Mental health court is set to begin Monday in Stanislaus County. Can it reduce homelessness?

Starting Monday, a program including Stanislaus County and the Superior Court will try to assist people who aren’t getting treated for severe mental illness.

Stanislaus is one of seven counties in the state’s CARE Court pilot program aiming to get people with untreated mental disorders off the streets and into housing and treatment. Many of these adults are not sheltered and exhibit behavior that could lead to injury or incarceration.

The CARE (Community Assistance, Recovery and Empowerment) Act requires counties to provide services for people with severe untreated disorders, such as schizophrenia, through voluntary or court-ordered treatment plans.

“Stanislaus County has a rich history of implementing innovative mental health programs,” said Ruben Imperial, assistant county executive officer. “As the CARE Court program emerged, we were one of the counties the state reached out to and invited us to participate.”

Stanislaus, Tuolumne, Glenn, San Francisco, Orange, Riverside and San Diego counties are rolling out their programs next week. Los Angeles is slated to begin court-mandated treatment in December, and other counties are expected to implement programs in December 2024.

The county expects 90 to 100 people will participate in CARE Court the first year. Counties implementing the CARE Act could assist 12,000 people, statewide.

Imperial said family members, behavioral health staff, first responders, hospital directors or friends can petition the Superior Court for a mental health evaluation of someone who needs help. One criteria is that the illness has become so severe it’s impairing their daily functioning and decision-making.

Families may file a petition for a loved one whose untreated condition is becoming more severe and is impacting their daily living, Imperial said. A roommate may also petition the court.

A judge will review petitions and may order a care team to perform a mental health assessment and develop a plan for treatment if needed. County Behavioral Health and Recovery Services will work with the individual and the person’s appointed attorney to design a plan that may include mental health care, medication and housing.

County behavioral health staff will keep tabs on the individual through the treatment process.

Improving access to mental health treatment for homeless adults is a priority, but people who are not currently homeless are eligible for CARE Court. Imperial noted that adults who meet the CARE Act criteria probably are not employed anymore and risk losing their housing if they are not already homeless.

CARE Act petitions can also be submitted for people in crisis who’ve received emergency psychiatric care multiple times because they don’t get outpatient treatment for mental illness. In addition, some criminal defendants can be diverted from court proceedings to CARE court.

County officials don’t expect CARE Court will eliminate homelessness. But they hope it will be a lifesaver for many and divert people with mental illness away from restrictive conservatorships, arrest or incarceration, while giving them support in the community.

Under law, people can’t be forced to take medication. But there could be consequences for those not complying with a court-ordered plan, depending on how the CARE Act statute is interpreted.

The CARE Act says if a person is failing to participate in the process, the judge may terminate the plan. In that event, the statute says “the court shall provide notice to the county behavioral health agency and office of the public conservator and guardian”.

The person’s failure to complete the CARE plan will be considered if there’s a subsequent conservatorship hearing in court, the statute says.

County officials have interpreted that to mean a person not complying with CARE Court has a greater chance of placement in a restrictive conservatorship. But those questions are left up to the court, Imperial said.

Judge Ruben Villalobos, who will preside over CARE Court in Stanislaus County, said Thursday it’s not appropriate to give his interpretation of the statute ahead of time. But philosophically, he said, it’s clear CARE Court is a voluntary program and he will do everything within the law to encourage participants to cooperate with treatment.

“I will be inviting all parties to look at outside-the-box ways to access services,” Villalobos said. “I am not looking at what happens if they fail. I am looking at what we can do to help folks succeed.”

The Superior Court will hold CARE Court once a week (Mondays) to start with and will devote more court time depending on the number of petitions, Villalobos said.

Imperial said the first year will be a learning process for counties and courts in the pilot program, and what is done about noncompliance may be handled differently in each county.

Stanislaus, as one of the first counties, was expecting to receive $3.7 million from the state for planning and implementation. County BHRS added 15 staff positions for CARE Act services.

The state has said housing is an essential component of mental health care, so CARE Court participants will have priority for what’s available in the county, whether it’s an adult residential facility, board and care home or supportive housing, Imperial said.

Imperial said a court website was created with information on filing petitions. The court starting Monday will accept petitions at windows 10 and 11 in the Family Law lobby at 1100 I St. in Modesto. The website says forms can be filed electronically and assistance is available from the Self-Help Center.