Post Type Description
Discharging to Gerard on 1/10
Patient presented from Bar None shelter after A verbal altercation. Had been in Bar None RTC however got into a physical altercation several days prior and moved to the shelter on a behavior contract. When patient became verbally agitated, patient was sent to ED and is now discharged from the facility. Patient denies MH symptoms, has no placement. Guardian reports referring patient to North Homes and Gerard who report several month wait lists.
Patient presented after being found on the run, recently discharged from Oshki Manidoo CD treatment unsuccessfully due to aggression and sneaking in a vape. Ongoing substance use concerns, need CD treatment.
1.4.24 – Nexus YCT doing an intake next week.
Presented to ED after altercation with Mom resulted in property destruction and pushing her. Behavior concerns specifically aggression in home towards mother, siblings; patient is in a level 4 special-education program due to ongoing challenging behavior at school often leading to multiple suspensions, needing higher level of intervention. The police have been called to the home multiple times due to patient’s increasingly violent and aggressive behavior, poor impulse control, low frustration tolerance, agitation and oppositional behavior.
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
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
Patient presented to ED due to concerns of sexual abuse. Patient has extensive history of eloping from home to meet up with adult men she met online and have sex with them. Mom does not feel she can keep her safe at home due to her risky behaviors.
Patient presented to the ED after making a suicide gesture in a grocery store (held knife to neck) in order to be brought to the hospital. Baseline SI and no history of suicide attempts. History of autism. Has complex psychosocial history, was living in Fargo with father however father brought to MN and left to return home without patient. Mother currently homeless in MN and has no ability to take patient in with her. Patient has no active services in MN due to most recently living in Fargo. Need shelter placement alongside establishing providers for long term placement.
12.21.23 This week the case worker came and discharged the child. Created safely plan, and child went home with gramma.
12/13/2023-History of Present Illness: This is a 10-year-old female patient was assessed by the crisis team crisis team recommended the patient go to a higher level care. Patient brought to ED for placement. The patient currently lives with grandmother but is Custody Of Indian child welfare. The patient has a history of PTSD, ADHD, anxiety, The patient has been hospitalized previously at primary care in Brooklyn Center Minnesota for 9 days, on October 23, 2023. The patient has a history of a mental health team including a home counselor at school counselor and outpatient services. Patient was transported here by law enforcement services. On examination the patient denies any pain Or complaints. There are 2 workers from Indian child welfare present with the patient here.Patient evidence of UTI Macrobid 100 mg orally was given Patient will need prescription Patient is transferred or discharge.
Impression: #1 Behavioral issue #2 UTI
Writer met with pt, sleeping and did not wake, and pt’s social worker Vanessa 218-850-9918 to discuss prior services. Pt has several services in place to assist with managing her behaviors. She has a therapist she sees regularly, medication management, is on an IEP, is able to take breaks at school, has in home services, engages in skills work, and does family therapy. Pt is in foster care with her grandma and has been since a young age. Pt does see her mom and gets violent with the siblings. Pt is violent both at school and will destroy property. Pt has aggression towards grandmother and will hit her, law enforcement has been called, however, grandmother does not file charges. Pt was in Prairie Care in October for roughly 9 days with no issues. At this time ICW social worker and grandmother feel inpatient treatment is the next option. Residential treatment was discussed briefly, however, without any legal charges or any recommendations, as well as pt’s young age as a barrier, residential placement is not an option at this time.
Staff will continue to look for inpatient treatment at this time.
Patient presented from foster home due to SIB via cutting and passive SI. Recommended for discharge, however foster parent unwilling to take patient back due to concerns for behaviors (passive SI, reportedly giving men her address online). Needs shelter or foster placement.
Patient brought from foster placement as foster family was going out of town and no other placement could be located for patient in the interim, therefore county brought to ED for shelter. History of sexual assault charges and schizophrenia. Patient denies MH concerns currently. Unclear if foster family will take patient back when they return. Patient is accepted to an RTC in PA however ICPC needs to be completed by county and timeline for completion is unclear.
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