Why Nonprofits Are Pushing Back Against California’s CARE Court

Nonprofits continue to express their opposition against CARE Court. The policy, partially aimed at eradicating homelessness in California, would force people with severe mental health disorders into treatment. 

In March, Gov. Gavin Newsom hosted an event to discuss CARE Court, a policy that would effectively force Californians with severe mental health disorders into treatment. 

In a grassy, tree-lined courtyard of Napa State Hospital, health care providers, California politicians and family members of people with behavioral disorders voiced their support for CARE Court, citing the precarious state of mental health today. 

“Too often, Californians with the most serious behavioral health conditions become fixed in a cycle of untreated mental health, homelessness and incarceration,” Stephanie Clendenin, director of California’s Department of State Hospitals, said in the event’s opening statement. 

Midway through the assembly, Newsom stepped up to the podium with a passion. 

“What the hell are we doing about those that are struggling out on our streets and sidewalks?” He asked. 

In California, 1,243,000 adults face serious mental illnesses annually, according to the National Alliance on Mental Illness’ California chapter. Newsom’s solution, SB1338, or CARE Court, will likely become a law this summer.

Despite passing unanimously in the California Senate, the policy faces significant backlash from nonprofits and human rights groups.

“We’re opposed to any increase in involuntary treatment for those with mental health challenges,” said Matt Gallagher, assistant director at Cal Voices, a behavioral health nonprofit based in Sacramento. 

A bit of research shows that involuntary treatment produces grim outcomes for people with mental health struggles. For example, one study published in European Archives of Psychiatry and Clinical Neuroscience found that forced treatment can increase “self-stigma, reduced empowerment and poor quality of life.”

The way CARE Court works is that family members, behavioral health providers or first responders connected to somebody battling severe mental health disorders like schizophrenia would petition before a superior court. If they can justify somebody’s need for treatment, the court will set up a clinical evaluation. 

Afterward, depending on the evaluation’s results, the judge will enforce a CARE Plan. This may include court-ordered medications, social services and a housing plan. 

If somebody does not complete their assigned CARE plan, which lasts up to 24 months, they may be subject to a conservatorship. 

“This approach not only robs individuals of dignity and autonomy but is also coercive and likely ineffective,” Human Rights Watch (HRW) said in a letter to the state’s Assembly Health Committee. 

This process, HRW wrote, violates human rights, denies due process, does not enhance mental health care access and harms black, brown and unhoused communities. 

HRW said it defies international human rights law’s obligation that everybody has the “highest attainable standard of physical and mental health.” They said that part of this is the right to refuse treatment. 

According to the non-profit, CARE Court denies due process by giving automatic legal leverage to law enforcement and potentially abusive family members. 

“For example, interpersonal conflicts between family members could result in abusive parents, children, spouses, and siblings using the referral process to expose their relatives to court hearings and potential coerced treatment, housing, and medication,” the letter said. 

The policy won’t enhance mental health care access because of its lack of funding toward it, HRW wrote. New money won’t be allocated toward behavioral health programs but instead to the courts. 

Additionally, the policy does not fund permanent supportive housing, even though it requires courts to formulate housing plans for individuals with mental health struggles. 

“You’re really setting people up for failure,” Gallagher said. “Yes they’re going to be prioritized for housing services, but we know there simply isn’t enough housing to go around.” 

Lastly, HRW said CARE Court exacerbates racial injustice by targeting people experiencing homelessness, which are disproportionately black and brown due to a history of disparities in “housing, employment, access to health care, policing and the criminal legal system.” 

Six and a half percent of Californians are black or African American. Still, they make up 40 percent of the state’s homeless population, according to CalMatters. 

Human Rights Watch, Cal Voices, Disability Rights California and American Civil Liberties Union California Action are some of the many non-governmental organizations opposing CARE Court. 


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