CARE Court plan gets backing from San Diego cities, county

California has a fragmented, inadequate mental health care response system, for which no single government entity is in charge of guaranteeing that people grappling with severe mental illness get care. Our society’s efforts to deal with this human tragedy have been a failure. We need a new approach.

Gov. Gavin Newsom has proposed a new way, outlined in Senate Bill 1338. The governor’s CARE Court plan has earned the support of San Diego County and all the mayors of its 18 cities.

We see the reality of our troubled mental health care system all too often on the streets of San Diego County: A man, self-medicated with drugs and alcohol, lying half naked, passed out in the doorway of a small business. A woman, shuffling down the sidewalk, screaming profanities at voices that only exist in her mind. An emaciated man sitting exhausted on a park bench, a gaping wound on his leg festering from inattention.

The city and county of San Diego have collaborated on better ways to deliver behavioral health services. We’ve invested in mobile crisis-response teams and created new facilities such as crisis-stabilization units and low-barrier shelters. CARE Court, however, presents us a new opportunity to help a small but highly visible segment of our homeless population — people who do not have the support they need to properly manage their mental health and get on a better path.

Under the proposed legislation, first responders, service providers, health care professionals or even family members could refer a person to CARE Court. A licensed behavioral health professional would then evaluate the individual for the court to determine whether they are a good candidate. The county would provide services to the individual under supervision of the court program. Cities could have a role in providing housing, all with the goal of shifting away from emergency crisis response toward longer-term housing with services.   

Individuals would be represented by a public defender and a volunteer supporter. If the person opts in to the program as an alternative to jail or time in a locked facility, they would be provided a plan managed by a team in the community for up to 24 months. The program guarantees them supportive services, as well as access to medication and housing resources.

CARE Court is voluntary, offering a way to avoid conservatorship. Conservatorship — in which a judge places a gravely disabled person and their affairs under the control of someone else — is a last resort. 

The program shares responsibility between the individual and government. As the leaders of government entities responsible for implementing CARE Court, we must provide the care and the housing; the individual, with plenty of support, must do the hard work. 

In addition to policy changes, the governor has vowed to make investments in our behavioral health workforce. Right now, as we have expanded mental health programs locally, we are seeing workforce shortages. We support the state’s investment of $1.5 billion to fund and recruit qualified and trained professionals. 

Additionally, the governor has pledged $1.5 billion to address the immediate bridge housing and treatment needs of people experiencing homelessness and another $805 million for adult and senior care facilities, plus more investments for addiction treatment and children and youth behavioral health services. These investments, along with Project Homekey, which rapidly created 12,000 new homes, will ramp up housing opportunities while CARE Court ensures the services are guaranteed for those who will accept them. 

CARE Court provides an option that does not exist today.

If CARE Court becomes law, it will allow us to act earlier to support the most vulnerable people in our communities. This gives them a fighting chance to recover and an opportunity to move from just surviving on the streets to an environment in which they can live with dignity. We can no longer ignore the mental health crisis playing out on our streets. Let’s act now and save lives.

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Todd Gloria previously has written about parking regulations for housing developments. Nathan Fletcher previously has written about preventing suicide among first responders.