In early March, Governor Gavin Newsom announced the Community Assistance, Recovery and Empowerment (CARE) Court program, which would create yet another separate court for poor and unhoused people with mental health conditions and substance use disorders. Governor Newsom has explicitly discussed CARE Court as a tool to address street homelessness, and the proposal is consistent with a string of bills nationwide that seek to increase the power of the state to institutionalize unhoused people under the pretense of “compassion.” The devil is in the details, and the only real investments in this proposal are in the court system. By broadening and bolstering the structure for bringing people under court-ordered “Care Plans” while doing nothing to increase the capacity of treatment programs or access to housing, this proposal simply reinforces the mechanisms that continue to produce unequal, unacceptable health outcomes in our communities. It sets poor people and people with mental health disabilities up to fail, and then stands ready to punish them when they do – the next step for someone who can’t complete “Care Plans” is conservatorship, where a representative of the state is given control of all their life decisions. Funding systems of oppression over voluntary treatment and truly affordable housing will not “end homelessness.”
What does the proposal say?
According to the bill text (running as two identical bills in the assembly and senate) the CARE Court process begins when a “specified individual” petitions to refer someone to the court. The list of “specified individuals” is alarmingly broad, and it includes “family members, first responders, including police officers or outreach workers, the public guardian, service providers and the director of the county behavioral health agency.” The court then reviews the petition and schedules a hearing.
The three central criteria for the CARE Court program are that someone a) is on the schizophrenia spectrum or has another psychotic disorder, b) that they “lack medical decision-making capacity,” and c) are not receiving any other treatment. If the judge decides in the hearing that a person meets these criteria, the court will mandate a “Care Plan.” This Plan will allegedly be developed jointly by the individual subject to the Care Plan, a court appointed “Supporter,” and the county behavioral health department.
The Care Plan can last up to two years and can consist of forced treatment and medications, including long-acting injections. The bill also mentions a housing plan, but housing is defined to include interim/bridge shelters and will only be offered “as feasible.” Since there is a state-wide housing crisis, the probability that people will be offered actual housing is slim to none.
If someone fails to complete their Care Plan, the next step is for that person to be referred to a conservatorship, where a representative of the state is given authority to make all life decisions for that person, indefinitely. A conservator can order a person to continue forced treatment and medication, tell them what shelter they must accept, and control other basic decisions like how to spend money.
Reading between the lines: A carceral ultimatum
CARE Courts do not seek to provide care, but to weaponize it. Newsom talks about outdated, abusive conservatorships and state hospitals as the reason that we need this “upstream intervention,” but his CARE Court upholds and intensifies the carceral history of mental health policy in California. Like the numerous system-expanding courts created to address social issues before – Mental Health Court, Substance Abuse Court, Homeless Court etc. – CARE Court simply promises to create a channel for people that politicians and business owners consider a nuisance to be disappeared into a never-ending cycle of criminalization and state bureaucracy, while simultaneously funding the courts to do “social justice” work.
Separate courts do not create any discernible improvement in the lives of the many people that cycle through them, and oftentimes refer people to services and treatments that fall through or don’t exist. And though framed as an “upstream intervention,” they do not reduce the overwhelming number of defendants facing criminal hearings and trials, nor do they decrease the volume of people being criminalized in the first place. As with most government institutions that process poor people, they are—intentionally or unintentionally—designed to fail. They impose requirements that are easily met by middle class people, but are often impossible as a practical matter for the poor and disabled. And, when those requirements are not met, that is the basis for determining that, in the bureaucratese of the CARE Court proposal, “The participant cannot successfully complete a Care Plan,” which in turn leads to them being put into a conservatorship. The state’s proposal to conserve people rises to a shocking new level of warfare against the poor and dispossessed, threatening to strip them of every bit of human dignity and right to self-determination. People with disabilities, unhoused people, or people who use drugs are not the “problem”—the cause of this crisis is solely based on our government’s refusal to utilize our vast resources to ensure that health care and safe decent housing is available for all of us who need it. Programs like CARE Court will never solve social issues rooted in structural inequality and systemic racism because the criminal justice system is the executioner of the status quo.
As people with lived experience, frontline service providers and organizers have attested all along, the primary obstacle to accessing treatment and housing isn’t lack of follow-through on behalf of “broken” and “service resistant” individuals. Rather, it is a complete and overwhelming lack of capacity in any program they apply to. This program will simply formalize a carceral ultimatum: “participate” in (forced) treatment or face the possibility of conservatorship. Meanwhile, the defunct system of coordinated entry and ramshackle service provision remain as major barriers. And in areas where access to treatment is historically worse than others, namely Black and indigenous people of color and rural communities, this disparity will manifest in increased conservatorship and incarceration of marginalized people.
We Demand Real Care, Not Courts!
There are many ways to transform our mental health system that are not predicated on incarceration and institutionalization. We need deep state investments, not just in expanded crisis stabilization such as acute diversion units and psychiatric urgent care, but also peer support programs, open residential treatment programs that serve individuals with co-occurring diagnosis and multiple languages, residential care facilities, cooperative living programs, reimagined board and cares, supportive housing and residential step-down housing. In other words, a mental health treatment system that meets individuals needs with a diversity of offerings that ensure people with mental health issues have agency in garnering the services that work for them.
In order for Newsom to address the issues he professes to care about and truly create a new paradigm in providing treatment for people to achieve healthy and positive outcomes—the only defendants receiving a court order would be our federal, state and local governments requiring them to provide homes for all in need. House keys not handcuffs!
This article originally appeared in Street Sheet.
Jade Arellano is an organizer with the Western Regional Advocacy Project (WRAP) who works with community leaders across the US to draw out the common threads of local organizing campaigns and build power nationally.