By David M. Greenwald
Executive Editor
Sacramento, CA – Governor Gavin Newsom has proposed a new policy framework—CARE Courts—to provide community-based mental health and substance use disorder treatment services to Californians with the most acute challenges, many of whom are experiencing homelessness.
SB 1338, authored by Senator Thomas Umberg and Senator Susan Eggman, has been moving through the legislature.
While the legislation has had strong support in the legislature and from Democrats, progressives have been concerned about its impacts. The ACLU of Southern California and LA Progressive recently hosted a webinar, “We Oppose CARE Court – and You Should Too.”
USC Law Professor and author Jody Armour said, “We’ve been here before.” He cited the Safer City’s Initiative, 2006. “LA decided it was gonna solve the homelessness problem by cracking down on the down and out and putting more police in the middle of skid row than in any other area in the country, heavily [producing] police citations.”
The idea he explained is that “we’re going to fix the broken people that are the stuff that houselessness is made of, because houselessness is not about lack of affordable housing or lack of jobs, for lack of adequate healthcare. It’s about people lacking personal responsibility and we need to teach ’em personal responsibility.”
But he argued this approach did not work. “Look at how much the houselessness problem grew worse while we funneled literally hundreds of millions of dollars… throwing good money after bad.” He said, “We find ourselves in a much worse condition than when we started that punitive approach.”
He added, “So when we’re looking at people in skid row, we’re not just looking at hapless victims of circumstance, who should be pitied. Rather we’re looking at, we’re looking at symptoms of our own social injustice. We’re looking at people whose plight we are in complicity with the creation of…” He called that “uncomfortable.”
Shonique Williams an organizer with the NO CARE Court Coalition said, “It was very important to amplify a black voice in this space because we were not included in the original conversation. However, it is important to note that black community members will be those disproportionately harmed as black community members are the ones that find themselves at most risk for misdiagnoses of bipolar disorders, schizophrenia, and other psychotic disorders.”
She recognized the work of Assemblymember Ash Kalra. She said, “We were originally told, starting this work, that there would be no elected official that would go up against Governor Newsom, that Governor Newsom wants this bill for his own political agenda. And because of that, other folks in this process and the legislative process would be fearful to speak out in opposition.”
She said that she has now spoken with the Senators and is working her way through the Assembly, “They have all, and I’m saying all that I have spoken to and, you know, we can go back and forth that I have spoken to have said that they know that this bill is harmful to black and brown community members.”
She explained, “The first time I was unhoused, I was 15 years old and no one knows those fears and those dangers and those concerns being out there unless you are the one out there and what it looks like to worry about where your next meal is going to come from, where you’re going to safely lay your head.”
Susan Mizner, Executive Director and Founder of the ACLU Disability Rights Program, said, “We know what works. We know that Housing First works. We know that patient and persistent outreach works. We know that harm reduction works and we know that we currently don’t have nearly enough money for any of those things in the system.”
She argued, “We can’t afford to spend money on this incredibly ridiculous bureaucracy that is just going to add more hoops that is just going to stigmatize and criminalize more people.”
Mizner added, “We know the wealth gap and we know the systemic racism that created the wealth gap. And so we have this systemic problem of increased disability and increased perceptions of disability.”
She also pointed out how expensive the ultimate result is for this program. She said, “The ultimate result that people are shooting for is putting people under conservatorship. That we put them into a locked ward and the LPS conservatorships are supposed to be only for one year, but they cost, I’ve looked up contracts that the state has with these locked facilities and the least expensive ones are still more than a hundred thousand dollars a year. The most expensive ones are over half a million dollars a year per person.”
“So the money that we are spending through this incredibly unnecessary court system, and then locking people up in these institutions would be much more effectively spent by increasing the services, housing, and supports that we know have been effective,” Mizner said.
Paul Boden Executive Director at the Western Regional Advocacy Project said, “This is a political campaign that is harming and oppressing and endangering the lives of poor people, whether they’re homeless, whether they have a mental health challenge, this is about othering them in order to achieve a political goal. This is not unique.”
He continued, “We have mental health courts, substance abuse courts, community courts, behavioral health courts, conservatorship courts, family courts, foster care courts. Like we have all of these court systems around social justice, social humanity issues. And yet we screw people over.”
He said, “We deny we commodify housing and treatment and education. And then we say to the people themselves, well, you ain’t accessing the stuff because you’re not trying hard enough when everybody knows that that’s complete and total BS.”
Susan Mizner noted, “Intuitively, I think we can all understand that coercion when you are trying to work with a trusted medical professional is counterproductive. If my doctor says, take this medicine, I’m gonna lock you up. I’m gonna run screaming from the office, right? And the data shows that is also true.”
She added, “Multiple studies have shown that coerced treatment is no more effective than voluntary treatment. That patient and persistent outreach is what is effective.”
Mizner explained that “virtually any therapist, any professional therapist is going to tell you that, for therapy to be effective, you need what’s called a therapeutic alliance, which is just a fancy way of saying that the person being treated and the person providing the treatment have a good relationship.”
Shonique Williams spoke about her background as a survivor of sexual abuse and pointed out, “So when I think about care, I think it is very detrimental to mental health to survivors such as myself, to not correlate forced treatment with care, to not correlate forced medication with care, because then someone that has experienced things such as myself and has not learned how to advocate for themselves and have not learned how to speak up for themselves, they will confuse that with care.”
Paul Boden pointed out that “we don’t do nothing without street outreach. And making sure that whatever we’re talking about is representing the voices of the people that live in our community.”
He noted that “we talked to over 300 people in San Francisco and 92% of the self-identified people with mental health challenges that they’re dealing with that are unhoused have tried to access treatment and can’t get in.”
He said that “if you’re talking about you have thousands and thousands of people nationwide trying desperately to access treatment, trying desperately to access housing, and you change the criteria for who gets in.”
He said they don’t “care.” He added, “This is about a political agenda to, to get brownie points, to get reelected.” He noted that Newsom has gone from being appointed by Willie Brown to the Board of Supervisors all the way up to governor, “And he’s done it on the backs of attacking poor and homeless people, every step of the process.”
