Legislature’s Funding Boost To Expand Anoka Mental Health Hospital Aims To Reduce Numbers Of Severely Mentally Ill In Minnesota’s Jails

Legislature’s Funding Boost To Expand Anoka Mental Health Hospital Aims To Reduce Numbers Of Severely Mentally Ill In Minnesota’s Jails

For years local jails have swollen with mentally ill Minnesotans, including those who cannot get court-ordered treatment because of limited capacity at secure state hospitals.

Although the biennial budget recently passed by Minnesota lawmakers was mostly one of cuts, there was one bright spot for those watching the growing space where criminal justice and mental health intersect: the $75 million expansion of the state’s main secure mental health hospital in Anoka.

The Miller building is seen on the Anoka Metro Regional Treatment Center campus on Wednesday, June 11, 2025. The vacant building is to be torn down for an expansion that will add 50 additional beds, boosting the facility's capacity in the coming years from 96 today. Credit: MinnPost photo by Kabedi Mutamba / MinnPost

The multiyear demolition and replacement of the Miller building of Anoka Metro Regional Treatment Center will add 50 beds to the hospital’s current capacity of 96 and, advocates say, decrease the number of mentally ill people awaiting treatment at local jails and hospitals.

This over 50% increase in the facility’s capacity is aimed at addressing an increase in the number of people considered “priority admissions” to state hospitals like the Anoka treatment center or the smaller Minnesota Security Hospital in St. Peter. These priority admissions include those who are civilly committed after being found “incompetent” to stand trial due to a mental health issue and are considered dangerous to themselves or others.

Priority admissions cases have exploded over the past 15 years. According to this year’s report from the Priority Admissions Task Force, in 2013 there were only 46 priority admissions to all state programs. By 2024 that number was 424 – more than nine times higher.

This mounting strain on a system with limited capacity led a diverse group of stakeholders, from doctors and advocates to county prosecutors and sheriffs, to push for the Anoka treatment center’s expansion in response to the growing number of cases that need the facility’s combination of security and treatment.

“We’re always hesitant to increase institutional beds because community is where people are at,” said Sue Abderholden, executive director of the Minnesota chapter of the National Association for Mental Illness (NAMI), reflecting the broadly held view among mental health advocates that being locked away far from family and other support systems is detrimental to treatment and, in this case, competency restoration.

“But I think the sheer volume, the percentage increase, there’s no way we could do it without adding capacity,” she said.

Competency and commitment

If a court finds a defendant incompetent to stand trial and other criteria are met, that defendant can be civilly committed and ordered to enter a competency restoration program, which can be in jail, in the community, or at a state hospital.

Those who require priority admissions are those who are unlikely to get the help they need through a jail-based competency restoration program, but would present a safety risk in a community-based program.

The only option that addresses the individual’s mental health treatment needs and the public’s safety needs in these cases are the state programs in Anoka or St. Peter. But the state is chronically low on beds in those hospitals and lacks the ability to safely increase capacity without major investments into the facilities.

This has left some to languish in local jails without proper treatment while waiting sometimes months for a bed to become available. In order to guarantee the safety of the committed individual with minimal strain on resources, some counties will put them in solitary confinement.

While this may meet the basic need to separate the mentally ill and vulnerable from the jail’s general population, isolating someone for weeks or months at a time can cause further deterioration in their mental health. The UN and human rights groups consider prolonged solitary confinement, which lasts more than 15 consecutive days, as a form of psychological torture.

The Miller building is seen on the Anoka Metro Regional Treatment Center campus on Wednesday, June 11, 2025. The vacant building is to be torn down for an expansion that will add 50 additional beds, boosting the facility’s capacity in the coming years from 96 today. Credit: MinnPost photo by Kabedi Mutamba / MinnPost

The Anoka expansion is a way to address the patchwork of county-level approaches to handling the mentally ill.

“More people with serious mental illness will get care in the right treatment setting,” said Christopher Sprung, a spokesperson for the Direct Care and Treatment programs run by Minnesota’s Department of Human Service, which includes the Anoka treatment center.

The expansion will take at least two years to complete and up to another year before the new wing can operate at full capacity. Sprung said 350 new hires will need to be trained to staff it.

“The number of patients [the Anoka Metro Regional Treatment Center] can admit in a year varies. Some patients with severe illnesses require much longer hospital stays, which means some beds don’t turnover as quickly as others. But we expect to be able to admit 150 to 200 more patients each year,” he said.

