As widespread promises of new behavioral health courts take shape later than expected across California, Santa Clara County is among the last counties to roll out the courts.
A new civil court process known as the CARE Program (or CARE Court) allows anyone from family members to first responders to petition courts to help adults with schizophrenia or other mental disorders. The process will begin Dec. 2 and involve working with the individual and the Santa Clara County Department of Behavioral Health Services to develop a voluntary mental health treatment plan. Supporters hope it will pave the way for people to access community-based services to avoid ending up on the streets or in prison.
Disability rights groups have warned against the idea, but last October, results from other counties that have implemented CARE showed that CARE could be used to address Silicon Valley’s mental health and drug use crisis. They are tempering expectations about how big an impact it will have.
One reason for this is that potential customers who are eligible for the program are not required to participate. Meanwhile, the state has not provided funding to support the 58 counties required to implement the program. This law was signed in October 2022.
County Executive James Williams said he is committed to the program’s success, but called it “another example of a state mandate that lacks the necessary funding.”
“That means other critical services and capabilities will be missing,” Williams told San Jose Spotlight. “New initiatives require the resources to make them happen.”
The success of CARE Court depends on having sufficient behavioral health workers, housing and court staff, including clinicians who can diagnose candidates. Of particular concern is the back-and-forth between courts and county behavioral health workers regarding client evaluations. This especially occurs when people change their mind about participating midway through the process.
Santa Clara County Board of Supervisors Chairwoman Susan Ellenberg said the program’s development has been inadequate, both in terms of the number of people it actually serves and the fact that it provides outpatient, community-based treatment. He said he was concerned that it would set expectations. Opposed to safe placement of hospitalized patients.
“To the extent that the CARE Court process allows high-need populations to enter treatment programs, it is undoubtedly a win for each individual. But the overall impact is invisible to the average resident. , they can be disappointed if a promised program is not delivered as expected,” Ellenberg told San Jose Spotlight. “Additionally, the fact that this program is unfunded only exacerbates the existing challenges of expanding access to inpatient beds, outpatient slots, and more of the workforce in Santa Clara.” The county takes on difficult challenges every day and will continue to move forward with all available resources to expand access to care at all levels of need.”
Supervisor Otto Lee said he has observed counties across the state reporting lower than expected numbers for petitions, public hearings and CARE plans.
“We anticipate a similar situation in Santa Clara County, and we are ready to serve as many county residents as possible who come through our CARE courts,” he told San Jose Spotlight.
Lovina Nimbalkar, executive director of NAMI Santa Clara County, said it’s unrealistic to expect big results from the beginning.
“Changing lives through mental health and substance use treatment is a gradual process that requires continued effort,” Nimbalkar told San Jose Spotlight. “Over time, with consistent implementation and support, homelessness and behavioral health crises in public spaces may begin to decline, but results will require patience and continued investment.”
southern california lessons
Los Angeles County, California’s most populous county, was among the groups that jumped to the front of the CARE line. Since the program’s rollout, authorities have reported 308 petitions and established 28 CARE agreements and four CARE plans. LA County officials have scheduled 81 more CARE hearings through January 14th.
How long does it take Los Angeles behavioral health practitioners to achieve their program vision, from persuading hesitant clients to agree to hearings and evaluations to following up and identifying them later in the process? I am learning.
“Just building relationships took time,” Martin Jones, L.A. County CARE program manager, told San Jose Spotlight. “We approached it through so-called persistence. Someone on our team might have coffee with someone who doesn’t want to talk about what they’re going through. So we… Find something they’re willing to talk about, whether it’s sports or whatever, and then approach them again.”
Jones said this is how his team finds success. But then another challenge arises. It’s about knowing where to find people at critical points in a case.
“If a person doesn’t leave the house and is moving around a bit, the team should find a photo of that person, talk to their loved ones and friends, and find out where they are known to spend their time during the day. “It doesn’t have to be,” Jones said. Said. “Being able to actually engage with people who are initially reluctant to receive mental health services takes a lot of time, creativity and flexibility. It can be a slow and methodical process. there is.”
But while the overall results are yet to be seen, Jones said the impact on individuals has been “dramatic.”
“When it comes to their life trajectories, from incarceration and out of treatment to going back and forth through the justice system and multiple hospitalizations, we have some I’ve seen it in action,” Jones said. “The majority of the petitions we receive are from families.”
Closer to home, San Francisco officials declined to be too specific about the numbers. A spokesperson said the city’s courts have received 47 petitions since the implementation of the CARE program, but declined to say how many resulted in agreements or planned court orders.
program work
People who can file a CARE court complaint include family members, behavioral health providers, and first responders with a history of involvement with the person. The CARE Court excludes people with certain conditions and disorders, including mental illnesses other than psychotic disorders, such as bipolar disorder, major depression, and post-traumatic stress disorder. Mental disorders due to medical conditions such as traumatic brain injury, autism, and dementia are also excluded.
Incoming Santa Clara County Supervisor Betty Duong is one of two new board members who will take over the program and its development.
“I am in regular contact with county staff and have repeatedly been assured that CARE Court has the resources, staffing support and administrative support to deploy,” Duong told the San Jose Spot. told Wright. “When doing something new, and as someone who knows there are already unforeseen challenges with unfunded missions, and many of them looming over us, resources have always been a concern. .”
Duong said Santa Clara County’s advantage is knowing what other counties have already experienced.
“It’s very important to our success,” she said.
Contact Brandon Pho. [email protected] or @brandonphooo on X (previously known as Twitter).
