Success of Gavin Newsom’s plan to tackle serious mental illness may hinge on California housing efforts

State Senator Susan Eggman called 911 on her way to the Capitol earlier this month because a person was standing in the road pouring water on their head in the middle of the lane. turn. It’s something the Democrat said she sees a lot on her commute from her home in Stockton to her job in Sacramento: people with such severe mental illness they can’t protect themselves.

Currently, calling the police is the only option many people have when trying to get help for someone with a serious mental illness. As a result, many end up in emergency rooms and jails and don’t get the care they need, Eggman said. A proposal by Governor Gavin Newsom that Eggman lead the Legislative Assembly would create a new path to help them.

The plan would create a system called Care Court that would allow family, community members, probation officers and others to refer people to services if they have schizophrenia or another mental illness. People could also be introduced into the system if they are suspected of a crime or about to be released from involuntary detention in a mental institution.

“We haven’t been able to reach many of these people,” Eggman said. “Care Court will provide a different on-ramp.”

The proposal, written by Eggman; Sen. Thomas Umberg, D-Santa Ana; and Assemblyman Richard Bloom, D-Santa Monica, is still in the early stages of the legislative process. It aims to help a small but highly visible portion of California’s homeless population, although participation in Care Court is not limited to unhoused people.

Some advocates who have reviewed the latest version of the legislation say it still lacks key details and should come with additional funding, but they say it shows promise.

Others argue this is the wrong approach, as it would force people into treatment, but not provide adequate housing. Even supporters of the plan acknowledge that its success depends on increasing the supply of housing in California to provide shelter and stability for people with serious mental illness.

Newsom’s plan, informed in part by the mental health crisis on the streets of San Francisco, would force people to accept treatment plans issued by Care Court judges. The plan also requires counties to provide these services.

“This is one of the most tragic faces of the homelessness crisis,” said Dr Mark Ghaly, Newsom’s health and social care secretary. “I think it’s really important to tackle one of the most difficult and important aspects of homelessness.

Expanding the range of people who can sue to try to get someone treated could be a major improvement, said Lisa Dailey of the Treatment Advocacy Center, a national nonprofit focused on mental illness issues. serious.

Under the current system, Dailey said there is no follow-up for many people after they are discharged from hospital after a psychotic episode. Eventually, they get sick enough again to be arrested or rushed to the emergency room.

“That’s how you get this kind of revolving door situation where someone goes back and forth between the highest level of restrictive care and nothing,” she said. “It puts law enforcement in the position of having to make clinical decisions, which obviously doesn’t make much sense.”

The care court, or community support, recovery and empowerment court, would provide a way for a court to monitor the person and determine what they need. It would also allow people who know them to decide when they need treatment. Dailey said it would force counties to a uniform standard for the services they must provide to people with serious mental illness.

Graham Knaus, executive director of the California State Counties Association, called the current proposal “a blueprint” that is unclear about how the process would actually work in California’s existing court system and how counties l would administer.

To work, he said, the state would also have to increase its housing supply and hire additional workers to run the program.

In a letter to lawmakers on Tuesday, a coalition of 38 organizations, including the American Civil Liberties Union and Disability Rights California, wrote that they oppose the plan because it would force people into treatment but not guarantee them housing.

“CARE Court is the wrong setting,” they wrote. “The right setting enables people with disabilities to maintain autonomy over their own lives by providing meaningful and reliable access to affordable, accessible and integrated housing combined with volunteer services.

Michelle Cabrera of the Association of County Behavioral Health Directors said the labor shortage is so severe that there are not enough people to implement such a program. She said in particular that low-wage workers, like counselors for substance use disorders, are being diverted from tough behavioral health jobs to jobs in fast food restaurants and Amazon warehouses.

In theory, the proposal could be positive, she said, but it would require more funding to pay behavioral health workers competitively and more affordable housing for the counties in which to place people.

“If this proposal can deliver those things, then we’re in,” she said.

Eggman noted that strong tax revenues in California provided a record amount for affordable housing construction. She also pointed to new laws the Legislative Assembly has passed in recent years to streamline housing construction and accelerate the construction of affordable housing.

The Care Court proposal, SB1338 and AB2830, has not yet been heard in committee, a crucial first step in the legislative process. Newsom said he wanted it passed by June. Ghaly, who serves as the mental health policy focal point in the Newsom administration, said he expects a lively debate on the proposal over the next two months.

One aspect that has yet to be worked out is how Care Court would interact with existing laws relating to the treatment of serious mental illnesses such as Laura’s Law, another scheme that compels people with serious mental illness to seek treatment, has Dailey said.

House Republican Leader James Gallagher said he and his GOP colleagues don’t think the Care Court proposal goes far enough to get people into treatment. The Yuba City Assemblyman described it as a modest step in the right direction, but one that lacks teeth unless the standard for when people can be involuntarily confined and forced to take medication is lowered to include people who do not understand the extent of their own disease. He introduced his own bill which make it easier to coerce these people into treatment expanding the definition of “severely disabled”.

Even if the program works, Ghaly and Eggman acknowledge that it will not be a panacea for the homelessness crisis and will only apply to a fraction of the homeless population.

On the contrary, Eggman said she sees Care Court as an essential part of the solution to the state’s mental health crisis. She introduced eight bills to address the problem, including one that expand the definition of “severely disabled” to include people who cannot look out for their own safety. Strengthening the state’s social safety net will also be key, she said.

“We’re not talking about helping everyone on the street,” Eggman said. “People need to temper their expectations because there is no magic except a lot of hard work to create more housing.”

Sophia Bollag is editor of the San Francisco Chronicle. Email: [email protected]: @SophiaBollag

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