatric hospitalizations in October 2024 and December 2024. Patient has a history of partial hospitalization programming in October 2024. Patient presented to PrairieCare through the ED following a suicide attempt and increasing behaviors at home. The current recommendation is for residential or PRTF..
The patient has a history of ADHD, disruptive mood dysregulation disorder, anxiety, and PTSD. Last night he became frustrated at residential treatment facility- Bar None, kicked a door with his right foot, and put a shoestring around his neck out of frustration. He states he was not trying to hurt himself and did not intend to hurt himself. Bar None completed an administrative review and will not allow his return.
Patient sent to Cambridge medical center ED due to aggression and numerous ED visits from Bar None. Bar None discharging the patient.
12 year old, history of trauma with subsequent depression and anxiety ADHD and anxiety. Multiple treatment interventions at PHP. Patient reports that depression has been worsening over the last several months and has becoming more difficult to manage. Patient reports ongoing suicidal ideation and difficulty thinking about anything in the future that would be of benefit. Patient reports ongoing mood disorder low mood low energy reports difficulty with school reports anxiety.
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Previously diagnosed with depression, anxiety, PTSD . Numerous admissions to psychiatric hospitals and Emergency Departments because of suicidal ideation, suicide attempts and self-injury. History of CPS, county mental health case managers and crisis services. Plan to jump off a bridge. Self injury has included cutting, scratching, burning and head banging.
History of present problem: pt endorsed SI and having thoughts/plan to slit his wrists with a knife, which he has access to at his dad’s house, and endorsed self harm via cutting in recent past. Pt reports feeling isolated due to lack of consistent phone connection.
**Aggression is verbal and throwing objects (no contact)
**MnCHOICES Assessment referral made
**Psychiatry scheduled at BHSI – Brooklyn Center
Patient presented to the ER via EMS on 12/4/24 after an intentional overdose of chlorpheniramine maleate 4 mg / dextromethorphan hydrobromide 30 mg pills in an attempt to get high. He required PICU admission for anticholinergic toxicity and treatment with Precedex related to agitation and history of aggression with anticholinergic toxicity. He has had multiple ER visits for substance use. He was previously admitted here for inpatient psychiatric hospitalization from 11/7-11/15 and was discharged with plans to attend outpatient SUD treatment in Wisconsin. as he was not willing to participate in residential treatment. This is at least his 6th intentional overdose in attempts to get high and his 5th hospital admission requiring PICU admission. He is currently under the emergency guardianship of Mille Lacs County related to a CHIPS petition as he has been abandoned by his mom who moved to Wisconsin. He is also currently on probation with Mille Lacs County. He has not previously been successful with past SUD treatment or inpatient psychiatric hospitalizations. Has very poor insight and follow through- though is able to express his desire for sobriety.
Pt has has multiple psychiatric hospitalizations, is aggressive often, and very unpredictable in her behaviors. She was in an ED for about a month, and was placed at Northwoods residential treatment. She was engaging in self harm. and making threats to jump out of a window. Pt assaulted police who came to remove her from the facility for psychiatric care. Northwoods does not feel that they can keep her or the other patients safe there, so they are not willing to accept her back.
Kiddo came to us on 11/7 from East Bethel PRTF. East Bethel has discharged reporting they are unable to meet his needs based on his ongoing SI and behaviors. They are completing a referral to CABHH. Has a long history of SI. There is currently no County involvement. Aunt is working on setting up CMH services, but County has reported they don’t have any placement options. Our team will be requesting County look at approval for out of state options once they are open due to limited options in MN for this level of care.
