He died on the streets. Can California CARE Courts do better?

During the 16 years that James Mark Rippee lived on the streets of this Bay Area town, his sisters Catherine Rippee-Hanson and Linda Privatte unsuccessfully pleaded with politicians, bureaucrats and medical professionals to give their schizophrenic little brother the help he so desperately needed badly needed – but did it. I do not want.

Her advocacy made Rippee possibly the most famous homeless person in California – well known to state and local legislators and repeatedly featured in the media. But it was no use.

In late November, Rippee was rushed to a hospital gasping for air in the middle of the night, still too deep in his severe mental illness to understand that he needed medical attention. He died a few days later at the age of 59.

He was officially killed by pneumonia and sepsis that caused organ failure, but Rippee-Hanson is clear that the real cause is the ugly battle between civil rights activists and families like hers over when it’s fair and necessary to intervene in someone’s life with severe mental illness.

“When did families lose the right to protect their own loved ones?” she asked me the other day, less a question than a statement of frustration and heartache. “All we were trying to do was keep him alive.”

This brawl over what moral and legal justice looks like for our most severely mentally ill is headed—once again—into the California court system, where many efforts to reform our laws over the past few decades have been thwarted.

Last week, as my colleague Hannah Wiley wrote, a trio of disability rights and civil liberties groups filed a lawsuit in the state Supreme Court to stop the Community Assistance, Restoration, and Empowerment (CARE) Courts, Gov. Gavin’s plan Newsom to tackle the blockage help for people with serious brain diseases.

If the Supreme Court accepts the case, or even sends it back to trial in lower courts, it could indefinitely put California’s only real plan to help our most vulnerable and severely mentally ill on hold. More people like Rippee will die on our streets. More families like his are being shamed and blamed for trying to help.

Because when someone like Rippee in California doesn’t want mental health care, even if they’re in deep psychosis, it’s almost impossible for family members to do anything.

It is considered a violation of civil rights.

“It feels like David and Goliath. It feels like it’s the family members trying to open the eyes of people who believe they have a higher, righteous purpose to protect the rights of someone who can’t make up their minds,” said Rippee- Hanson. “If Mark wasn’t severely disabled, then nobody in California is.”

CARE Court has largely been billed as a plan to tackle homelessness, and that’s probably the governor’s biggest misstep in an otherwise good and necessary idea. This framing has led to legitimate fears that the new courts will be used to unfairly arrest and perhaps even incarcerate homeless people deemed disruptive or disruptive, people with addiction problems or less serious mental illnesses.

In their filing, the three organizations petitioning the CARE Court, the Disability Rights California, the Western Center on Law and Poverty, and the Public Interest Law Project to shut down, argue that “thousands of homeless Californians with mental illness are being threatened with court orders and are doing so are being coerced into involuntary treatment and swept off the streets, not because they pose a danger to themselves or others, but because a judge has speculated they are “likely” to become so in the future.”

If CARE Court failed like that, it would be ruthless. We are all saddened by the endless suffering on our streets, angry and frustrated by a problem that seems to be growing exponentially despite countless political promises to solve it. Yet few of us want people to be institutionalized or deprived of their right to autonomy.

But as Rippee-Hanson puts it, “What about the right to live? What about the right to treatment for an illness through no fault of your own?”

It didn’t matter to civil rights activists or those in power that Rippee heard voices and had delusions that kept him trapped in his own reality. For a time he believed that the police nurtured new recruits — spawned other people using his body as an incubator — and it was the whispers of those creatures that rattled in his head.

It didn’t matter that he’d lost both eyes and part of his forehead in a motorcycle accident in which he was thrown into a grain chopper when he was 24 years old.

It also didn’t matter that he was twice hit by cars or that he often slept in front of the district building, forcing those in charge of his help to regularly walk past him and see him suffering outside their office windows.

Mark Rippee was trapped by a cruel disease that made decisions for him. And his sisters, who spent almost every day of their adult lives caring for him as best they could, lost decades explaining to all of them the pain and horror of this alternate reality as he lapsed into a “mangled, broken man.” . as Privatte, Rippee-Hanson’s twin, described him.

You should have had some right, limited by a great oversight, to help this beloved sibling. And that’s what CARE Court will do.

Although the law allows medical providers, police and others to petition the CARE Court, more importantly, it allows family members to do so. One of the key aspects of CARE Court that gets lost in translation is that people like Rippee-Hanson and Privatte might finally have a powerful tool to stabilize their ailing loved ones before they become homeless or crumble into illness and death.

CARE Court could force counties to finally offer services and treatment to people like Rippee. This is the part of CARE Court that few talk about – the requirement that counties and other service providers comply or be sanctioned.

People with serious mental illnesses like schizophrenia are often the last line when it comes to getting help these days, as they can be difficult and time-consuming to deal with. It’s far easier to shrug and say someone like Rippee turned down the help and instead direct our scant resources to those with lesser needs. Rippee-Hanson has experienced this so many times that even she is skeptical of CARE Court, fearing its potential could prove to be just another false promise.

However, there is an individual accountability and oversight that gives me hope.

Under the CARE Court, a judge has the power to order stable placement to ensure the person does not fall through the cracks of the services, to force the government to do more in the most difficult cases. In fact, it takes an estimated 12,000 people, who are almost always expelled from the services for one excuse or another, and focuses on them.

But CARE Court is not involuntary treatment. Although those to whom it is referred receive notifications to appear in court, there is no penalty for ignoring court orders. There is no penalty for not participating in a treatment plan. A person simply cannot show up and little would happen other than visits from social workers – no arrest warrant, no police looking for them, no injection of drugs against their will.

CARE Court is a one-year program that can be extended to two years. If the person does not attend, the only possible consequence is that they may be referred for guardianship, an entirely separate judicial process that may result in the person being placed under government supervision.

It is true that there is a “black robe effect,” as the lawsuit alleges, that appearing before a judge can create a sense that obedience is required. Maybe this boost of authority isn’t so bad after all, for those who need help and for those who are supposed to provide it.

I attended Rippee’s memorial service a few weeks ago at Moose Lodge in Vacaville, where he played pool in better days. Privatte, raw with grief, spoke from a beige stage, mounted antlers adorning the wall above her. She described a little brother who loved to play pranks. Rippee was the kind of kid who, after meeting her fourth-grade teacher, Mr. Slacks, would say, “Mr. Slacks, every pair of pants he owned.” Pants” for years to come.

“I can still feel his tiny hand in mine,” she said. “A vivid reminder of a simpler time when we walked to the grocery store and home.”

Mark Rippee lost both eyes at the age of 24 after a motorcycle accident that also caused a serious head injury.

(Renee C. Byer / Sacramento Bee)

State Senator Susan Talamantes Eggman (D-Stockton), a longtime advocate of families like the Rippees, also paid her respects. Eggman’s aunt had bipolar disorder, so she understands the complexity.

“People with untreated mental health issues aren’t the only ones who suffer,” Eggman said. “It’s the families who feel so helpless who have asked for help over and over again. And with all the compassion we think we have, we turned a blind eye and said, ‘No, people have rights.’”

CARE Court will run in seven counties through the fall if the lawsuit is unsuccessful in stopping them. A few months later, Los Angeles will participate as by far the largest and most important county.

It is a program that requires scrutiny and transparency. We should all be careful that it is not misused or misused, as it is the most serious governmental intervention to curtail a person’s freedom.

But James Mark Rippee died with his rights intact and the failure of our all-or-nothing mentality.

It wasn’t polite and it wasn’t right.