A new court system seeks to find a middle road between jail and ignoring the mentally ill, many of whom live on the streets.
A homeless woman sweeps the sidewalk in front of where she'll be sleeping in San Diego on March 24, 2023. Washington Post photo by Melina Mara
In a few months, altering its past path, the state will begin an experiment in what amounts to coercive compassion, an initiative that unlike today’s mental health system will force people into treatment programs instead of jail and monitor their progress for at least a year. Rachel Hayes at an encampment in downtown San Diego on March 24, 2023. MUST CREDIT: Washington Post photo by Melina Mara
“The transformation has to be radical,” said Luke Bergmann, chief of San Diego County’s Behavioral Health Services. “We don’t need something that’s just chipping away at the problem, but a new focus on longer-term solutions to it. What we do know is that things are not working right now.” Care Court will also be an option if a person is involved in a criminal or civil court case and is determined to be unfit to stand trial. The treatment plan itself would rely on a meeting with professional counselors and medication, a course that is reviewed regularly. In either case, the person will have the right to leave the program at any time, risking more severe penalties for doing so that could include jail time or conservatorship.
Craig Moon, who said he has a culinary degree, tries to heat canned beans outside his tent at a homeless encampment in San Diego on March 24, 2023. Washington Post photo by Melina Mara Gloria, who was elected in 2020 partly on a pledge to find new solutions to the city’s homeless crisis, said the city of San Diego alone receives 50,000 mental health-related emergency calls each year, taxing the police, fire departments, emergency response workers and the county court systems.
Deep concerns over the program have already surfaced. Before it is even put into effect, advocates for some of those whom the program is meant to benefit challenged the Care Court rules and resources, filing a petition with the state Supreme Court to have it stopped on constitutional grounds. In mid-April, the state Supreme Court declined to hear the petition. It did so without offering a reason.
That changed in 2004, when state voters passed the Mental Health Services Act, which imposed a 1 percent income tax on individuals making more than $1 million a year. The money was designated specifically for mental health services but not for housing. Other concerns center on the way the Care Court law is being carried out. Although eventually winning its support, the legislation divided the California State Association of Psychiatrists, a 1,500-member organization whose doctors will probably be called on to participate in court evaluations.
“Many of us wanted to expand the pool of folks who would be eligible for this,” Koh said. “It is very difficult to say whether someone is purely schizophrenic or is suffering from drug-induced psychosis.”
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