From spare capacity to no vacancies

State Rep. Luke Frederick, DFL-Mankato, who has worked for over 20 years at the Minnesota Security Hospital in St. Peter, currently as a security services supervisor, introduced the budget for the Anoka expansion in the House this year.

He sees the shortage of beds as an instance where a well-intentioned law has failed to keep up with the reality of the past 15 years.

The report from the state’s Priority Admissions Task Force noted that “[i]n 2010, the average wait time for admission to the Anoka-Metro Regional Treatment Center (AMRTC), was 19 days. By 2013, the average wait time jumped to 30 days and the time from commitment order to placement had grown unacceptably long.”

In response, the Priority Admissions Law was enacted in 2013. It was intended to help law enforcement cope with the growing cohort of individuals with mental illness being held in jail, and to get them quickly into a court-ordered treatment facility.

The law included “the 48-hour rule,” which required that those who were civilly committed be moved to an appropriate treatment setting within 48 hours of their commitment. At the time there was spare capacity in the state’s facilities, Frederick said, and for several years it led to quicker hospitalizations from jails.

“When you have the capacity to be able to do that, that law makes sense, right?” Frederick said in an interview before the budget for the expansion was passed by the state Legislature.

“If you’re not having a lack of bed space, then there’s no reason to not get someone into a setting where they can get the help and supportive services that they need. Not to mention, if they were in a hospital, it allows the hospital to care for other patients now. Or if they were sitting in a jail, now the jail staff don’t have to deal with someone that they’re not necessarily equipped to be able to handle.”

But by 2023 it was clear the law was not functioning as it should. Without the capacity, the statute was impossible for localities to satisfy, exposing them to fines and lawsuits, which they argued should be directed at the state.

The report from the Priority Admissions Task Force said that the law caused:

• Patients prone to aggressive behavior filling direct care treatment facilities while employees at those facilities sought safer working conditions
• Patients from jails filling waiting lists while civilly committed patients waiting in hospitals had “virtually no hope of being admitted”
• “A raft of lawsuits” requiring the Department of Human Services to admit people within 48 hours while the department argued it was impossible

All of this led to the law’s amendment in 2023 to read that localities must move an individual within 48 hours of a “medically appropriate bed” becoming available, effectively defanging the 48-hour rule and relieving the legal pressure on counties. It also gave counties a two-year stay of fines related to not moving patients to hospitals quickly enough. That stay was extended another two years in this year’s budget. Frederick was an advocate for the 2023 changes, which also created the Priority Admissions Task Force, as well as this year’s extension.

“The 48-hour law is a bad law, and the change is OK,” Abderholden also said, echoing concerns about the law’s usefulness in the face of limited capacity.

Community mental health solutions needed

The 50 beds that will be part of the Anoka expansion are belatedly addressing a shortage that has existed for the past decade. But both Frederick and Abderholden warn that if civil commitments continue increasing, Minnesota will be up against capacity limits before we know it.

“One of my concerns is that we increase capacity, but then five or 10 years from now, we find ourselves in another position where we’re maxed out,” Frederick said. “Which is why I go back to … who is getting civilly committed, and how do we address people in their community and reduce the number of civil commitments, too?”

Abderholden, of NAMI, who is on the Priority Admissions Task Force that is trying to address those concerns, also believes that a community-based approach is the best path to treat people who otherwise would need the services of the Anoka treatment center.

“We have 60 [Intensive Residential Treatment Services (IRTS)] facilities across the state, but they’re not locked, so a judge would likely not be ready to send someone [who is committed] there because of fears of flight,” she said.

Abderholden is an advocate of creating locked IRTS facilities, which would be in the community and staffed by mental health professionals, but could offer some of the security necessary for those who are civilly committed.

But NAMI also supports other initiatives that would ideally get to someone before they commit a crime and divert them away from the justice system.

“Minnesota is one of the few states where every county, all 87, are covered by a mobile crisis team,” Abderholden said, which are alternatives to law enforcement.

She also believes that law enforcement needs to stop arresting so many people who may have committed minor crimes while in the throes of a mental health crisis.

When sheriffs complain about their jails holding too many mentally ill Minnesotans, she has little sympathy.

“Well, who brought them there?” she said. “Was there somewhere else they could have gone? Was there some other action that could have been taken?”

SOURCE: MinnPost