Eight California counties are going first in a planned statewide, controversial experiment to try to fix a seemingly intractable problem every parent around the table is grappling with: How to get treatment and support for loved ones with serious mental health challenges, mostly schizophrenia and other psychotic disorders.
Some of these people end up cycling in and out of police holds, jails, emergency rooms and homeless shelters and encampments. The nationwide problem is particularly acute in California, which accounts for nearly one third of all people in the United States experiencing homelessness.
Some cities including Los Angeles estimate that 10% to 17% of individuals who are unsheltered have been diagnosed with a serious mental illness. But the fact that so many go without a formal diagnosis, experts say the true percentage is likely far higher.
Diana Burdick’s son used to play guitar in a band, loved to draw pen and ink landscapes and worked for a time as an electrician’s apprentice, his mom says. But for years now, Burdick says, Michael has been wracked by delusions and paranoia and frequently self-medicates with narcotics, mostly methamphetamine.
He doesn’t want any help, she says, because Michael refuses to think of himself as ill at all. “In fact, he thinks that he owns IKEA, and that I have a trust fund with Bill Clinton and that should be giving him monthly checks, and that’s why he refuses to get care because he doesn’t think that anything’s wrong with him. ”
California’s Care Court plan is part of the state Care Act, which passed the California legislature last Fall and signed into law by Gov. Gavin Newsom, who championed the project as a potentially transformative fix for a broken system.
“I’m not interested in the status quo,” Newsom said at the bill signing. “I’m not interested in the compassionlessness-ness of the approach we have today of people moralizing and normalizing that suffering on the streets and sidewalks.”
Care Courts launch as pilots this October in the counties of Glenn, Orange, Riverside, San Diego, Stanislaus, Tuolumne, and the City and County of San Francisco, followed by Los Angeles County in December. Under the plan, a wide variety of people – including family, friends, first responders and clinicians – can petition a judge who could order mental health and other treatment and support under a two-year “Care Plan” that counties’ behavioral health systems have to fund.
“Over time we are really going to give Californians a new tool to support our neighbors who are both experiencing severe behavioral health conditions and the sequelae of those conditions like psychotic disorders and their connection to issues of housing instability, homelessness and the inability to meet basic needs,” says Dr. Mark Ghaly, California’s Secretary of Health and Human Services. “I think that is transformational, that is a game-changer.”
Dr. Ghaly estimates that Care Court will initially serve between 7,000 and 12,000 people across California.
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