Newsom signs CARE Court proposal aiming to help mentally ill

Brian Lungren and his family wonder what could have saved him some of the 13 years he spent at Napa State Hospital treating mental illness and serious drug and alcohol addictions.

When Brian, or Bri in his family, was diagnosed with bipolar schizoaffective disorder as a teenager, his parents did everything they could to save him from a years-long and emotionally painful spiral of drug use, incarceration and homelessness.

His father, Brian Lungren Sr., recorded nine temporary and involuntary psychiatric arrests and up to three failed attempts at court-ordered conservatorship.

Only after a judge found Brian not guilty by reason of insanity for stabbing another patient with a butter knife at an Auburn treatment center in 2007 did the family have hope for his eventual recovery. Brian was admitted to Napa State Hospital in 2008 after spending several months in the county jail.

“We tried to give him the best possible help. But we didn’t have a chance,” said Lungren Sr.

Similar stories influenced Gov. Gavin Newsom’s decision this year to introduce a sweeping new proposal to order mental health and addiction treatment for thousands of Californians, dubbed the Community Assistance, Recovery and Empowerment (CARE) Court.

Newsom signed the bill into law on Wednesday.

“It’s a new paradigm. It’s a new approach,” Newsom said, flanked by local officials and families before signing the law.

“This was designed in a completely different way than anything you’ve seen in the state of California, arguably in the last century.”

Three young people are smiling and holding skis.

Brian Lungren with his siblings on a ski slope.

(family photo)

CARE Court advocates are calling it a major change in the state’s approach to treatment, a way to divert Californians struggling with drug use and serious mental illness from incarceration and homelessness — while avoiding more restrictive, court-ordered guardianship.

An estimated 7,000 to 12,000 of California’s most vulnerable residents are expected to qualify for CARE Court, those who are at greatest risk of dying or getting worse because of their condition.

To initiate a CARE plan, family members, first responders, healthcare professionals, and behavioral health professionals, among others, may first seek a judge to order an evaluation of an adult with a diagnosed psychotic disorder who is in urgent need of treatment and often housing.

If the person meets the criteria, the judge will order a series of hearings and assessments to begin developing an individual care plan, which could include medication, social services and treatment to stabilize, and housing tailored to their needs.

For up to two years, a plan would provide a clinical team, an attorney and a volunteer supporter with a role to help individuals understand the options available to them during their treatment so they can make decisions with a degree of autonomy .

The governor and his administration have been careful to designate CARE Court as voluntary because people who qualify can still technically opt-out to participate.

That has done little to mitigate fierce opposition from a vast network of influential civil and disability rights organizations. They have spent much of this year’s legislature slamming the CARE Court as a way to criminalize mental illness and strip away basic liberties from already marginalized groups.

legal challenges according to the law are expected.

In a scathing letter to Newsom last month, dozens of human rights organizations claimed the CARE Court was ignoring California’s root problems — a lack of affordable housing and supportive services — and favoring a new system that “will only result in the institutionalization and criminalization of those who are already isolated.” are the streets.”

“Our fundamental belief is that it’s a bad idea that will be worse in execution and have disastrous effects on homeless people,” said Brandon Greene, director of the ACLU’s racial and economic justice program in Northern California.

Anita Fisher, a mental health counselor in San Diego County, dismisses these arguments.

Fisher said their 44-year-old son Pharoh was a doting older brother, a sports fan and movie fanatic — until he stopped taking his medication for schizophrenia.

“He’s paranoid. He [has] delusional thoughts. He is leaving the house. He begins self-medicating with street drugs, which results in him becoming homeless. Which leads to us waiting for him to be arrested. Then I can start working on his care again,” she said.

After being locked into that routine for more than two decades, Fisher said she supports CARE Court even in its “imperfect state.”

“I have visited my son in prison and in jail more times than I have ever visited a hospital. That tells you there’s a problem,” Fisher said. “Everyone keeps saying, well, it’s a choice. How can there be a choice… for someone to give up their rights when they don’t understand that they are sick?”

Brian Lungren Sr. agreed.

“Think 13 years in a state hospital – which my son had to go through because there was no mandate, no gavel, no violence, whatever definition you want to use – you think that was better for him as a person, you think , which was better for society, was it better for taxpayers? Obviously the answer is no,” he said.

