Why It Matters
California lawmakers are moving forward with legislation that could significantly alter the state’s approach to treating severely mentally ill individuals, including those living on the streets. The proposals would create new pathways from voluntary treatment programs into involuntary psychiatric care, a shift that carries major implications for civil liberties, family intervention rights, and the state’s broader homelessness strategy.
What Happened
Two bills aimed at addressing gaps in Governor Gavin Newsom’s CARE Court program recently passed through the Senate Judiciary Committee. The mental health court system, launched in 2023, was designed to help thousands of homeless Californians suffering from untreated psychotic disorders. However, the program has struggled to serve its most vulnerable targets.
As of January, California courts had received 3,817 petitions for CARE Court participation but approved only 893 treatment agreements. The Newsom administration initially estimated between 7,000 and 12,000 Californians would qualify for the program.
Senator Catherine Blakespear, a Democrat from Encinitas, is carrying both proposals. Senate Bill 1016 would allow petitioners to request that a judge order a mental health assessment for individuals unable to comply with voluntary treatment. Depending on the assessment results, a judge could order the person into a conservatorship, which typically involves placement in a locked psychiatric facility and mandatory medication.
The second bill would make it easier for emergency medical technicians and other first responders to refer individuals to the mental health court system.
By the Numbers
California’s CARE Court program has processed 3,817 petitions since its 2023 launch, but has approved fewer than 900 treatment agreements. The approval rate represents less than one-quarter of petitions filed. Initial state projections suggested the program would serve between 7,000 and 12,000 people. The current participation falls well short of those estimates, with families reporting that the most severely ill individuals often cannot be helped under the program’s voluntary framework.
The Debate
Disability rights advocates have raised concerns that the legislation would force more people into unwanted treatment. Samuel Jain of Disability Rights California testified that the bills would add “an expensive, coercive and convoluted layer” to the court system that could drive up costs and erode trust among those the program is meant to help.
Families who have attempted to use CARE Court tell a different story. Many expected judges could order their relatives into treatment, but discovered the program cannot compel care for individuals too ill to recognize they need help. When participants refuse treatment or cannot comply, their cases can be dismissed while they remain on the streets.
Jennifer Farrell, who filed a CARE Court petition for her brother in Alameda County, described the program as lacking critical escalation mechanisms. Her brother, who struggles with schizophrenia and methamphetamine use, was housed through CARE Court for several months before leaving his placement. He spent three months on the street before receiving a conservatorship through a separate process. Farrell said a direct connection between the two systems could have prevented that deterioration.
Zoom Out
The California debate mirrors a national conversation about involuntary treatment for severe mental illness. Several states have expanded civil commitment laws in recent years, citing rising homelessness and public disorder tied to untreated psychosis. New York implemented a policy allowing involuntary hospitalization for individuals who cannot meet their basic needs due to mental illness. Florida and other states have similarly broadened criteria for involuntary treatment.
The tension between civil liberties protections and public safety concerns has defined mental health policy for decades. California historically moved away from widespread involuntary commitment in the 1960s and 1970s, citing concerns about warehousing and overreach. The current proposals represent a measured but significant shift back toward court-ordered treatment for a subset of severely ill individuals.
What’s Next
Both bills must clear additional committee votes before reaching the full Senate floor. If approved by the legislature, the measures would require Governor Newsom’s signature to become law. The debate will continue to center on whether creating pathways to involuntary treatment improves outcomes for the severely mentally ill or undermines their autonomy and trust in the system.
Implementation would fall to county courts and mental health departments already stretched thin by existing CARE Court requirements. The proposals do not include specific funding provisions for the additional assessments, hearings, and conservatorship placements they would authorize.