The California governor’s call to create specialized courts in counties to help homeless people with mental health and substance abuse care and services has received support in San Mateo County, with questions about details and scale remaining.
Don Horsley, president of the San Mateo County Board of Supervisors, supported the proposal but was cautious about its effectiveness without details on how the state would rapidly build the system.
“I think it’s good recognition from the governor,” Horsley said.
On March 3, Gov. Gavin Newsom called for a Community Assistance, Recovery and Empowerment, or CARE Court, to help people with mental health and substance abuse issues get psychiatric treatment, medications and housing. Under the system, all counties would set up a mental health branch of a civil court, with people getting help and support over 12 to 24 months, aiming to help before an arrest. The long-term strategy calls for court-ordered individualized interventions and services, stabilization medication, advanced mental health directives and housing assistance. The plan still requires approval from the Legislature, but it is seen as a starting point to address the growing issues of homelessness and lack of mental health services in the state.
Bart Charlow, CEO of Samaritan House, a mental health professional for more than 50 years, praised the proposal as a needed step to address cracks in the system. Rather than seeing people on the street struggling, he believes it will help correct errors around for decades in the mental health system. Samaritan House is a large nonprofit that offers food and shelter services to people in need in San Mateo County. Charlow believes about 30% to 50% of Samaritan House inhabitants could use this court.
“The plan, if properly funded and administered, is a good one. It’s proven successful in situations like drug courts and homeless courts,” Charlow said. “If done right, the mental health courts are going to improve the situation on the streets for all of us, but especially for the people with mental health challenges and their families.”
Charlow emphasized that the court would only be successful with significant funding and services. Proper help includes funding for specialized housing, wraparound care from mental health professionals, access to medication and talk therapy.
“This is a tall order, but it can be done, and I think we know how to do it,” he said.
While the program is a solid first step, several county officials reiterated calls for more state funding to address the growing problem. Concern also remains that some mental health court options could allow for people being involuntarily held in psychiatric programs or lengthier conservatorships, affecting people’s agency and freedom. Supervisor David Canepa wants more housing and intensive wraparound services like the new Navigation Center in Redwood City and purchasing hotels to house the most vulnerable. He also called for more funding for preventative services, as many under the proposal contend with severe behavioral health issues, including substance abuse.
“It’s a step toward addressing the state’s homelessness problem, but I’m not sure that forcing people into treatment is the right approach or will even work,” Canepa said.
Horsley wanted more state help around community-based organizations, housing, case management help, and solutions for local hospitals that maxed out in beds and availability. He hoped the proposal included significant legislation funding. Horsley suggested updating the Lanterman-Petris-Short Act, or LPS, which outlines the protections and rights available for mental health clients to account for changes and provide more services.
San Mateo County District Attorney Steve Wagstaffe said something needs to be done to create a new standard that allows the courts to help people in need. He stressed giving the courts all the tools required to help those in need. He suggested turning prisons into mental health treatment facilities.
“I do believe that if we do get them before they commit a crime, it would 100% benefit the community. I’m very supportive of that. It’s just making sure that we have the tools to do that,” Wagstaffe said.
In late February, the number of people in county jail was around 879, with those receiving psychiatric services or medication at more than 50%. San Mateo County isn’t facing numbers like San Francisco, but Wagstaffe said people with mental health issues who commit serious crimes could benefit from civil court help.
Marie Jackson, chief marketing officer for LifeMoves, a nonprofit organization in the Bay Area that helps people find housing, said it has a limited number of clients with serious mental health illnesses.
“Some of these individuals would benefit from mandated care, which could, in the future, drastically reduce their contact with law enforcement, incarceration, involuntary psychiatric hospitalizations, and other limiting factors on their freedom. While perhaps not an agency perspective, if used appropriately, it could have a positive impact on both some individuals experiencing homelessness and on the greater community,” Jackson said by email.