Psychiatric Diagnosis: Depression

Depression is a psychiatric diagnosis characterized by persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in activities.

PH-F16-7247

Recommending outpatient wraparound services.
16-year-old female who presented to PrairieCare after being brought to the emergency department from their group home after an increase in suicidal ideation after intervening twice with a peer’s suicide attempt in the group home.
Patient has a history of 5+ inpatient hospitalizations, group home and PRTF placement.
Children’s mental health case manager is pursuing RTC and group homes as an alternative to home. Referrals were sent to:
– Northwoods (PT has been on waitlist, anticipated timeline at least 1 year as of 07/29)
– Community Living Options
– Little Sands
– Nexus Gerard RTC
– Avanti
– PORT
– Acadia Healthcare
– South East Regional Crisis Center (SERCC)
– Boys Town RTC in Nebraska
– North Homes RTC
– Village Ranch

PH-F15-7244

Recommendation is QRTP or PRTF.
Patient presented to PrairieCare Inpatient Hospital after suicide attempt by hanging on two consecutive days while at Avanti Center for Girls Residential. She has been at 3 different residential treatments (North Homes, Bar None Haven, and Avanti). This is her 4th psychiatric inpatient hospitalization.

Discharge Plan:
Establish QRTP/PRTF:
-Avanti (discharged d/t suicide attempts and elopement concerns)
-PrairieCare Residential (declined d/t suicide attempts and elopement concerns at Avanti)
-Grafton (referral sent)

Outpatient Providers:
Red Lake Ombimindwaa Gidinawemaaganinaadog (OMBI) Program: Outpatient therapy
Sagent Behavioral Health: Medication Management/ Psychiatry Services

MHF-F13-7240

This youth presented to the hospital after eloping from her foster residence. She had been on the run for over a month and was brought in by EMS after attempting to enter a youth shelter. She was admitted to the hospital for medical needs and determined to be appropriate for discharge. The foster residence is unable to take her back at this time due to needed home repairs and working on increasing staffing from 1:1 to 2:1.

MFIUP-M9-7237

Admitted to hospital due to suicidal ideation, auditory & visual hallucinations. Pt presented after a suicide attempt via intentional overdose on her prescription methylphenidate.
Predisposing factors: chronic mental illness, extensive family history mental illness; early exposure to domestic violence, childhood trauma, seizure disorder. Precipitating factors/Stressors: family dynamic. Perpetuating factors: history of CPS involvement, chronic mental illness, family dynamic/stressors.

MFIUP-F15-7229

Admitted due to suicidal and homicidal ideation. Patient struggles with explosive outbursts when she does not get her way. Patient has a hx of calling CPS frequently alleging abuse against mom. Diabetes was managed with an insulin pump until recently, when the pump was removed for inpatient admission and she was transitioned to insulin injections. She reports that the pump was helpful in regulating her diabetes. She reports daily suicidal ideation, describing it as a persistent struggle, with plans to smother or strangle herself. She also experiences homicidal ideations, particularly directed toward her mother and sister.

MFIUP-F14-7201

Pt has hx of several suicide attempts, chronic SI, impulsivity, substance use, and PTSD with dissociative symptoms. Pt has a long history of IPMH and two residential stays at Heartland Girls Ranch. She recently was at a dual treatment center but was discharged following a suicide attempt. We were initially looking for dual RTC, but we have expanded our search to find placement as pt continues to struggle with prolonged hospitalization.

LAHC-M14-6887

Has been with us since January. Arrived from Prairie care from Mayo Clinic before that for verbalized increase in SI and engaging in SIB. History of abandonment from bio mother and apparent abuse and substance use in the household per history. History of temporary foster care. Difficulty with boundaries and impulsive behaviors. Often losing his temper, being easily annoyed and irritable, arguing with adults of authority, and not complying with rules/structure. Current and historical property destruction and elopement. Behavioral instances at school, threatening gestures and actions. History of vaping nicotine “if I have it I will use it” mentality. Witnessed DV, history of homelessness, and physical abuse.

CH8SCH-F14-7113

Patient presented to ER following discharge from residential due to aggression to staff and eloping. No other placement locations as she is not able to return to previous foster placement. Patient with poor boundaries, impulsivity, and instigates other peers to engage in negative behavior. Appears lower functioning or potentially with ASD in which we will be completing psych testing.

C8SM8SP-F15-7087

Child presented to Children’s ED due to increased suicidal ideation. Dakota County has had guardianship prior to him presenting to ED. Child was residing at a group home and reported to staff about increase thought of self-harm. Staff at group home called EMS and child was brought to Children’s ED for mental health evaluation. They did not meet inpatient criteria and have been recommended to discharge. The group home denied their return due to unsafe behaviors, such as tying clothing around their neck when dysregulated. Extensive trauma history from bio parents.

OCC0FS-F17-7034

Was hospitalized in at Prairie Care Psychiatric Hospital discharged May 30th- June 15th for significant self-harm by cutting, recommendations were residential, was accepted to Newport, Prairie Care RTC, and Rogers; however, due to bed availability was discharged home and started Prairie Care PHP on June 16/17th. Wound became infected on leg, he was hospitalized and treated for Sepsis, wound vac was placed. He was discharged home with recommendations of residential treatment once wounds healed. He was unable to go back to PHP or Residential (there was a bed opening at one of the placements) he was unable to return to PHP or be admitted to Residential due to wound vac/wound care needs. Within 24 hours of discharge, he was back in the hospital due to self-inflicted wounds on his leg caused by a blade of a box cutter requiring medical intervention and hospitalization. He has been in the hospital since his wounds are healing, there is no longer a wound vac, 9 or the 10 wounds have been sutured and one on his leg requires wound packing 2x per day.