Supporters argue a treatment plan developed through CARE Court will be less restrictive than alternatives, such as state hospitalization or conservatorship.
To qualify, an individual must be 18 years or older, diagnosed with schizophrenia or another psychotic disorder, deemed likely to benefit from a supervised treatment plan and found to be at risk of harming themselves or others.
A recent analysis by the Benioff Homelessness and Housing Initiative at UCSF and the California Policy Lab found that, based on data from hospital emergency rooms and the criminal justice system, upwards of 760 people in San Francisco might be eligible for referral to CARE Court when the program begins in October. Some experts expect the number to be more than 1,000.
Ensuring counties have enough funding to run the new CARE Courts is a concern shared by critics and supporters alike. Among the agencies involved in implementing CARE Court will be the Superior Court, the Department of Public Health, the Human Services Agency, the Department of Homelessness and Supportive Housing, the City Attorney’s Office and the Public Defender’s Office.
San Francisco City Attorney David Chiu said each participant will be required to go through five court hearings before a treatment plan is approved. But, he said, the state hasn’t allocated any additional funds for that.
“In addition to the work our office is going to do, there’s the work of, say, public defenders and other advocates, work of the court itself. And all of these actors are going to need additional resources,” Chiu said.
And, once someone has a treatment plan in place, San Francisco social worker Charlie Berman said, it isn’t clear whether the city’s existing facilities will be able to absorb new patients. For the past decade, Berman has worked on the streets of San Francisco with people suffering from severe mental illness — exactly the population CARE Court targets.
“I think CARE Court really isn’t going to do much of anything more than the existing programs we have, because those existing programs are already not really able to do their job as well as they should due to lack of capacity,” he said. “And that means so many people who are cycling in and out of the [psychiatric] emergency room aren’t getting inpatient services because half the people at S.F. General [Hospital] are awaiting placement.”
Supervisor Hillary Ronen is frustrated and worried that CARE Courts will simply shift attention and funding away from other programs aimed at helping the city’s unhoused population, including those with serious mental illness.
“It’s not the design of CARE Court that I have a problem with,” she said. “It’s the constant diversion of attention and strategies and the inability to just stick with one strategy and see it through.”
Ronen added, “Overall, the diversion from everything that we were already doing in San Francisco towards implementing CARE Court is a net negative for the city.”
Breed — who may ultimately be held accountable for the success or failure of the program — dismisses those concerns.
