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Gavin Newsom’s CARE Court plan for mentally ill is controversial — and long overdue

Sacramento Bee - 5/20/2022

A truly brilliant college classmate with a debilitating mental illness got in touch with me some years back, looking for help finding a job. By then, I realized that Joe had shown every symptom of schizophrenia even when we were in school.

When we met for lunch, though, he was in worse shape than I’d feared. In fact, he was living in a Washington, D.C., homeless shelter, having spent everything he’d inherited from his parents on advanced degrees from schools that had relieved him of all of his assets and none of his agitation.

I told him the truth, which was that he needed treatment more than job leads, and offered to work with him to find whatever help he needed. Help for what, he kept saying, when his only problem was the many people and institutions conspiring to keep him unemployed. He was yelling by then, as he did every time we talked.

And you know, I’d yell, too, if I had a disease so cruel that it kept me from having any kind of a life, and even from seeing that disease for what it was.

Two years ago, Joe Slovinec died in a shelter in his hometown of Chicago, so alone that for many months, the friends he’d pushed away did not know he was gone.

He never did get any treatment, rejecting all services right up to the end. And died blessedly free of any government intrusion on his freedom to slip away unnoticed.

So you bet I support Gov. Gavin Newsom’s controversial plan to “take some damn responsibility to implement our ideals” by making people like Joe get the care that the symptoms of their *&^% of an illness can keep them from ever addressing.

One of the many criticisms of Newsom’s proposed Community Assistance, Recovery and Empowerment Court is that it’s coercive. And yes, it is, because for people like Joe, it has to be.

What’s most infuriating to me is that even after all these years of seeking solutions, only the scale of the problem of those living on the streets has changed. And while it’s still true that seriously mentally ill people are more likely to be victimized than to be a danger to others, the new P2P meth does make those who take it more violent, causing paranoia, hallucinations, rapid brain damage, and yes, an explosion of homelessness.

As laid out in a deeply reported November 2021 story in The Atlantic, schizophrenia and bipolar disorder normally announce themselves in the young. Now, though, as the result of this purer, cheaper and more plentiful form of meth, “people in their 30s and 40s with no prior history of mental illness seemed to be going mad … In the L.A. area, homelessness more than doubled from 2012 to 2020,” while “the most visible homelessness — people sleeping on sidewalks, or in the tents that now crowd many of the city’s neighborhoods” is “clearly due to the new meth.”

So yes, it’s past time to try some new and even desperate measures, and that’s exactly what Newsom’s proposed Community Assistance, Recovery and Empowerment Court is.

The new system would let family members, first responders and behavioral health providers petition a civil judge to initiate a CARE plan that could last for up to two years.

A friend who runs treatment programs in another blue state sees this is an approach that’s desperately needed. But if she even mentions it, she’s vilified by disability advocates who see forced treatment as a human rights violation that criminalizes mental illness and addiction.

Only, our prisons are already filled with people who are there because they’re sick — and who might not be there if they’d had the kind of long-term treatment that this program would offer.

Critics say it would waste money better spent on education and early intervention, but what about those for whom it’s too late for early intervention?

Senate Judiciary Committee Chairman Tom Umberg says those pushing the plan, as he is, are as concerned as critics are that there’s too little of the housing that’s “a critical component of stabilization, both for treatment purposes and family reunification.”

There’s also a shortage of mental health professionals, who are underpaid and vulnerable to burnout.

But what we’ve been doing for the last 40-plus years has not worked. As state Sen. Scott Wiener, a Democrat from San Francisco, has said, “these are people who are trending toward death.” Their stories do not end well.

And as much as I appreciate the effort to protect their civil liberties, I care more about keeping them alive, and maybe even helping them to have more of a life.

There are thousands of Joe Slovinecs out there, and to keep doing things the same old way is really to give up on them.

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