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Mental Health

CA’s Mental Health CARE Court Addresses Psychotic Disorders

— October 24, 2023

California is set to launch a groundbreaking initiative, known as CARE Court, aimed at assisting individuals with untreated psychotic disorders, including schizophrenia. This controversial and costly program is slated to begin in eight California counties by December, with plans for statewide implementation. CARE Court has ignited hope among those who have struggled to access mental health services for their loved ones.

Anita Fisher is a mental health advocate who considers CARE Court to be lifeline for individuals. She considers it to be the saving grace for her son, Pharoh Degree. 22 years ago, her son was diagnosed with schizophrenia while in the Army. For years, Fisher faced challenges in ensuring her son received the necessary treatment, especially when he stopped taking his medication.

Her repeated calls for psychiatric intervention, without her son’s consent, went unanswered. Pharoh eventually became homeless, and Fisher was left searching for him desperately. The situation changed only when he was arrested for vandalism and received medication and treatment while in custody.

California Governor Gavin Newsom, a staunch supporter of CARE Court, characterizes the existing system as a “fail-first system.” This system often provides support and treatment only after individuals enter the criminal justice system. Newsom believes that this must change, and CARE Court is a step in the right direction.

CA's Mental Health CARE Court Addresses Psychotic Disorders
Photo by SHVETS production from Pexels

California already has laws in place to help individuals with severe mental illnesses, but many argue that these laws fall short. The Lanterman-Petris-Short Act, which governs involuntary psychiatric treatment, often comes into play too late, offering help only when someone is already in crisis.

Similarly, Laura’s Law, which authorizes assisted outpatient treatment, has faced criticism due to its limited implementation and inadequate funding. The homeless crisis in California adds to the urgency of addressing mental health issues. Over 170,000 people are homeless in the state, and over 75% of these have abused a substance or are suffering from a severe mental illness.

CARE Court is expected to provide assistance to an estimated 12,000 individuals, not limited to those experiencing homelessness. Anita Fisher, who advocates for mental health, expressed her hope that her son would never need CARE Court but emphasized her willingness to initiate proceedings if necessary. She hopes that if he does, it will be a positive experience where his voice is heard.

CARE Court is open to individuals aged 18 and older with a diagnosis of schizophrenia or other psychotic disorders. Eligibility also depends on the individual’s likelihood of safely surviving in the community without supervision and without posing harm to themselves or others. The person must be deemed likely to benefit from participating in CARE Court.

The process involves a referral such as that made by a close family member, roommate, hospital director, first responder, or a health professional. After evaluation, a CARE Court judge reviews the petition. If the criteria are met, the judge can order a mental health treatment plan, which may include medication, therapy, and housing. The plan runs for one year, with an option to extend it for a second year.

Participants in CARE Court have access to a public defender and can refuse treatment without being incarcerated. However, if someone refuses treatment, a judge may consider conservatorship as a last resort, which can strip individuals of certain rights and compel them to undergo treatment.

CARE Court has not been without its critics. Some argue that it is coercive, limiting individuals’ choices and forcing treatment upon them. Concerns also exist regarding the administration of medications without consent. While the Newsom administration has allocated about $17 billion to combat homelessness and address mental illness, many counties believe that this funding falls far short of the resources needed to support the thousands expected to enter the CARE Court system.


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