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**Screengrab from Riverside County video explaining the CARE Act, designed to provide support, medication, and housing to severely mentally ill individuals**
In a philosophical face-off between those who advocate for individual freedom without government intervention and those who argue that civilized societies cannot allow mentally ill individuals to live and die on public streets, Governor Gavin Newsom has spearheaded a “paradigm shift” with the help of Senators Tom Umberg (D-Santa Ana) and Susan Talamantes Eggman (D-Stockton). The result is the CARE Act – Community Assistance, Recovery, and Empowerment – which will be implemented on October 2nd in Orange, Riverside, San Diego, San Francisco, Stanislaus, Glenn, and Tuolumne counties. Los Angeles County will join them on December 1st, followed by the rest of the state next year. “Staying where we are is simply unacceptable,” stated Dr. Mark Ghaly, Secretary of the California Health & Human Services Agency, as the counties prepare for the launch.
California is home to approximately 170,000 homeless individuals, with nearly a third of them suffering from severe mental illnesses. The CARE Act is primarily focused on the 10,000 people who are at the highest risk and have refused assistance in the past. Dr. Ghaly highlighted the need for comprehensive care plans that prioritize self-determination, access to medication, and secure housing as the keys to stability. However, critics anticipation a struggle to implement the program effectively.
The program is voluntary for individuals with mental illnesses, referred to as “respondents” in official documents. It aims to offer treatment and stability while respecting their rights and autonomy. However, critics argue that participation will not be entirely voluntary. Senator Umberg clarifies that the resources provided by the program are not voluntary. Holding the components of the system accountable is a significant aspect of the CARE Act, ensuring that essential resources are available for recovery without coercion.
So, what exactly is the CARE Act? The program allows concerned individuals such as parents, spouses, siblings, or medical professionals to file a petition with the court seeking assistance for someone with severe untreated mental illness. A judge will review the petition, potentially ordering an evaluation by mental health experts to determine eligibility. To qualify, individuals must be at least 18 years old, diagnosed with a schizophrenia spectrum disorder or another psychotic disorder, not currently receiving voluntary treatment, and in severe and deteriorating conditions. The CARE plan must be the least restrictive alternative to ensure their recovery and stability.
It is crucial to note that the CARE Act is not intended for everyone experiencing homelessness or mental illness, as emphasized by the state. Substance use issues are unlikely to qualify for the program unless they are associated with severe psychosis. Instead, it targets individuals with untreated mental illnesses who face the most significant challenges.
If an individual qualifies for the program, the government will utilize all available resources, including medical treatment, stabilizing drugs, clinical behavioral health care, counseling, specialized psychotherapies, peer support from individuals who have experienced similar hardships, and a housing plan. CARE plans can last up to 12 months and be extended as necessary. The ultimate goal is to prevent unnecessary stays in jails and psychiatric hospitals, conservatorship, and premature death, while promoting recovery and independence.
Critics argue that the CARE Court system is a coercive and involuntary outpatient civil commitment that infringes on the right of individuals with mental health disabilities to make decisions about their lives. They claim that evidence does not support the effectiveness of involuntary treatment and advocate for investing in evidence-based practices that empower individuals with mental health disabilities to retain autonomy without court intervention.
Despite the disagreement, it is undeniable that addressing homelessness, incarceration, hospitalization, conservatorship, and premature death among individuals with severe mental illness is a pressing issue. Behavioral health funding has increased significantly, reaching $1.8 billion for Los Angeles County, $385 million for Orange County, $268 million for Riverside County, and $295 million for San Bernardino County. State and federal funding for homelessness has also risen, with $1.7 billion allocated to Los Angeles County, $218 million to Orange County, $126 million to Riverside County, and $149 million to San Bernardino County. The utilization of funds for housing is expected to be a substantial step forward.
The initial funding for implementing the CARE Act was $57 million, with the selected counties receiving approximately half of that amount.
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