City report finds gaps in behavioral-health services; highlights voluntary engagement pilot and coordination opportunities with Hennepin County

Policy and research staff presented a landscape analysis of behavioral health treatment and care courts to the committee on Oct. 1, outlining service gaps for unhoused people and options to improve access and continuity of care.

Sarah Renner, a legislative, policy and research staffer, told the committee that Hennepin County and Minneapolis face persistent shortfalls in care for people with serious mental illness and co-occurring substance use disorder. She reported survey and county data showing that among roughly 2,300 unhoused people in Hennepin County in July, 69% reported a mental-health diagnosis and 36% reported an alcohol- or drug-use disorder.

Renner summarized policy options and national examples: California's CARE Act enables court-ordered care plans (voluntary participation is the norm during the court period), backed by a statewide bond authorization voters approved to fund treatment and supportive housing; critics, including disability-rights groups and the ACLU, argue care courts risk increasing conservatorships for people who are disproportionately BIPOC and unhoused. Renner said early data from California showed relatively low enrollment and that some counties attributed that to the challenge of engaging service-resistant unhoused people.

Hennepin County has won a state grant to pilot a 90-day voluntary engagement program permitting assertive outreach by certified peer specialists and trained practitioners to encourage voluntarily engaged care. Renner recommended connecting the city-run 24/7 Behavioral Crisis Response (BCR) team and the county's voluntary engagement pilot to improve continuity of care for people encountered in crisis.

The report identified operational gaps: insufficient integrated treatment for co-occurring mental illness and substance use, inconsistent access to timely mental-health diagnosis and beds for undiagnosed unhoused people, limited data sharing across mobile crisis teams and hospitals, and unclear enforcement and reporting on mental-health transport holds under Minnesota statute.

Renner told the committee that counties implementing care courts have emphasized the need for skilled outreach staff to enroll service-resistant people; she also noted that initial California data did not show a short-term increase in conservatorships but warned it may be too early to assess the long-term effects.

Council members asked for clarification on the narrow eligibility California used and whether counties were changing eligibility; Renner said California is considering expanding eligibility to include bipolar disorder and to broaden definitions in follow-up legislation.

Council members and staff discussed next steps the city could take without pursuing involuntary court-based models: better integration and data sharing between the city's BCR and county services, linking BCR encounters to Hennepin County's voluntary engagement pilot, and improved public dashboards for mobile crisis response data. The chair asked the clerk to file the report.