CARE Court in California: A Primer

by Gloria A Lightheart

In September 2022, Gov. Gavin Newsom signed Senate Bill 1338, creating a mental health court. The Community Assistance Recovery & Empowerment (CARE) court program empowers judges to compel people with mental health disabilities or substance abuse issues to accept psychiatric treatment and medication. The legislature approved the bill on a near-unanimous vote.

In the new system, a court-appointed conservator would make financial and health care decisions, and control a patient’s medication and treatment —including powerful brain-altering drugs that could potentially be delivered initially at an involuntary temporary stay in a residential psychiatric facility. Could this be the housing Newsom promised when he announced his CARE Court plan?

The CARE Court is opposed by more than 40 advocacy organizations for unhoused people, legal, civil rights, human rights, and disability rights groups, including Human Rights Watch and the American Civil Liberties Union, who has called the conservatorship “… the greatest deprivation of civil liberties aside from the death penalty.” Set up by Newsom to get the unhoused off the streets, CARE Court is backed by the California Big City Mayor’s Coalition, including San Francisco Mayor London Breed and San Jose Mayor Matt Mahan.

But one need not be unhoused nor mentally ill, nor diagnosed with substance use disorder to be hauled into CARE Court, even if one hasn’t committed a crime and is not a danger to themself or others. The process requires only a petition to be filed with the Court by a “specified individual” such as a relative, community member or police officer, backed by a signed affidavit from a behavioral clinician diagnosing a person with schizophrenia spectrum disorder or other psychotic disorders. Those who dispute such diagnoses might be suffering from “anosognosia,” or lack of awareness of a mental health condition, according to the Schizophrenia & Psychosis Action Alliance, which preaches “compassionate involuntary intervention.”

Ultimately, it is up to the CARE Court judge to decide whether you have the decision-making capacity to handle your own medical care. If the court decides you do not not, it can deprive you of your right to self-determination.

Originally published in the People’s Tribune