CITATION: Citations could be cleared if participants stick to their plan. SMDP Photo

The County of Los Angeles is accelerating implementation of a new legal framework to deliver services to individuals suffering from severe mental health disorders.

Supervisors have approved plans to begin CARE courts by Dec. 1, 2023, a full year ahead of schedule.

CARE courts would provide court-mandated treatment plans for severely mentally ill individuals, and in particular, individuals experiencing homelessness and psychotic illnesses. Family members, first responders, and mental health care providers could petition the court to implement a plan for up to two years that could include individualized interventions with supportive services, medication and housing.

Once passed by the judge, the relevant county would be legally obligated to provide the prescribed care, including housing resources when applicable. Those who do not complete their care plan could be hospitalized or be placed under a conservatorship.

The CARE Court proposal is inspired by the model of local homeless community courts (HCCs), which have been established in cities across California to connect unhoused individuals to services and treatment. While the structure of these courts varies from location to location, they typically require unhoused individuals to follow a treatment plan in return for having misdemeanor charges expunged from their record upon completion.

The proposal received bipartisan support in the state Legislature despite some pushback from some organizations who said the system would penalize those who were unable to complete the plans.

According to estimates from the Governor’s Office, CARE Court would apply to 7,000 to 12,000 people experiencing severe mental illness across California. Los Angeles has joined seven other counties in implementing the system this year.

“We are in a homelessness emergency and we know that many who are living on our streets are struggling with severe mental illness. Governor Newsom’s Care Court model has been a missing piece in our effort to bring people inside,” said Los Angeles County Supervisor Janice Hahn, Chair of the Los Angeles County Board of Supervisors.

“Across Los Angeles County, we have seen the effects of our mental health crisis spilling out onto our streets. Too many residents with severe mental health issues lack adequate treatment and often find themselves in a devastating cycle between our emergency departments, our jails, and falling into homelessness,” said Los Angeles County Supervisor Hilda L. Solis, First District. “CARE Court will provide people with untreated mental health issues an opportunity to get stabilized in a compassionate manner. I want to thank Governor Newsom for including Los Angeles County as one of the first participants, and I look forward to working with him to ensure a swift and effective implementation.”

The City of Los Angeles has also voiced support for the plan.

“I want to thank the Governor for his leadership. It is profoundly inhumane to allow people to suffer mental illness and die on our streets,” said Los Angeles Mayor Karen Bass. “We will lock arms with Los Angeles County, building CARE Courts and expanding mental health and substance abuse programs to help Angelenos get well while respecting all civil liberties.”

The need for a statewide system of mental health care dates back to the 1967 Lanterman-Petris-Short Act, which ended the notoriously abusive system of involuntarily committing mentally ill individuals in psychiatric facilities. The LPS Act replaced the asylum system with the conservatorship system, whereby family members can petition a court to have control over a loved one’s medical treatment. The bar to establish a conservatorship is very high and following the LPS Act, the state did not develop a robust mental health care system to treat those who do not meet the standard of “gravely disabled.”

“CARE Court brings real progress and accountability at all levels to fix the broken system that is failing too many Californians in crisis,’’ Gov. Gavin Newsom said in a statement. “I commend Los Angeles County leaders, the courts, and all the local government partners and stakeholders across the state who are taking urgent action to make this lifesaving initiative a reality for thousands of struggling Californians.”

The housing and services for CARE Court clients is supported by the state’s $15.3 billion investment in addressing homelessness, including $1.5 billion for behavioral bridge housing; more than $11 billion annually for mental health programs throughout California; and more than $1.4 billion for our health and human services workforce.

Additional funding has been promised in upcoming budget cycles. The State anticipates that at full implementation, the state will provide $215 million annually to support the operation of CARE Courts.

In Los Angeles County, the Los Angeles County Department of Mental Health will oversee and coordinate the implementation of CARE Court.

Matthew Hall

Matthew Hall has a Masters Degree in International Journalism from City University in London and has been Editor-in-Chief of SMDP since 2014. Prior to working at SMDP he managed a chain of weekly papers...