California’s New Plan to Tackle Mental Illness Crisis


What is CARE Court?

CARE Court is a new civil court system that will launch this fall in eight counties in California, including San Francisco, Los Angeles, and Orange, and will expand to the rest of the state in 2024. The acronym stands for Conservatorship, Accountability, and Recovery Enhancement. The goal of CARE Court is to bring mental health care into the courtroom and help people with severe mental illness who are living on the streets or at risk of becoming homeless.

Under CARE Court, family members and first responders can ask county judges to order people with psychotic illness into treatment, even if they are not unhoused or have not committed a crime. A judge will then determine if a person meets criteria for the program and may oversee a care agreement or compel a treatment plan. That treatment plan could include medication, therapy, housing, and even involuntary commitment.

Why is CARE Court needed?

California has the largest homeless population in the country, with more than 170,000 people living on the streets or in shelters. One in four of them has a serious mental illness, such as schizophrenia or bipolar disorder. Many of them refuse help, either because they do not believe they are sick or because they have had negative experiences with the mental health system. As a result, they often end up in jail, emergency rooms, or worse.

Gov. Gavin Newsom, who signed the bill creating CARE Court last year, said he was outraged and disgusted by the status quo and wanted to change it with a bold and novel plan. He said CARE Court is not an experiment, but a proven approach that has worked in other states and countries. He cited the example of Kendra’s Law in New York, which allows courts to order outpatient treatment for people with serious mental illness who have a history of violence or hospitalization. Studies have shown that Kendra’s Law has reduced homelessness, arrests, hospitalizations, and suicides among its participants.

How will CARE Court work?

CARE Court will be modeled after other collaborative courts in California, such as drug court and veterans court, which aim to provide alternatives to incarceration and address the underlying causes of criminal behavior. CARE Court will be voluntary, meaning that people can opt out of the program at any time. However, if they do not comply with the court-ordered treatment plan, they could face consequences, such as being placed under a conservatorship, which is a legal arrangement that gives someone else the authority to make decisions for them.

California’s New Plan to Tackle Mental Illness Crisis

CARE Court will also require counties to provide adequate and appropriate services for people with mental illness, such as crisis intervention, case management, peer support, and housing. The state will allocate billions of dollars to fund these services, as well as to train judges, lawyers, and mental health professionals on how to implement CARE Court. The program will also be monitored and evaluated by independent researchers to measure its effectiveness and impact.

What are the benefits and challenges of CARE Court?

Supporters of CARE Court say it will save lives, improve public safety, and reduce costs for taxpayers. They argue that CARE Court will help people with mental illness get the help they need before they harm themselves or others, and that it will reduce the burden on the criminal justice and health care systems. They also say that CARE Court will respect the rights and dignity of people with mental illness, by offering them a choice and a voice in their treatment, and by providing them with recovery-oriented and trauma-informed care.

Opponents of CARE Court say it will violate the civil rights and autonomy of people with mental illness, by forcing them into treatment they do not want or need, and by potentially subjecting them to coercion, stigma, and abuse. They argue that CARE Court will not address the root causes of homelessness and mental illness, such as poverty, racism, and lack of affordable housing. They also say that CARE Court will divert resources and attention away from voluntary and community-based services that are more effective and humane.


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