PH-F16-2321

UDPATES TO Discharge Plan 12/12/23:
-Grafton PRTF (Pt accepted, could admit 12/20, due to staffing moved back to mid-end of January)
-Nexus-East Bethel PRTF (Pt accepted, could admit mid -January)
-CABHH (Pt denied admission)

Recommending PRTF. Referrals completed.
Cannot return to previous Group Home. Per County, no interim plan available as parents and foster parents are reportedly not an option. Still seeking county to arrange interim living arrangement between Inpatient and PRTF – for crisis stabilization or group home.

Patient was previously at a group home, due to running away and SI/SIB, pt was readmitted to Inpatient. Inpatient hospitalizations 7/8/23-7/28-23, 9/29/23-10/13/23, 10/16/23-Present.

Patient has the following outpatient providers:
CPS Worker/Legal Guardian
CMHCM
GAL
Medication Management
PCP
School Counselor

Insurance: BCBS MN and MN MA

PH-F15-2511

Update 1/24- County funding for RTC denied on 12/26, now following alternate recommendations as determined by the county. DC was scheduled for 1/4, due to parent request, rescheduled for 1/5.

DISCHARGE PLANS:
Hospital Recommendation is RTC-
Avanti -referral made, accepted, intake 12/28/23
North Homes- referral made, reviewing, no immediate openings
Gerard- referral made, accepted, intake 1/9/24

Alternate Plan:
Mobile Crisis Team (Referral sent by CMHCM)
Day Treatment- Christian Family Solutions (Referral sent by CMHCM, waitlist to about 1/19/24)
Intensive family therapy (Referral to be sent by CMHCM)
PCP- Marlene Jilek, APRN (Mankato Clinic)
Therapy- Claire Alexander, MS, LPCC at PrairieCare Mankato (Availability as soon as next week, requests patient guardian call to schedule appointments)
CMHCM- Nicole Wigern (Blue Earth County)

Presenting Problems: Major Depressive Disorder, PTSD, SI/SIB, Inpatient for the third time this year, has done PHP twice this year

MHF-F15-2472

Patient is presenting to the ED for the following concerns: verbal agitation, suicidal ideation, threats to harm others, property destruction. Patient became upset at school, threw items, and ripped things off of the wall. Patient left school grounds, and police/ambulance were called. Patient has been living with her aunt for the past few months. Patient’s biological mother died when she was an infant, and was abused by a family member who obtained guardianship. Patient makes suicidal and homicidal threats often.
Patient was in the Fairview PHP program earlier this year. She was in the ED in May ’23. Patient no longer has a medication management provider. She has a county CPS worker and a newer case manager. Patient is currently in Equine Therapy 1x/week at Hold Your Horses.

MHF-F14-2469

Patient is presenting to the ED for the following concerns: suicidal ideation, depression. Patient reports he tried to kill himself last night by stabbing himself with a dull pencil. Patient reports suicidal and homicidal thoughts that have increased in last two weeks. He has been at North Homes for three months. He was discharged to North Homes after a hospital stay at UMMC in September for SI. At North Homes, the patient escalated and told staff he was suicidal. He took the batteries out of a remote and tried to swallow them. He also tried to stab self with dull pencil. He became combative and needed to be restrained and then kicked staff in chest and tried to kick another staff. Patient then stated he would find each clients personal info and then take pictures of other clients after he killed them and send to parents. Patient told staff he would kill other clients and himself.
Patient reports long history of MH including PTSD, MDD and GAD. Patient has been hospitalized 2 x in past 6 months. Patient reports history of trauma. Patient states he has history of SIB.

PH-F10-2551

Discharge Plan:
-Gerard (PT denied d/t documented IQ, requested reconsideration as new testing shows IQ as 78, pending)
-Northwoods (Waitlist is 1+ years long)
-North Homes (Pt denied d/t age)
-Acadia Out of State RTC network (Referral sent, pending)
-CABHH (Referral sent, pending)

10 yr old female admitting from Windom Area Health emergency department for suicidal ideation and homicidal ideation. Pt eloped from school and attempted to run into traffic and was brought to the ED via the police. Nobles County is Legal Guardian.

Existing services:
-Psychiatry through Southwest Mental Health Center
-New therapist starting in December through Healing Path in Levurne
-Previous therapist through Greater MN Family Services
-Neuropsych done with Surdy Psychological Mankato
-Nobles County guardian and CMHCM
-Nobles County guardian and CPS

MHF-F15-687

Patient is presenting to the ED for the following concerns: substance use, intoxication, anxiety. Patient was at WINGS treatment center for substance abuse/mental health from 10/17/23-10/28/23, before eloping. Patient was living on the streets, and staying with friends, before going to her aunt’s house. Patient was then picked up by her guardian/grandmother and brought to the ED.
Patient has a history of elopement and substance abuse.
Patient attended Prairie Care’s PHP program in June 2022, but was discharged due to behavioral problems.
Patient was in FV inpatient unit from 3/10/23-3/16/23 when she eloped while being transported to FV residential treatment program.
Patient was readmitted to the inpatient unit on 3/17/23 where she remained until admission to FV residential treatment could be arranged.
Patient was discharged from treatment due to behaviors and ran away from home, when she was found and brought back to FV ED on 4/24. where she remained until eloping on 5/28.
Patient has been accepted to Oshki Manidoo treatment center, and will admit once a bed opens up.

AH-F15-2359

SI, self-harm, history of suicide attempts, past (not current) substance abuse, fetal alcohol syndrome disorder (normal IQ), reactive attachment disorder.

Denied from village ranch due to Mental Health concerns, Heartland due to behaviors, Little Sand denied due to recent suicide attempts, Greater MN denied due to hygiene concerns. Just completed res tx in Oct. Cadii waiver? Has been screened for the waiver. Jen Butler will connect. Hunters Place and Port are reviewing. UPDATE FROM 1/12: Accepted to North Homes Eval Program for 1/18/23

AH-F11-2284

SI, SIB, high risk behaviors (running away, substance use), foster family found burn marks on her sheets. Has been in 7 foster homes over last 2 years. CPS/foster family found notes referencing suicide in her room, SIB. ETOH use, THC use, deceitful, dishonesty. School staff and therapist was shocked, presents as a well-adjusted child. As in school. Struggles to connect with people. Makes poor choices with her sister. Likes to burn candles and leaves them, does she forget or is it intentional. Burn marks on sheets, lighter in room. Admitted because of SIB/SI notes. Struggling to find a foster family – from small area so other foster families hesitant to take her in. Question as to if residential treatment is appropriate? At this point, foster care or shelter care is rec. Was formerly at a partial program at Prairie Care.

MCR-M17-2128

Chemical Dependency (fentanyl and meth) suicidal statements when intoxicated. ED boarded 9/20/22-10/5/22 when brought from CRU for making suicidal statements. Placed at PORT group home in Bemidji, eloped in less than 24 hrs. presented to ED 10/12 after being hit in the head with machete. Surgically cleared, mayo filed for MI/CD commitment. Olmsted currently deciding between CHIPs commitment or family court to obtain court ordered CD tx. Needs locked CD or dual dx residential. Discharged to CD group home and eloped within 24 hours. dropped off at Mayo after OD. proceeding with commitment.

RMC-F17-2074

History of suicide attempts and self-harm, verbal and physical agression, DD, FAS, ADHD, identifies as non-binary

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