Cases – Page 34 – Mental Health Collaboration Hub

PH-F16-3212

Update 5/16/24: No new information from 5/8 update. Accepted at Bar None Haven, county funding approved. QI completed with recommendation for secure residential setting that is able to accommodate both chemical dependency and mental health treatment. County is inquiring to see if this can be accommodated at Bar None Haven or if they have to look into additional placement options. Medical recommendation is locked mental health RTC. Comprehensive assessment (rule 25) recommends Mental Health Residential. Accepted at Nexus East Bethel PRTF- opening midsummer.

Update 5/8/24: Accepted at Bar None Haven, county funding approved. QI completed with recommendation for secure residential setting that is able to accommodate both chemical dependency and mental health treatment. County is inquiring to see if this can be accommodated at Bar None Haven or if they have to look into additional placement options.

Update 5/01/24: Accepted at Bar None Haven, county funding approved. Missed admissions on 3/20 and 4/30 due to county wanting to complete QI process and having VPA signed in front of a judge before approving placement.

Update 4/25/24: Accepted at Bar None Haven, second opening is now 4/30 and county approved for placement, they are not approving transition on 4/30 wanting a judge to sign the VPA in court and wait the QI process.
Accepted to Nexus East Bethel PRTF, estimated wait list out until August-September.

Update 4/17/24: County funding approved, awaiting open placement at Bar None Haven, previously missed admission due to no funding. Pending acceptance decision at Nexus East Bethel PRTF.

Update 4/3/24: Pt has MA now. CMHCM in process of being assigned and requesting preplacement screening for funding. Denied from Grafton. On waitlist at Bar None Haven, missed admission due to no funding. Pending East Bethel.

Discharge Plan:
Level 6 RTC/PRTF-
Grafton (Referral submitted; Not in network with Prime west, can contract with MA MCO’s and obtain SCA, Denied 2.8.24, re-reviewed, denied)
Nexus East Bethel (Referral submitted; pt will need straight MA; several month waitlist, now has MA so re-reviewing, accepted, admission waitlist til mid-summer)
Bar None Haven (Referral submitted, Tentative admit 3/20-3/21, dependent on county funding, county declining JST screening, requested again, approved)
CMHCM at Beltrami County (Guardian currently in communication with the county, case manager was not being assigned until pt has CD treatment, requested reconsideration)

Notably, Previous services/interventions attempted: Dual Diagnosis IOP, Outpatient therapy, outpatient psychiatry, PCP, CMHCM, CTSS, CD RTCs, Inpatient x3, JDC, previous foster placements.

CMHCM at Beltrami County (Referral completed, services in intake)
INSURANCE- NOW Straight MN MA (was a PRIME WEST MA)
Description: Patient is a 16-year-old Native American female who has a history of depression, anxiety, ADHD, nicotine use disorder, cannabis use disorder, and unspecified trauma. Patient experiences significant impairment(s) in the area(s) of social, emotional, and academical. Patient identifies current supports as her father, sisters, and grandmother. Patient has a history of inpatient psychiatric hospitalization through PrairieCare and Prairie St. Johns.

MHF-F16-4103

Came to ED on 6/2 after a fight with her guardian, Grandma. Grandma reported she has run away in the past and had made comments related to SI. Grandma refused to pick up and then flew to another state, notifying us she did not know when she would return. We tried to refer to shelter programs, but struggled due to Grandma’s unwillingness to work on reunification post shelter placement. CPS has now opened and will be pursuing temp custody, once they have that they will pursue placement options.

MHF-M11-3256

Update 6/7- Pt moved to IP unit to board there
Update 6/4/24- Pt was initially in Fairview ED for 2 months, transferred to inpatient to board there for 1 month, was discharged to a foster placement for less than a week, and returned again to Fairview ED 6/4 due to behaviors, is again boarding in ED. Struggling with appropriate placement due to autism, limited verbal skills, and ongoing aggressive behaviors.
Update 5/6/24- Patient was moved to inpatient unit to manage behaviors, but still remains boarding there. No longer followed by ED team.
Update: 3/21/24 Dad is not going to take the child back. Did get MA switched to MN.
Update: Meeting today 3/14/24, potentially back to dad? Working on switching MA from WI to MN
Patient brought in from home due to aggressive behaviors. History of autism, recently returned to living with father after being in foster care in WI. Since returning to MN, has had limited services set up. Father does not feel safe taking patient home due to aggressive behaviors and other children in the home. Case managers in Wisconsin & MN working together on determining placement.

RMC-F16-4041

16 year old female who was brought in by EMS in 4-point restraints after being restrained by PD trying to enter river to “drown herself”. Patient argued with her mother just before she threatened to “drown herself in the river;” destruction of house/property per mother’s report. Patient admits to past similar behaviors and has multiple MH hospitalizations on record.

MHF-F12-4051

This pt arrived in Ridges ED on 5/31 after behaviors at her Grandma’s house. St Louis County has temporary guardianship. Grandma is refusing to let her return to her home. Made suicidal statements at home and was verbally escalated. County is exploring Heartland Girls Ranch and 35 day assessment programs. Referral is being completed to Nexus YCT.

PH-F17-3785

Recommendation is for level 5 Residential Treatment; patient is currently inpatient.

Patient is a 17-year-old individual who identifies as non-binary and uses they/them pronouns. They admitted to PrairieCare Inpatient Hosptial via ED due to an increase in suicidal ideation. This is their 3rd psychiatric inpatient hospitalization, they have done PHP, and engaged in outpatient mental health therapy and psychiatry. County funding has been approved for RTC on 4/25/24.

Discharge Plan:
RTC: (county funding approved on 4/25)
-Avanti (ACCEPTED, scheduled admission Tuesday 6/4/24)
-Gerard (Referral sent & received, awaiting secondary review)
-North Homes (accepted with immediate opening – county and guardian declined placement)

Continue with established outpatient providers:
-Individual therapy: South Central Human Relations-Owatonna
-CMHCM: MN Prairie County Alliance

CH-M17-4047

Pt brought in because they locked themself in their room and wouldn’t come out. Police involvement encouraged patient to come in to see a therapist. Dad refused to take patient home fearing that patient would become aggressive. Patient has historically been violent in times of parents taking away electronics. CPS report made. CPS did not feel patient should be forced to go home with dad because patient was threatening dad while in the ER that they were going to notify police that dad and roommate forced them to take marijuana edibles. Referral made to 180 degree shelter, who declined.

AH-F15-4044

Patient is under guardianship of Scott County; most recently residing at JAF who is not allowing her back. Foster family cannot take back.

PH-F11-3982

The patient presented after expressing homicidal thoughts (threats of aggression) toward her grandmother with whom she lives. Patient was on her way home from school when she pulled her school lvan driver’s arm to the back of the van as she did not want to return home. Patient was then returned to her school where her grandmother picked her up and eventually brought her to the Emergency Department. Since her presentation to the Emergency Department, the patient has not displayed any aggressive behavior. Patient has irritability and emotional outbursts with grandparent(s) and has displayed these behaviors at school as well. Has mostly been pleasant and cooperative in the Emergency Department. Has some attention seeking behaviors when the Emergency Department is busy.