Archives: Cases

Post Type Description

PH-F16-3524

Update 4/3/24- funding in place, waiting available RTC- accepted at Gerard and North Homes. Waiting to hear back from Avanti and East Bethel.

Case Description: Patient is a 16 y/o individual w/ hx MDD, GAD, ADHD, multiple previous hospitalizations, currently presenting due to SI. Patient went to foster care after discharge in previous hospitalization at PC ( october 2023) and returned to mothers home end of Dec after 1 month. Patient was hospitalized at Prairie St Johns for 1 week ( discharged 3/8) due to intrusive SI . Patient feels she was discharged earlier than she should have been because she was still struggling w/ “feeling safe”. Patient indicated that depression /anxiety and intrusive SI improved significantly in foster care. Patient indicated during the time in foster care, patient worked on her relationship w/ mother and feels it was “helpful. Patient transitioned to mothers home and feels that overall relationship has improved and does not know why depression/SI has escalated again.

Discharge Plan: RTC (county funding approved for RTC)
-Avanti (Referral done, waiting to hear back)
-Gerard (Referral done, Accepted)
-North Homes (Referral done, Accepted, currently on waitlist, openings anticipated in June)

PRTF:
-Nexus East Bethel (Referral in progress)

Existing outpatient providers:
-CMHCM at Sherburne County
-Individual therapy Main Street Family Services-Elk River (Appt scheduled 3/27)
-Family therapy at Main Street Family Services-Elk River
-Primary care at Stellis Health-Monticello
-Psychiatry s at Nystrom & Associates
-In-home skills

MHF-M16-3505

Pt was in residential at Prairie Care and was discharged due to behaviors/property destruction/aggression, not allowed to return. Just switched custody from one CPS worker to another so details of history are not complete, but information is being gathered. Know she was previously in out of state placement in Oklahoma where she was discharged due to physical aggression. County is looking at VOA- Bar None Haven and Nexus East Bethel, and hospital is referring to Nexus YCT.

PH-M16-3429

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

HCMCECC-M13-3482

**Contact department: HCMC Acute Psychiatric Services (APS) 612-873-9300

13 y.o. male boarding in ED. Brought in by adoptive mother after running away from home 3 times. Multiple suspensions from school (including currently) for fighting. Mother unwilling to bring patient home. Physically assaulted mother after he was brought back home. Went to Uncle’s house and left via window. Has been making passive comments indicating suicidal ideation and not having any sense of danger- getting into cars with strangers. Significant increase in challenges since he began going through puberty about 6 months back.
Copied from ED note:

“Collateral from mother and family:
Foster mother took in his sister first, took him as well at 16 months old. States that when he first came to live with her he would eat out of the trash, and from bowls on the floor like a dog. Took several months to correct this. Patient was then returned to his paternal grandmother in chicago, but was only there for two months. Foster system asked mother to adopt him and keep him with his sister. Some school issues, briefly on IEP. Mother was kindergarten teacher.
In the past 6 months, since hitting puberty and undergoing a growth spurt, patients behaviors have been worsening. In Nov of 23 patient attempted to start a fire in his bedroom. He has been in a plethora of fights at school. Is currently suspended. Believes that everyone hates him. Since January he has been making comments to family about ending his life. Reportedly had knife in his room at one point. 3x running away from home. 1st time was not far and he came home quickly. 2nd he made his way from north Minneapolis to S St. Paul, and was with a complete stranger for approximately 9 hours. Family reports that patient refuses to speak about this time. Was acting strangely after he returned. 3rd was yesterday after he became angry and physically assaulted mother. Was found by police (allegedly engaging in burglary?) Was brought to uncles house per request of mother, as he had been quite belligerent with her earlier. Patient normally behaves well with uncles, but today he waited until he was unsupervised and climbed out of a ground floor window to run away again.”

Not appropriate for inpatient pediatric medical floor. Boarding in HCMC Emergency Department. HCMC Acute Psychiatric Services do not feel patient needs an inpatient psychiatric admission. Family and NEXXUS advocate not comfortable with discharge unless plan for significantly increased outpatient support. No formal diagnoses. Has been completely compliant and appropriately behaved since presenting to the ED 32+ hours prior.

HCMCH-M16-3181

Per Emergency Protective Care Order, in need of out of home placement. Legal guardian through county, living with father in ND wasn’t successful.
Foster placement is not being recommended. Kinship placement has not been successful and is not a current option.
Patient has gone through Hennepin County QRTP screening – residential placement is recommended and is in alignment with psychology and psychiatry consult recommendations.

MHF-M17-3467

Pt came to ED 3/25 after being on the run for a few weeks. Was previously at hotel crisis respite prior to being on the run, damaged property there and can not return. County is current guardian, though patient turns 18 very shortly and will be his own guardian at that time. History of behaviors, verbal and physical aggression and property destruction. Has been denied from shelters due to behaviors and previously denied from RTCs in and out of state, though due to age would no longer be an option. Refuses all mental health services and has not had a DA since 2020. Is on CADI waiver. Recommendation on weekly call to discuss benefits of IRTS program/treatment with him.

MHF-M17-3392

Patient presented with police after being found as a runaway from parents home, staying at friends house. Patient reportedly having increased aggressive episodes at home towards parents and property destruction. Parents unwilling to have patient in the home at this time. Working with family and case manager on shelter or alternative placement need.

MHF-F15-3389

Patient presented from guardian’s home after a verbal argument. Guardian unwilling to have patient return home and patient does not wish to return home. Guardian in agreement for need for shelter placement at this time, awaiting acceptance to a shelter bed.

MHF-M14-3383

Patient presented to the ED from Aspen House after destroying property and agitation. Unable to return and unable to return to adoptive parents home. Boarding in the ED for shelter placement.