How California’s CARE Court will address mental illness

California has a new statewide approach to treating people struggling with serious mental illness: the CARE Court.

The program connects people in crisis to a court-ordered treatment plan for up to two years, while diverting them from possible incarceration, homelessness, or restrictive court-ordered guardianship.

Gov. Gavin Newsom signed the measure (Senate Bill 1338) on Wednesday. However, since it will not take effect immediately, most California counties will not implement it until 2024.

The law takes a phased approach, with Glenn, Orange, Riverside, San Diego, Stanislaus, Tuolumne and San Francisco counties implementing the program by October 2023. The remaining districts must start the program no later than December of the following year.

How will CARE Court work?

To initiate a treatment plan, a family member, behavioral health professional, or first responder requests a judge to order an evaluation of an adult with an untreated psychotic disorder (such as schizophrenia) who is in urgent need of treatment and, in some cases, housing. A court may also initiate the program by referring a person to a CARE treatment plan from a supervised outpatient treatment, guardianship proceeding, or misdemeanor proceeding.

The judge then orders a clinical evaluation and appoints counsel and a CARE volunteer supporter. The supporter would help a CARE recipient understand the options available in the program so that the recipient can make decisions with the greatest possible autonomy.

If the person meets the criteria, the judge orders a series of hearings and the development of an individual care plan that is culturally and linguistically appropriate.

The plan, developed by the county’s behavioral health professionals, the individual, and the volunteer supporter, may include behavioral therapy, medication, substance abuse treatment, social services, and housing specifically tailored to the individual’s needs.

If necessary, the court may issue orders necessary to assist the CARE recipient in accessing housing and services, including imposing sanctions on providers and local government agencies if they fail to provide court-ordered services or treatment.

During this process, the court will conduct status hearings as needed to liaise with the recipient and review progress made, services provided, any issues the individual may have with the program, and recommendations for making the plan more successful.

Individuals who complete the program remain eligible for ongoing treatment, supportive services, and community housing to support long-term recovery.

Who is eligible for this program?

The CARE Court program is for individuals diagnosed with schizophrenia spectrum disorder or other psychotic disorders in this class, as defined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders.

A person struggling with these mental health problems must also be at least 18 years old and not currently stabilized by treatment. In addition, the person must be in significant deterioration and “unlikely to survive safely in the community without supervision” or be at risk of relapse or deterioration leading to “serious disability or serious harm to the person or.” other” would lead.

This program may be an appropriate step for someone who has experienced a short-term involuntary hospitalization (either 72 hours or 14 days) or who can safely be distracted from certain criminal proceedings.

Is this program voluntary?

Although participation in CARE plans is voluntary, a court may make a plan for a qualified person, and a judge may order placement and other services for that person, without that person’s consent. Some critics of the program, including the ACLU and Human Rights Watch, argue that it is coercion to force people to go to court to obtain treatment.

If you refuse or fail to participate, no criminal sanction can be imposed. Individuals who do not successfully complete their treatment plan will be removed from the plan, although they will continue to be entitled to all the services and support to which they are entitled.

In such cases, a court may use existing authority under the Lanterman-Petris-Short statute to ensure an individual’s safety by notifying the county behavioral health board and the office of public conservator and guardian.

If all reasonable benefits of the CARE Plan have been provided but the individual has not attended, this will affect all hearings held for that individual under the Lanterman-Petris-Short Act in the following six months, thereby the suspicion arises that the person needs additional intervention beyond what CARE can provide.

Anita Chabria, a Times contributor, contributed to this report.

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