“Thousands of Californians are suffering from untreated schizophrenia spectrum and psychotic disorders, leading to risks to their health and safety and increased homelessness, incarceration, hospitalization, conservatorship and premature death,” the legislative counsel wrote about SB-1338, the Community Assistance, Recovery and Empowerment (CARE) Court Program.
The Pacific Palisades Task Force on Homelessness have watched with dismay when they realize someone needs help, but if that person refuses it, there’s nothing that these volunteers can do. They’ve worked with at least three different parents of homeless. Parents watch in anguish, with no options, because they are not allowed to seek help for their young adult children.
CARE supposedly will allow loved ones to act sooner.
But like many well-intentioned programs, the most serious flaw of this one is it is voluntary. The person who is mentally ill has to agree to the program.
In a Zoom meeting on August 26, Andres Lizardo (Norwalk Court Operations Manager), Linda Boyd (Program manager III for the Department of Mental Health) and Caitlin McCann (CARE court Coordinator Attorney) described the process.
To be eligible to enter this program, one has to be 18 or older, be schizophrenic or have another psychotic disease. It has to be shown that the mental health of the person is substantially deteriorating, and the person is unlikely to survive without community support.
Before SB-1338, families, roommates, or even a first responder could not request an individual be seen by the court – no matter how outlandish that person’s actions might seem.
Now, a parent can file a CARE form and show evidence of a recent involuntary hold. It can be done electronically at lacourt.org or in person.
After filing, an assessment will be done of the individual. Then a determination will be made of possible treatment, and oversight and implementation hearings will be done. There will be ongoing monitoring and evaluation.
The person being brought to court has to agree to enter the one-year program, because it is voluntary.
The care provided to the individual is required to be least restrictive.
During the Zoom call, the panel said that 230 cases have been filed since the program began in December and they are working on 171 cases. Of those, 20 people have entered into an agreement.
When a case is accepted, the person is automatically given an attorney. There are 50 attorneys with mental health experience, waiting to help clients, according to McCann.
The panelists were asked, if a person says ‘no thank you’ to the CARE program, then what?
Then a judge could still order the CARE program if he/she feels the criteria have been met.
Or there’s always the possibility the person with psychosis could say “not today” and then come back in the future.
At the end of a year, those in the program “graduate,” or they can elect to stay in the program, or they can be asked to stay by a mental health worker.
There are no graduates yet, since the program began in December 2023.
There was initial funding with $26 million for the first counties that implemented the plan and $31 million for all other counties, such as LA. All counties are required to implement CARE by December 2024.
The panel, which has experience with patients with mental illness was asked if they could wave a magic wand to fix the problem, what they would do.
The answer was fast, “Involuntary drug treatment, so the person could see what life is like, again. Or some mandatory medicine, to shut up the voices in their heads, so we could help them,” was the answer.
Elyn Saks eloquently wrote about her schizophrenia in the book “The Center Cannot Hold.”
At one point in her life, Saks, who is now an associate dean at the USC Gould School of Law convinced her doctor, Kaplan [a pseudonym], to lower her dosage of Zyprexa. But, she starts to experience a return of the disease.
“For some reason, I decided that Kaplan and Steve (her friend) were imposters. They looked the same, they sounded the same, they were identical in every way to the originals – but they’d been replaced by someone or something. Was it the work of alien beings? I had no way of knowing, but I was terrified.”