Woodson is the executive director and managing attorney for Think Dignity, a San Diego nonprofit with a mission to advance basic dignity to people experiencing homelessness through advocacy and innovation. She lives in Chula Vista.
Now that Britney Spears has won her freedom, Gov. Gavin Newsom seeks to place thousands of Californians under conservatorship. In September 2022, despite much opposition from civil liberty groups, Newsom signed a controversial bill overhauling California’s approach to mental health care for people diagnosed with psychotic disorders. The program it created launches Monday.
The Community Assistance Recovery and Empowerment or CARE Act mandates that counties create a new branch of their court systems, CARE Courts, specifically for mental health cases, allowing family and first responders to ask a judge — who may not have any experience in mental health cases — to order a treatment plan for people deemed to be suffering from psychotic disorders. Here is what is most alarming: Those who refuse could be forced to comply under a conservatorship.
Seven counties were chosen to be the test dummies for this unprecedented attempt to disenfranchise people from their right to make decisions around their own life: Stanislaus, Tuolumne, Glenn, San Diego, Orange, Riverside and San Francisco. The initial counties will receive $26 million of the $57 million startup funding for the CARE Court system.
Currently, unhoused people with severe mental health disorders can already be held against their will at psychiatric hospitals, but they must be released after three days if they promise to follow up with other services and take prescribed medication.
The new law provides courts with the power to force treatment plans for up to two years and, theoretically, provide access to medication, housing and therapy. However, it does not actually mandate counties to provide behavioral health treatment or housing at all. Instead, all CARE court-ordered services are “subject to available funding,” according to the fine print of state law. In other words, services will only be provided if they are available. The grim reality is there are currently not enough mental health providers or affordable housing units to meet the state’s needs and this new law does not dedicate funding to meet this need.
Moreover, the governor’s approach to CARE threatens to impact Black residents in California more than others. Racial disparities are proven to be detrimental to the medical care of Black people. Despite studies showing that there is no evidence of an actual genetic increase of schizophrenia amongst Black people, they are often misdiagnosed at higher rates than their White counterparts due to an overemphasis of unrelated symptoms and external factors such as interviewer bias. As a result, Black residents in the state are diagnosed with schizophrenia, on average, three to four times more often than White residents. Black residents also represent 30 percent of those experiencing homelessness in the state, but only 6.5 percent of the general population. This threatens to further entrench Black community into yet another legal system riddled with bias and discrimination.
CARE Court is often promoted as a “paradigm shift” that will allow people to heal in their community and “not behind locked walls of institutions and prisons,” yet this new law will only perpetuate the criminalization and disproportionate medical mistreatment of marginalized communities.
CARE Court is an involuntary and coercive system. The consequences for not following through with a CARE plan will lead to a court referral for conservatorship, in which a person will lose their rights to make decisions for their own life, such as controlling decisions about their own medical care, finances and housing preferences.
The CARE Act paves a dangerous precedent for the state to institutionalize people. While existing laws already force involuntary treatment for people who are found dangerous to themselves or others, this law will increase the scope of a judge’s discretion to allow them to impose restrictions on people deemed “likely” to become dangerous with little guidance in making that speculative determination.
Not only does CARE court create a “Minority Report”-like approach to enforcement, no studies exist to prove that a court order for outpatient treatment actually works. Rather, data continues to prove that the most effective solution is housing people first, then providing the resources that empowers them to decide their course of treatment.
Getting out of a conservatorship is monumentally challenging, but — unlike Britney Spears — the people who would be most impacted by this new law do not have the money, resources, or quite frankly, the fan base to advocate for their self-determination. Now, these people will be forced to trust the state to make decisions in their best interest when the state has clearly neglected their needs in the first place.
