California & USA

The California Mental Health CARE Court treats thousands of untreated psychotic diseases.

Many people are encouraged by CARE Court, a contentious and pricey effort that will begin in eight California counties in December before expanding statewide.

Judges will be able to force those with untreated mental disorders, such as schizophrenia, to seek treatment under the program, with counties having to assist. Anita Fisher sees it as a possible lifeline for people like her son, Pharoh Degree, who was diagnosed with schizophrenia 22 years ago while serving in the Army. He is now 45 years old and admits that living with the condition is difficult.

“Constant overthinking,” he added, emphasizing how tough it is to live with schizophrenia when it is untreated. “Your mind is constantly racing, and your inner voice is constantly speaking, racing, racing.” There is no peace. There was never any solace or calm.”

Why do advocates believe a CARE Court is required?

Fisher claims that until now, she has had few options for ensuring that her kid receives assistance. Last year, her son stopped taking his medication. Fisher requested a psychiatric intervention for seven months, but she claims her requests were rejected because she did not have her son’s consent.

The PPharaoh was forced to flee. Fisher spent days looking for him in and around their neighborhood. When she found him, she could see he was sick.

“He’d say, ‘I’m fine.'” “But no, he wouldn’t look good,” Fisher remarked.

He was detained for vandalism in October of last year. He was given medication and engaged in a treatment program while in detention.

Gov. Gavin Newsom, a staunch supporter of CARE Court, calls the present system a “fail-first system” rather than a “care-first system.”

“Which means you have to end up in the criminal justice system before someone finally provides you with support, a bed, and a solution,” Newsom explained. “We have to fix it. And that is exactly what we are doing.”

California already has regulations in place to assist many people suffering from serious mental illnesses, but many people believe they fall short. According to critics, the Lanterman-Petris-Short Act, which establishes standards for involuntary psychiatric treatment, comes into effect too late, only assisting when someone is already in crisis. Laura’s Law, which enables assisted outpatient therapy or court-ordered mental health treatment plans, has also been widely seen as a failure due to its lack of statewide implementation and lack of major funding.

On any given night, more than 170,000 individuals are sleeping on the streets or in shelters throughout California. One in every four people suffers from a major mental illness. The Newsom administration believes that CARE Court, which is not limited to persons who are homeless, will benefit an estimated 12,000 people.

While Fisher, who is also a mental health advocate, hopes her son never requires CARE Court, she says she would not hesitate to start the process.

“I hope if it does, he sees it as a positive experience in which his voice is heard,” she said.

Who qualifies for CARE Court, and how does it operate?

Only people over the age of 18 with schizophrenia or other psychotic diseases are eligible for CARE Court. Other eligibility criteria include the individual’s likelihood of surviving in the community safely without supervision or harming themselves or others. Individuals are also only eligible if it is determined that becoming a CARE Court participant will benefit them.

A person who has been referred to CARE Court for severe mental illness is evaluated, and a CARE Court judge considers the petition, which can be filed by a close family member, roommate, hospital director, first responder, police officer, or certified behavioral health professional.

If the judge believes the individual is likely to fit the required conditions, he or she may order a clinical evaluation. A judge might order a mental health treatment plan, including medication, therapy, and a place to live, based on the results. The plan will be valid for one year, with a one-time opportunity to renew it for another year.

Those in CARE Court will have access to a public defender and will be able to refuse treatment without facing jail time, but there is a catch. If a person in CARE Court refuses treatment, a judge may recommend them for conservatorship, which is an extreme conclusion in which they are stripped of their rights and forced to comply with therapy.

The CARE Court debate

Critics argue that the program, which is expected to go statewide by the end of next year, is coercive, removing options and imposing treatment. The state plan, according to Eve Garrow, a homelessness policy analyst for the ACLU of Southern California, is a path to conservatorship and the denial of civil liberties. She is concerned that people will lose the ability to choose which pharmaceuticals go into their bodies, among other things.

“There is no forced medication,” Garrow said, “but when there is pressure and coercion, you are more likely to potentially comply with treatment that isn’t meeting your needs.”

According to Garrow, the state should give comprehensive care to all Californians with mental health impairments. She sees it as a feasible proposal provided California invests in such services rather than shifting funding to the new court system.

This year, the Newsom administration spent almost $17 billion to combat homelessness and treat mental illness. However, authorities in many counties say the money set aside for CARE Court is insufficient to handle the thousands of people who are anticipated to enter the system.

Some of the money will go to Los Angeles, which has one in every eight homeless persons in the country. Marquesha Babers, 28, had been homeless on and off for years on the area’s famed Skid Row. Babers was living in a shelter when 60 Minutes visited her, and she told us she had multiple major mental health disorders, including bipolar disorder.

“I go almost every day to see if I can talk to a therapist or if I can get some mental health services or help,” Babers explained. “And there aren’t any. If you do find one, they’ll tell you, ‘Oh, well, the waiting list is six months before you can talk to a therapist.'”

She opposes CARE Court, calling it “medical incarceration” because of the prospect of conservatorship, which allows people to be locked up in psychiatric hospitals and treated without their consent.

“I just think there needs to be a lot more focus on services and prevention rather than the consequences of not having those services,” she says.

Babers’ relatives reported her missing last month.

Many of Babers’ worries regarding CARE Court have been expressed by advocacy groups as well. CARE Court has been slammed by more than 50 advocacy groups as a “costly mistake” that is “likely to cause real harm.”

Newsom replies that the possibility of conservatorship is not novel. He recognizes that many do not want to see it happen, but it is already a reality, and he feels that CARE Court can help some persons suffering from psychotic diseases obtain the help they require.

“And here’s all I ask: prove us wrong,” urged Newsom. “Don’t make assumptions about us. Your sympathy is not greater than ours.”

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