Once an extreme skier who raked in competitive wins and sponsorships from equipment and apparel companies, Brian became unrecognizable to his family when he succumbed to mental illness and addiction.

The Lungrens were in a more able position than most California families. Lungren Sr. is a lobbyist for a well-known Sacramento firm and the brother of Dan Lungren, a former Attorney General and US Congressman. Brian’s mother, Nancy, has had a long career in all corners of the Sacramento government, working in the offices of former governors. Arnold Schwarzenegger and Jerry Brown.

And yet Brian’s struggles continued.

“One young man’s life has been put on hold for thirteen years because groups have resisted any kind of reasonable mandate/coercion on people who actually need help,” Lungren Sr. said.

Newsom also expressed “exhaustion” towards the opposition on Wednesday, saying he was “not interested in the status quo”.

“I’m weary of some people just wanting to bury their heads in the sand about what’s going on with people struggling with schizophrenia spectrum, with psychotic disorders. They need help, they need intervention. And sometimes it’s hard,” he said.

The proposal to implement the CARE Court, Senate Bill 1338, sailed through the legislature in the assembly with only two votes against. The Senate sent the bill to Newsom in late August with a unanimous 40-0 vote.

However, concerns remain, particularly over whether California has the infrastructure to set up a new court system and to hire and train the numbers of mental health workers needed to handle the increased caseload, particularly in rural communities. Advocates worry that there is not enough affordable and supportive housing available for this demographic.

Newsom has pointed to billions in the state budget to set up CARE Court and hire skilled professionals. He has committed $63 million to help local governments and courts implement it, his office said, and has touted the $14.7 billion he has spent over the past two years to alleviate homelessness in California has provided. His administration said $1.5 billion in that pot is available for so-called bridge housing, temporary shelters for homeless people with behavioral health problems.

Newsom also agreed to delay implementation of the law by more than a year. Glenn, Orange, Riverside, San Diego, San Francisco, Stanislaus and Tuolumne counties must establish a CARE Court by October 1, 2023, and the remaining 58 counties in the state by December 1, 2024.

Michelle Doty Cabrera, executive director of County Behavioral Health Directors Assn. of California, said negotiations are ongoing with the Newsom administration on how to fully fund CARE Court beyond the initial investment.

“I think the key to our success will be how will California address this issue over the long term?” said Doty Cabrera. “Our work on innovating in homelessness is far from over. We should see this as a beginning, not an end.”

A family poses with Santa Claus with the text "Merry Christmas 2019."

The Lungren family at Christmas 2019.

(family photo)

CARE Court will not help everyone.

“Right now it can’t help Bri. He lost 13 years at Napa State,” Lungren Sr. said. “It will help other Bris. And other parents. And other sisters and other brothers. It will keep families together.”

(Lungren Sr.’s firm represents the California chapter of the National Alliance on Mental Illness, one of the leading proponents of the CARE Court.)

Last year, Brian was transferred from Napa State Hospital to a “step-down” mental health rehabilitation center. If all goes according to plan, he is expected to be placed on a parole program in the next few months, the next step once a patient or parole officer has stabilized after a long stay in a state hospital and is eligible for outpatient treatment.

He believes CARE Court could have speeded up his recovery.

“I know [my family] tried to help me as much as possible while dealing with my hostility because they were unstable. When I became schizoaffective, it was all new to me. I didn’t know that was understood,” Brian said in a recent Zoom interview with The Times.

Brian has spent the last year in treatment working on ways to identify his “triggers” and the feelings and thoughts that could lead to a relapse or threaten his progress. His family has a copy of this plan, he said, so they too can spot these early warning signs and take action.

“Right now I’m on my baseline. I’m totally stable. I am sober. I am consistent. i do what i have to do People ask me for things and I get them done. I’m reliable,” Brian said.

Brian must continue to attend his meetings with Alcoholics and Narcotics Anonymous. He hopes to volunteer with the American Society for the Prevention of Cruelty to Animals and spend more time with his sister Alanna and brother PJ.

He is looking forward to a hot chocolate with his family at Christmas.

https://www.latimes.com/california/story/2022-09-14/newsom-plan-court-ordered-treatment-mental-health Newsom signs CARE Court proposal aiming to help mentally ill

Alley Einstein

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