Amid care crisis for kids with special needs, a renovated downtown building offers hope

Terri Boettcher knows all too well the challenges of finding care for children with complex mental and developmental health needs. She’s experienced it firsthand with her two children, both of whom were adopted and have past trauma, mental health challenges and one of whom has developmental disorders.

She’s also seen this through her work as the parent-to-parent program manager at Family Voices of Minnesota, an advocacy group that connects families with children with special health needs to resources. Her job is to make sure parents’ concerns are being heard and they know what options are available to them.

Boettcher was a speech therapist in Mankato before she adopted her children, so she already was familiar with many services and the process of getting kids help. “But my experience is way different than most parents’ experience, where they don’t even know that there are services out there,” she said. 

Across Minnesota, thousands of families like the ones Boettcher works with wait for months or longer to access care for their children with developmental and mental health challenges. In recent years, the need has been rising, making the availability of care even more scarce. In downtown Minneapolis, a long-awaited expansion of St. David’s Developmental and Therapeutic Services will begin to alleviate the challenge by opening up additional, much-needed classrooms and therapeutic spaces for children with complex mental and developmental health needs.

As construction continues, care will expand

St. David’s three-phase renovation project started in 2024, when it acquired the YWCA building on Nicollet Mall, Julie Sjordal, CEO at St. David’s, told MinnPost. The first renovation phase wrapped up last summer and the second phase is now underway after a groundbreaking in June. The completed building will include a pediatric assessment and treatment wing, a feeding clinic for kids with food- and eating-related challenges, playgrounds and multiple therapeutic classrooms.

Among other services, St. David’s provides occupational therapy, feeding therapy, early childhood education, therapeutic recreation for youth with disabilities and outpatient mental health services. It operates out of three sites – two in Minneapolis and one in Minnetonka – and multiple partner sites. 

Currently, the downtown Minneapolis location is partially operational. St. David’s therapeutic classrooms and occupational and speech therapy treatment rooms are in use, and the YWCA’s Early Childhood Education Center still has a space there. 

Some of St. David’s programs have experienced a recent rise in demand, like the Latino Responsive Classrooms program, which provides culturally-responsive preschool instruction for Latino children with autism.

To most observers, the program looks like a typical preschool classroom, said Megan Weber, executive director of St. David’s Minneapolis sites. But amid songs and play and early learning, teachers and mental health professionals, many of whom are Latino and speak Spanish, also provide occupational and speech therapy throughout the day, along with emotional regulation skills. 

After community need increased on the heels of Operation Metro Surge, Weber said a day treatment program for Latino children focusing on trauma will start at the end of the summer. 

But while St. David’s will be able to serve these children, many more are waiting. Sjordal said the nonprofit currently has over 2,000 kids on its waitlist for developmental and therapeutic services.

Minnesota’s ‘State of Mental Health’ decline

For mental health care in particular, Minnesota was long recognized as a leader for young people’s access and outcomes. But in recent years, the state’s reputation has declined.

Mental Health America (MHA), a national nonprofit mental health advocacy organization, has published yearly “State of Mental Health” reports since 2015. The reports rank each state based on the prevalence of mental illness and the level of access people have to care. It uses a series of measures from multiple federal agencies, like the number of youth who have had at least one major depressive episode (MDE) in the past year and youth who had an MDE but did not receive mental health services.

In the years prior to the COVID-19 pandemic, Minnesota’s overall youth ranking was among the top in the nation. Today, it’s barely in the middle. Though changes to federal data collection make it difficult to compare results before and after the pandemic, the state’s decline is startling. 

Even over the past two years, Minnesota has seen a pronounced drop in its ranking for youth mental illness prevalence and access to care, according to MHA’s reports. In 2024, Minnesota ranked 19th in the assessment of the prevalence of youth mental illness and access to care. As of last year, it sits at 30th. 

Maddy Reinert, senior director of population health at MHA, told MinnPost that Minnesota’s drop could be attributed to a few key factors: about 14% of the state’s youth experienced serious thoughts of suicide in the last year, higher than the national average; almost two-thirds of youth with an MDE in the past year did not receive mental health services; and 30% of youth did not receive a preventative health visit in the past year.

Keith Kozerski is the chief program officer for Catholic Charities Twin Cities. The nonprofit, which provides social services like housing, meals and mental health resources to individuals, considers itself a peer of St. David’s due to the overlap in care they give. 

“All across the state, anyone that’s working with youth has seen increased demand,” Kozerski said.

Lauren Moberg, the executive director at Minnesota Association for Children’s Mental Health, said things like COVID, the shooting at Annunciation Catholic Church and School and Operation Metro Surge have been major contributors to negative trends in parent and child mental health over the past few years.

“We’re just hearing more and more from professionals that kids are struggling, parents are struggling, and professionals are then struggling because they’re not sure how to support,” Moberg said. “They’re explaining more mental health concerns that feel out of their realm of expertise.”

Rising need for developmental healthcare

Alongside demand for mental healthcare, healthcare needs are significant for kids with developmental disabilities.

About 5% of children in the state have one or more disabilities, according to Minnesota Compass. Data collected by researchers at the University of Minnesota found that by the age of eight, one in 28 children from a Twin Cities metro area sample were identified as having autism. According to the researchers, the numbers showed “that we are identifying more children with autism in our communities than ever before.” 

Researchers found that as the overall prevalence of autism is rising, the proportion of kids with autism who also have an intellectual ability is stable, between 30% and 40%. “This tells us that the overall number of children with autism with intellectual disability is also increasing,” said Dr. Amy Esler, who helped lead the project.

From 300 to 2,000 kids served

The second phase of St. David’s renovation has a target end date of April 2027. Once completed, Sjordal said the new location will be able to provide care to about 1,100 children, up from the 300 it can currently serve.

After the third and final phase of the renovation, set to be complete sometime in 2028, a St. David’s spokesperson said the number will jump to about 2,000.

Kozerski, from Catholic Charities Twin Cities, said St. David’s renovations will be a welcome addition for families in need of additional care. “Whenever we’re able to offer the community more services, it’s a win for everybody and a win for our community,” he said.

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