Two bills aim to fix loopholes in Gavin Newsom’s mental health court – CalMatters

from Marissa KendallCalMatters

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manager Gavin Newsom promised to help thousands of homeless Californians when it launched a new mental health court in 2023. Until now, it has struggled to help the sickest, most vulnerable people, but a Southern California lawmaker is introducing two proposals this year that he hopes will fix the program’s flaws.

Both bills renew the debate among families and advocates about when it’s appropriate for someone to undergo mental health treatment without their consent.

One bill would create a path for people with the most serious disabilities to go directly from Newsom’s voluntary psychiatric court to involuntary hospital treatment. The other would make it easier for EMTs and other first responders to refer people to mental health court. Both bills recently passed the Senate Judiciary Committee despite concerns from disability rights advocates that they would force more people into unwanted treatment.

“Although early deployment is promising,” Senator Catherine BlakespearDemocrat from Encinitas, said during a recent committee hearing, “obstacles in the current petition process prevent the program from reaching many of the people it is intended to serve.”

CARE Court launched in 2023 as a key part of Newsom’s strategy to get people off the street with psychosis. It allows family members of people with untreated schizophrenia and other psychotic disorders to refer them to the court program, where they can work with a judge, public defender and caseworker on a plan for medication, therapy, housing and any other help they may need.

But a CalMatters investigation found the program crashing does not meet expectations. As of January, California courts have received 3817 petitions on behalf of prospective CARE Court participants and approved only 893 treatment agreements. At first, the Newsom administration estimated that between 7,000 and 12,000 Californians would qualify for the program.

Some families who tried to use CARE Court to help their seriously ill loved ones told CalMatters that they disappointed with the results. They thought a judge could order their family members into treatment. But that turned out not to be the case. If someone is too ill to realize they need treatment, CARE Court cannot help, meaning their case may be dismissed while the person continues I pass out in the street.

This is the problem Blakespear is trying to tackle Senate Bill 1016. It would allow anyone petitioning the CARE Court to ask a judge to order a mental health evaluation to determine whether the petitioner is “severely impaired” or a danger to himself or others—if the subject cannot comply with voluntary treatment.

Depending on the results of the evaluation, a judge may order that person placed under guardianship, which would likely mean a stay in a locked mental institution and mandatory treatment.

The idea is to create a formal bridge between voluntary treatment under the CARE Court and involuntary treatment through conservatorship.

Adding the specter of involuntary care will make people with mental illness less likely to accept help from the CARE Court, Samuel Jain of Disabled Rights California said at the committee hearing.

“SB 1016 adds an expensive, coercive and complex layer to CARE Court that will increase costs and further erode the rights and trust of Californians that our system is supposed to help,” he said.

Family ‘disappointed’ by CARE Court

Jennifer Farrell, who filed a CARE Court petition in late 2024 for her brother in Alameda County, sees things differently. Farrell’s brother, 59, who struggles with schizophrenia and meth use, has been homeless since 2017. He was able to stay housed through CARE Court for a few months but then left his placement in September and disappeared in the streets.

It was clear he needed more help than CARE Court could provide, but the program had no way to elevate him to a higher level of care, Farrell said.

“At that point, I was really disappointed,” she told CalMatters.

Farrell’s brother spent three months deteriorating on the street before a case officer found him in December. He was hospitalized in a temporary psychiatric hold and eventually placed in a conservatory. He is still in a locked facility being treated and appears to be doing much better, Farrell said.

For Farrell, it’s “absurd” that there isn’t yet a direct link between CARE Court and conservatorship — a link she says could save her family some grief.

In creating the CARE Court, Newsom said people who don’t follow their CARE plans can be moved into conservatorship. But Farrell and other families CalMatters spoke with said if their loved one can’t agree to treatment, there’s no clear path forward.

Technically, CARE Court judges can order participants to follow mandatory “CARE plans” — something that happened just 32 times between the end of 2023 and January — but judges can’t force participants to follow them.

Easier CARES Court Petitions

Blakespear’s other account, SB 989addresses another CARE Court challenge: the low number of people who participate.

Petitioning the CARE Court is a complex and time-consuming process. Whoever submits the application needs the person’s medical record. They then have to appear at the first court hearing – something that overworked fast responders don’t always have time to do.

That’s a key reason people who work in public safety, such as firefighters and EMS, say they don’t file petitions in the CARE Court, said Megan Subers of the California Professional Firefighters, who spoke in support of the bill at a Senate Judiciary Committee hearing.

SB 989 would create a framework for first responders to refer clients directly to their county behavioral health department, which can then petition the CARE Court on their behalf. The county will have 30 days to decide whether to file.

Some counties are already making efforts to train and support their first responders in filing CARE Court petitions. Stanislaus County allows first responders to refer CARE Court clients directly to the county.

But that collaboration doesn’t happen in a systematic way across the state, Subers said. This bill could help fix a broken system in which first responders constantly keep people with severe mental illness in and out of emergency rooms, she said.

“When our members have to repeatedly make these calls to people and take them to the hospital, knowing they’re going to have to answer that person again, my members tell me they feel helpless,” she said. “We see this time as another opportunity for them.”

Blakespear’s accounts follow a similar efforts last year from Senator Tom Umberg of Santa Ana to make CARE Court more efficient. His new law, which went into effect in January, expanded the CARE Court to include people experiencing psychosis as a result of bipolar disorder. Initially, the program was exclusively for people diagnosed with schizophrenia and other limited psychotic disorders.

This article was originally published on CalMatters and is republished under Creative Commons Attribution-NonCommercial-No Derivatives license.