An alternative mental health court to compel treatment for people with severe mental illness has received more than 100 petitions since launching in seven California counties, including San Francisco, in October, state officials said Friday.
The state believes between 7,000 and 12,000 people statewide will eventually be eligible for “CARE Court,” which launched on a limited basis before Los Angeles County became the latest and largest county to start the program on Friday.
“This is exactly where we want to be,” said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency.
Ghaly told reporters he's optimistic about the early results and that the number of referrals reflects the small population eligible until now. Only those who are at least 18 years old and have schizophrenia or a related disorder would qualify. Severe depression, bipolar disorder and addiction by itself do not qualify.
“We’re in good shape. We’re providing the time to our local partners to create the ability to manage the referrals to make sure that they’re doing all they can,” Ghaly said at a news briefing Friday. “In many ways, we see the snowball, if you will, building up little by little.”
The civil court process, created by Democratic Gov. Gavin Newsom, is part of a massive push to address the homelessness crisis in California. It empowers family members and first responders to file a petition on behalf of an adult they believe “is unlikely to survive safely” without supervision and whose condition is rapidly deteriorating. They also can file if an adult needs services and support to prevent relapse or deterioration that would likely result in “grave disability or serious harm” to themselves or others.
A special civil court in each county reviews each petition to determine eligibility before asking the individual to participate in a voluntary plan that includes housing, medication, counseling and other social services. If all parties cannot agree to a voluntary plan, the statute says the court will order they work on a plan. Among the ongoing petitions, some have entered the court process and are working on creating their care plans, while other referrals are still being reviewed, Ghaly said. Some cases have also been dismissed, the Los Angeles Times reported.
Lawmakers hoped the program could get people with severe mental illnesses, many of whom are homeless, the help they need and off the streets. California is home to more than 171,000 homeless people—about 30% of the nation’s homeless population. But critics worried the program will be ineffective and punitive because it could coerce people into treatment.
The administration didn't give specific data on the number of petitions submitted in each county. San Francisco, Orange, San Diego, Riverside, Stanislaus, Tuolumne and Glenn counties launched the court Oct. 1, with Los Angeles County beginning its program Friday. The rest of the state has until December 2024 to establish mental health courts.
In San Francisco, eight people had been referred to the court as of early November, but it was unclear how many of those individuals were eligible for the program, Melanie Kushnir-Pappalardo, director of the city’s collaborative court system, told The Standard last month. The city has received $4.3 million to implement the program, which could help an estimated 2,000 San Franciscans annually, according to the Department of Public Health.
Counties are trying different approaches to implementation. San Diego County is integrating CARE Court with its conservatorship system to help divert people off of conservatorships, while Orange County is moving the mental health court away from the typical courtrooms and into community spaces, Ghaly said.
“I’m pretty pleased with the level of engagement, the level of partnership, the level of, you know, belief and optimism that’s growing in our counties,” he said.
Representatives from Disability Rights California, a nonprofit that sued the state arguing the program would violate due process and equal protection rights under the state constitution, said CARE Court could result in unintended consequences.
“While officials express optimism, the rushed implementation may overlook critical aspects of community engagement and careful consideration,” community organizer Vanessa Ramos said.
Newsom signed a law in October to expand the definition of “gravely disabled” to include people who are unable to provide for themselves basic needs such as food and shelter due to an untreated mental illness or unhealthy drugs and alcohol use, which makes it easier for authorities to compel treatment.
Newsom is also pushing a plan to reform the state’s mental health system. Newsom’s proposal, which would overhaul how counties pay for mental and behavioral health programs and borrow $6.3 billion to pay for 10,000 new mental health treatment beds, will go before voters next March.