California's Big Plan To Get Help For People With Serious Mental Illness Is Off To A Slow Start

It’s been six months since Los Angeles County launched a new program aimed at getting more people with serious mental illness into treatment, but the number of petitions so far is much lower than expected.

Known as CARE Court, the program that launched Dec. 1 allows family members, behavioral health workers, first responders and others to petition a court to step in with a voluntary care plan for someone living with serious mental illness, like schizophrenia.

State authorities estimated that L.A. County would have as many as 1,900 petitions by now, but as of this week only 155 have been submitted — about 8% of what was projected. About 500 petitions have been filed statewide.

From those petitions, 13 participants now have treatment plans or agreements in place, county authorities said.

Orange County, which launched its CARE Court program in October, has three treatment agreements in place.

“Although maybe folks would like to see larger numbers, I think we see change one life at a time,” said Martin Jones, a program manager with the L.A. County Department of Mental Health, which oversees the program. “I think we see success one story at a time, and I think that there’s some significant work happening here.”

LA still leads other counties

Gov. Gavin Newsom and other state leaders have billed CARE Court as a way to get people the lifesaving treatment they need and as one tool for addressing California’s homelessness crisis.

Some mental health advocacy groups have opposed CARE Court, saying it inappropriately coerces people into treatment and strips them of certain rights. In 2022, 40 groups — including JusticeLA, Disability Rights California and ACLU California Action — signed a letter saying the program would strip “people with mental health disabilities of their right to make their own decisions about their lives.”

While in the program, county authorities work to create agreements between the participant and behavioral health workers that focus on what the voluntary treatment the person will entail. If they can’t agree, the court orders the care plan.

Los Angeles leads other counties in the state on the number of petitions, agreements and plans put in place so far, according to the Department of Mental Health. It’s also the county in the state with the largest population.

Marco Saenz, a deputy public defender and program director of the Independent Defense Counsel Office, told LAist the state was projecting 1,938 CARE Court petitions in L.A. County during the first six months after the launch. The Independent Defense Counsel Office, which is separate from but administered by the county Public Defender’s Office, worked to select a panel of 50 attorneys who will work with program participants.

‘It takes a while...’

As of May 31, there were 502 petitions filed statewide, according to Anne Hadreas, supervising attorney with the Judicial Council of California’s Center for Families, Children and the Courts.

Those petitions are from the first cohort of counties that launched CARE Court programs, including L.A., Orange, San Diego, San Francisco, Riverside and others.

“Since the goal of this is so much involved with outreach and engagement, it takes a while,” Hadreas said. “So these cases don’t always move as quickly as I think people thought they would.”

Recalling one case in particular, Jones said a team worked with a man for weeks to gain his trust before they were able to move him into medical care. Later, they learned he had an infection in one of his limbs and likely would have died without treatment.

Of the existing 155 petitions, at least 120 are still active, Jones said, adding that the county may provide services to people even if they are not the right fit for the program.

He said the county is aiming for more voluntary agreements than court-ordered treatment plans.

But that work takes time, especially when participants are living on the streets or go missing.

Supervising attorney Melanie Snider with the Center for Families, Children and the Courts said L.A. County has designated “private spaces” in 11 state courthouses where participants can use computers to make their court appearances virtually or connect with mental health providers.

She said she is pleased with the work the county has done to get resources in front of people, even if they aren’t eligible for CARE Court.

More petitions possible?

Some mental health advocates question whether enough people who might benefit from the program are aware that it exists.

“The number of petitions that are possible versus the number of petitions that are actually in the door, I think there’s a huge delta and what is the reason for that?” said Brittney Weissman, vice chair of the L.A. County Mental Health Commission. Weissman is also executive director of Hollywood 4WRD, a coalition that hopes to address homelessness in Hollywood.

Research from the California Policy Lab shows that in 2020 there were, at minimum, 4,500 unhoused people in L.A. County who had been diagnosed with a psychotic spectrum disorder, like schizophrenia.

Jones, from the L.A. County Department of Mental Health, said CARE Court provides support for family members who have struggled for years to get their loved ones help. More than 140 of the petitions received so far have come from family members of someone living with mental illness.

It’s not a quick process, he said, especially when some participants are suspicious of the program or may have experienced trauma.

“This is tough work, but it’s also rewarding. And it takes time,” Jones said.