While reports of child maltreatment have dropped in Hennepin County since the start of the pandemic, a larger share of foster care placements has resulted from families unable to care for children because of mental illness.

In 2019, when the county handled just over 1,000 foster care entries, 8.3% were primarily mental health-related. In 2021, that percentage nearly doubled, meaning mental health was among the top reasons children were placed in foster care — along with caretaker drug abuse and physical abuse.

The county handled 537 foster care entries this year, and more than 80 were mental health-related, according to county-provided data as of Dec. 6.

Those numbers include children entering foster care because of their mental health or their caretakers' mental health.

Amid the rise in mental illness that has accompanied the COVID-19 pandemic both locally and nationwide, Hennepin County and the state of Minnesota are expanding their services to families.

"The data we've gathered clearly illustrate a need for collaboration between child protection and behavioral health," Leah Kaiser, the county's behavioral health director, wrote in a statement. "We will continue to identify needs early and respond to them in a coordinated way to improve outcomes and reduce disproportionate impacts in communities of color."

Since 2015, about 39% of primarily mental health-related foster care entries were for Black children, about 26% were for multiracial children, 3.3% were for American Indian/Alaska Native children and 1.5% were for Asian/Pacific Islander children, according to data from the county. About 29% of entries were for white children. The county did not provide data for racial groups where fewer than 10 children were represented in order to protect their identities.

To address racial disparities, the county launched a "stabilization service" that sends a mental health professional to families requesting support. The goal is to eventually work with those families for several weeks, providing resources such as therapy and parenting classes, said Lisa Bayley, the county's senior policy adviser on child well-being.

"In the past, we've really focused on sort of a medical model of approaching these situations, where it's 'What's the diagnosis? How do we get this child out of there? How do we get the child the help that they need?'" Bayley said. The stabilization service "is trying to get at things from more of a family-support model to say, before we get to a crisis and the child needs to leave the home, 'What supports can we provide you with keeping this child in the home if possible?'"

Typically, a family whose child needs mental health treatment voluntarily places them in the protection system, rather than the child being sent to foster care through a court order. Since 2015, voluntary placements made up more than three-quarters of foster care entries in which the mental issues of children were the main reason. So far in 2021, about 95% have been voluntary.

A new law will soon offer another way for families to access mental health services for their children. Known among mental health advocates as the "third path," the Children's Mental Health Residential Service Path will provide county-funded treatment without the child having to enter the protection system, likely reducing foster-care placements in Hennepin County due to mental health concerns.

"If a kid needs to go to the hospital for any other health care condition, we don't go through the child-protection door," said Sue Abderholden, executive director of NAMI Minnesota who helped develop the legislation that led to the third path. "These kids need longer treatment and residential treatment, and they shouldn't have to go through that door."

"We've never had enough children's hospital beds; that's made it very difficult for families," Abderholden said. "Insurance sometimes doesn't pay for things like day treatment, and so even lowered levels of care that are more intense that would be helpful, families can't access because their insurance won't cover it."

Kirsten Anderson, executive director of the family services nonprofit AspireMN who partnered with NAMI Minnesota on the third path legislation, described it as a "statement of parity for everyone."

"We really wholeheartedly believe that we should provide mental health treatment to children as part of our medical ethic to care for all people, as opposed to requiring children and families who are leaning on public support to access care go through a child protection system that's really just not designed to meet the needs of families who are supporting a child with a mental illness," Anderson said.

Details on the third path are still rolling out, but the Minnesota Department of Human Services said it will be implemented in the first quarter of 2022.