By Lindsey Holden
About 75 percent of lifetime cases of mental illness begin by age 24, according to the National Institute of Mental Health. But the average delay between onset and intervention is 8 to 10 years, meaning people could go years before getting help. By Jim Donaldson
Last month, Gov. Gavin Newsom unveiled a plan to create a civil court system to compel treatment for people suffering from serious untreated mental illness, saying it’s time for the state to “take some damn responsibility to implement our ideals.” Newsom presented his proposal — the Community Assistance, Recovery and Empowerment Court, or CARE Court — as a way to help unhoused residents with conditions that cause psychosis. The policy is moving through the Legislature in the form of two bills — Assembly Bill 2830 from Assemblyman Richard Bloom, D-Santa Monica, and Senate Bill 1338 from Sen. Susan Eggman, D-Stockton, and Sen. Thomas Umberg, D-Santa Ana.
The bill is getting push-back from disability rights advocates, who say CARE Court forces treatment on mentally ill people with little regard for their civil rights. They also argue it wastes money that would be better spent on public education, early intervention and programming that doesn’t involve coercion. “We are neglected throughout the whole process, up until the point our condition is so severe that we can’t control it and we start doing things like breaking the law,” said John Vanover, legislative committee chair for the Depression and Bipolar Support Alliance of California. “And at that point, now, the governor wants to step in and make us criminals. So fundamentally, this idea is broken, just from that.”
How would CARE Court work? CARE Court would effectively create a new wing of the civil court system in all 58 of California’s counties that would allow a judge to order a mental “care plan” for those dealing with severe untreated mental illness. The program would apply to everyone who meets the criteria, but Newsom has repeatedly referenced it as a tool to help the homeless population. A person qualifies for CARE Court if they’re at least 18, diagnosed with “schizophrenia spectrum or other psychotic disorder,” are not receiving treatment, and lack “medical decision-making capacity,” according to SB 1338. California was home to nearly 162,000 homeless people in 2020, according to U.S. Department of Housing and Urban Development data. Nearly 38,000 people from that population — about 23% — were considered “severely mentally ill.”
CARE Court is meant to target the 10,000 to 12,000 people dealing with schizophrenia and psychosis who may qualify for the program, said Jason Elliott, a senior counselor to Newsom. The CARE Court program would enable a host of people — including family members, first responders and behavioral health professionals — to petition the court to create care plans for those who meet the criteria, according to SB 1338. County behavioral health departments would be responsible for carrying out the care plans. Those who don’t comply with their plans could be subject to California’s existing system of involuntary hospital stays and conservatorships.
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| President Ronald Reagan and Nancy Reagan at the Capitol in Sacramento. Mitch Toll Sacramento Bee file |
Such programs have been in place since the 1960s, following the state’s shift away from mental health hospitals and toward community-oriented care.
Since California dismantled the hospital system, the state has primarily made use of the Lanterman-Petris-Short Act and Laura’s Law to care for people who suffer from severe mental illnesses. LPS — which then-Gov. Ronald Reagan signed in 1967 — ended the practice of long-term involuntary commitments to mental health institutions. However, it does allow involuntary hospital stays for those deemed a danger to themselves or others. The most well-known of these hospitalizations is the 5150 hold — nicknamed for the section of legal code in which it appears — which requires someone to receive treatment for 72 hours. LPS also created the conservatorship system, through which other people take responsibility for a gravely ill individual’s medical care and personal assets. Laura’s Law, passed in 2002, created an assisted outpatient treatment program that can be court-ordered after a person who’s mentally ill has repeatedly been hospitalized or arrested. (Click to continue reading)
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