California’s Community Assistance, Recovery and Empowerment (CARE) Court has fallen short of expectations, assisting far fewer individuals than initially projected. Launched in January 2023, the program aimed to provide treatment for up to 12,000 homeless individuals and those suffering from severe mental illnesses. As of May 2023, however, only around 2,000 people had been referred to the program, with uncertainty surrounding how many actually enrolled and received treatment.
In the Bay Area, a survey revealed that only 439 referral petitions had been filed across the five largest counties, resulting in roughly 100 participants currently engaged in CARE Court. Local officials and mental health advocates attribute this slower-than-expected uptake to strict eligibility criteria, bureaucratic hurdles, and a lack of awareness regarding the referral process.
Soo Jung, a director with the Santa Clara County Behavioral Health Services Department, acknowledged the disappointing figures, stating, “Overall in the state, there has been a smaller number than we initially anticipated.” In contrast, Governor Newsom’s office has criticized certain counties for not fully embracing the program. Deputy Communications Director Tara Gallegos specifically pointed to Santa Clara County, which had enrolled just two individuals, compared to Alameda County’s 27 participants. Gallegos emphasized, “It’s time for lagging counties to stop making excuses and start delivering the help Californians desperately need.”
Santa Clara County Executive James Williams countered that his county has prioritized other treatment programs over CARE Court, describing the system as “lengthy, costly and inadequate.” This tension highlights the ongoing debate about the effectiveness of CARE Court as a viable solution for mental health crises.
Families with loved ones in CARE Court have expressed frustration over the program’s limitations in mandating treatment. Although individuals can be referred to the court without their consent, advocates suggest the program is intended to facilitate voluntary engagement with services. Jennifer Su, a mother seeking help for her adult son, lamented the lack of impact CARE Court has had on his situation. Since her son’s referral, he has been arrested multiple times and spent months in jail. Su remarked, “I didn’t think we would be in this situation. It seems so clear it’s bad for him and it’s bad for society that he is not mandated to get help.”
CARE Court aims to assist individuals with severe untreated psychiatric issues by allowing family members, first responders, and health care providers to initiate referrals. If deemed eligible, a judge collaborates with the individual and county health officials to create a personalized treatment plan. This can include medication, drug counseling, and housing options. While participants who resist treatment can be ordered to follow a “CARE plan,” they cannot be forced into services. Those who do not comply may face a conservatorship referral, potentially leading to involuntary treatment.
Mental health advocates highlight that the slow start of CARE Court may stem from the overwhelming nature of the petition process. Families often struggle to document a person’s medical history adequately. Furthermore, there is a general lack of awareness among law enforcement, nonprofit providers, and the public regarding CARE Court’s availability as an option for treatment. In response, organizations such as the National Alliance on Mental Illness are conducting outreach and training sessions to assist families in navigating the petition process.
Despite the hundreds of petitions submitted in the Bay Area, as of last month, only 99 resulted in voluntary “CARE agreements,” and just two led to court-ordered CARE plans. The program’s rollout across the state has varied, with San Francisco opening its court in October 2023, while other counties like San Mateo plan to follow suit in July 2024.
Santa Clara County’s CARE Court has faced challenges as well, receiving 42 petitions but establishing only one CARE agreement and one CARE plan. Local health officials noted that many petitions were dismissed due to strict eligibility requirements, which specify that participants must be diagnosed with schizophrenia or another serious psychotic disorder. “It narrows down who should be going through the CARE Court process,” Jung explained.
Despite these challenges, county health officials have successfully connected 60 individuals previously considered candidates for CARE Court to alternative treatment programs. Statewide, at least 1,358 individuals have been redirected away from CARE Court.
To address the low enrollment figures, Governor Newsom signed a bill in October 2023 designed to expand eligibility requirements to include those diagnosed with serious bipolar disorder and streamline the hearing process. Yet, disability rights advocates argue that the changes could increase eligibility without providing adequate funding for necessary mental health services and housing.
As families like Su’s continue to navigate the complexities of the mental health system, the efficacy of CARE Court remains a pressing concern. Su expressed her waning hope that the program would assist her son, advocating instead for a conservatorship to ensure he receives the support he needs. Reflecting on her experience, she noted, “I appreciate the efforts CARE Court has made, but their hands are really tied with situations like my son.”
