Depression – Mental Health Collaboration Hub

MHF-F14-7666

Youth came to the ER 10/20. County has custody and she was under a trial home visit with Mom. County indicated at first that it wasn’t safe for her to return home until an investigation was completed. Had a plan to return her home 10/27 however pt has lupus and ongoing rheumatologist requested labs be completed so she was admitted to our medical floor overnight for those. The next day she was struggling emotionally saying she didn’t want to go home with Mom, and on 10/29 the County reported they were no longer planning to return her to Moms at this time. They are looking for temp alternative placement. Report she isn’t eligible for County paid shelter/foster as she is still on trial home visit with Mom. Have her on the list for YSC crisis but uncertain when there may be an opening. Also exploring waiver crisis respite and potential in home waiver services to support the family. Recently completed RTC so not eligible for that currently.

C8SM8SP-M12-7655

Patient presented to Children’s ED after attempting to jump off 3rd floor balcony at home. Patient has been IPMH in the past and was originally recommended IPMH at this ED visit. However, after pt was not being accepted to IPMH units in metro, psychiatry was requested. Psych reported pt was near baseline behavior and mood, recommended to discharge home. Mother and father did not feel safe having pt return to either of their homes.

C8SM8SP-F14-7632

Patient has been living in a group home. At the group home patient had gotten into a verbal altercation with a staff member. When the altercation went on for longer, the patient contacted the police while still at her group home. Patient reports staff member was calling her several names and patient began to verbally escalate back to the staff member. She was brought to Children’s ED, received a mental health evaluation and was recommended to discharge. At this time, pt is no longer able to return to group home.

AH-F16-7617

Previous psychiatric diagnoses: PTSD, depression, anxiety, eating disorder, ADHD, complex trauma, suicide attempts, self-harm

Patient presented to the ED after reporting SI to their guardian. Patient reports a near daily experience of SI and AH/VH of his brother who abused him. Therefore, this is not a new symptom. Patient reports that yesterday there was no particular trigger for his SI and AH/VH, that he took a PRN medication, which usually works for him, and then called his guardian who told him to go to the ED.

While in the ED (and as is common in the community), patient will attempt to use clothing to strangle themselves when dysregulated, often revolving around trauma.

Guardian is Dakota County (Tori Thompson). No contact order for anyone in the biological family.

Hospitalized in ND for a full year and a recent over month stay at Children’s for placement from which they were placed in Mn Care Counseling Crisis home.

Crisis home has given an immediate termination notice and state as they are a crisis home they do not require a 30 day notice, due to inability to keep pt safe. They report running into traffic as a particular concern.

Recommendation is discharge with ongoing outpatient support coping skills, distress tolerance, emotional regulation and behavioral support. Pt presentation appears to be baseline and unlikely to mitigated by an admission which may conversely increase risk of maladaptive coping skills and hospital seeking behavior.

Referrals:

· Wingspan is future development of home for patient; not ready until January

referrals made to all PRTFs
Grafton
Leo Hoffman
North Woods
Nexus East Bethel
No update on possible openings

CABHHS – pt has been declined multiple times due to various reasons including high acuity, Diabetic, Eating disorder – A new referral is in process
Bridgeview—-Dakota county crisis placement; on list but currently full (2 bed facility for Dakota County youth)
Kid Link – referral to all 50 of the facilities they work with, no update on potential openings.
Out of state (Rogers and Acadia)—active referrals, no timeline

PH-F16-7411

Recommendation is now for group home. Patient presented to the hospital from the ED for acute safety concerns related to self-injurious behaviors and suicidality following an assault on patient by other residents in a shelter. Patient has a history of multiple inpatient hospitalizations and residential treatment.

PH-F15-7244

Recommendation is now for group home
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

C8SM8SP-F12-7511

Child presented to Children’s ED to receive a mental health evaluation after becoming dysregulated in foster home. Child was recently separated from grandmother’s house and sister. Pt made suicidal comments because she “misses her family”.

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.

C8SM8SP-F12-7384

Child came to the emergency department after getting into an altercation with grandmother at home. Child had gotten physical with grandmother due to phone usage. Child’s legal guardian is grandmother and does not have contact with bio parents. Child has a long history of trauma. Child’s aggression is only toward grandmother; they have also presented to the ED on 5/7, 6/29, 7/8, and 7/28 for similar situation (physically aggressive towards grandmother). Grandmother is refusing to discharge child back into her care.

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. Behaviors worsen in an attempt for connection seeking and to obtain friendships with peers. Patient has been on a 1:1 or close observation through the entirety of her stay as she will engage in negative behaviors to seek connection including self harm, opposition, and defiance.