California governor OKs mental health courts for homeless

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San Francisco — With more than 100,000 people living on California’s streets, Gov. Gavin Newsom signed the first law of its kind on Wednesday to require some of them to receive treatment as part of a program he described as “care” but which opponents argue is cruel.

Newsom signed the Community Support, Recovery and Empowerment Act on Wednesday. It allows family members, first responders and others to ask a judge to make a treatment plan for someone with certain illnesses, including schizophrenia. Those who refuse may be placed under guard and ordered to comply.

Currently, homeless people with serious mental health disorders flow from the streets to prisons and hospitals. They can stay in a psychiatric hospital involuntarily for up to three days. But if they promise to take medicine and attend other services, they should be released.

The new law allows the court to order a treatment plan for one year, which can be extended for a second year. The plan may include medication, housing, and treatment. While it shares some elements of programs in other states, the system will be the first of its kind in the country, according to Democratic state Sen. Tom Umberg, associate legislative secretary in his office.

For decades, California has largely treated homelessness as a local problem, channeling billions of dollars each year to city and county governments for various treatment programs. But despite all that spending, homelessness remains one of the state’s most pressing and visible issues.

“Keep doing what you’ve been doing and you’ll get what you got. And look what we got. It’s unacceptable,” Newsom said Wednesday before signing the legislation. “This (law) is drafted unlike anything you’ve seen in the state of California, which has been around for almost the last century.

Some progressives have opposed Newsom’s blocking of some of his priorities, including vetoing a bill to allow supervised safe injection sites for drug users and opposing a new tax on millionaires that would pay for more electric cars.

But in a year when Newsom speculated about his presidential ambitions and entered Shu-in’s re-election bid, the new program has drawn criticism from both political parties, with some on the left arguing it goes too far. It does not go far enough on the right side.

Newsom signed the bill against strong opposition from the American Civil Liberties Union of California, Human Rights Watch, Disability Rights California and several other organizations working with the homeless, minority communities and people with disabilities.

Courts are a scary place for many people with serious mental illness, and they say coercion runs counter to the peer-based model that is critical to recovery. In other words, critics say, a person has to seek help, and that can take months or years.

“There is absolutely no evidence that this plan works. It’s one more solution,” said Eve Garrow, policy analyst and advocate for the ACLU of Southern California. Research shows that adding a mandatory component to housing or mental health services does not increase compliance.

The program is not just for the homeless. It only applies to people with severe mental illness – mostly psychotic disorders – and only if they have no chance of surviving safely in the community without supervision or are likely to harm themselves or others.

That means people who struggle with alcohol and opioid addictions don’t qualify unless they have mental illnesses.

Newsom’s administration estimates that about 12,000 people could benefit from the program. State House Republican Leader James Gallagher said that’s not enough.

“Even though it’s better than nothing, the (Community Assistance, Recovery and Empowerment) Court is basically a new bureaucratic half-measure,” said Gallagher, who like most of his Republican colleagues in the state Legislature voted for the law. “What we want is not a fundamental policy change. It helps some seriously mentally ill people get treatment, but it doesn’t stop the explosion of homeless encampments in our community.

The program doesn’t begin until next year, and only seven counties: Glenn, Orange, Riverside, San Diego, San Francisco, Stanislaus and Tuolumne must establish programs by Oct. 1, 2023. All other counties will have until Dec. 1. In the year 2024

Each of California’s 58 counties must establish special courts to handle these cases. Non-participating counties can be fined up to $1,000 per day.

Michelle Doty said the new law’s biggest challenge is getting enough funding, housing and staffing “without wasting resources on the hundreds of thousands of county clients we serve, not to mention the important behavioral health and substance use disorder services we provide.” Cabrera, executive director of the California Association of County Behavioral Health Directors.

Newsom echoed those comments, saying implementation will be key. This year’s state budget includes $296.5 million for the “Workforce for a Healthy California for All Program,” with a goal of hiring 25,000 community health workers by 2025.

The California National Coalition on Mental Illness supports the proposal, as do businesses and dozens of cities, including the mayors of Los Angeles, Sacramento, San Francisco and San Diego.

They say treatment models and antipsychotics have changed dramatically since people were institutionalized. Proponents say the individual should be able to thrive in the community given the right clinical support team and housing plan.

Newsom said he was “tired” of arguments from civil liberties groups that the program would go too far.

“Their perspective is defined by what they see on the streets and sidewalks across the state,” he said.

———

Beam reports from Sacramento, California.

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