{"id":723364,"date":"2026-06-08T16:48:56","date_gmt":"2026-06-08T16:48:56","guid":{"rendered":"https:\/\/www.newsbeep.com\/ca\/723364\/"},"modified":"2026-06-08T16:48:56","modified_gmt":"2026-06-08T16:48:56","slug":"relentless-outreach-the-state-that-doesnt-give-up-on-mentally-ill-residents","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/ca\/723364\/","title":{"rendered":"&#8216;Relentless Outreach&#8217;: The State That Doesn&#8217;t Give Up on Mentally Ill Residents"},"content":{"rendered":"<p>One Thanksgiving, while most families gathered around dinner tables, Janina Estrada cruised the neighborhoods of Orange, California, searching for her 42-year-old son Jimmy Barela in the rain. For nearly two decades, he had cycled through schizophrenia, addiction, diabetes, homelessness and psychiatric crises. She knew his usual sleeping spot: behind the dumpster at Jack in the Box. Sometimes he would run from her.<\/p>\n<p>But in October 2023, Estrada believed she finally had a different option: California had just launched the <a target=\"_blank\" href=\"https:\/\/www.ochealthinfo.com\/services-programs\/mental-health-crisis-recovery\/adult-18-services\/community-assistance-recovery\" rel=\"nofollow noopener\">Community Assistance, Recovery and Empowerment (CARE) Court<\/a>, a new program designed for people with severe psychotic disorders. Less a traditional court than a structured intervention, CARE aims to connect people with housing, medication and treatment before they spiral into jail, conservatorship or death.\u00a0<\/p>\n<p>\u201cThese are the forgotten people,\u201d Estrada says. \u201cThey were left behind. I was not about to leave my son out there.\u201d<\/p>\n<p>She filled out the six-page petition herself. Within days, two Orange County behavioral clinicians, Juan Banda and Chauncey Bowie, were assigned to Jimmy\u2019s case. \u201cIf it wasn\u2019t for Juan and Chauncey,\u201d Estrada says, \u201cmy son wouldn\u2019t be here anymore.\u201d<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-27147\" src=\"data:image\/svg+xml,%3Csvg%20xmlns=\" http:=\"\" alt=\"The Orange County Courthouse in Santa Ana, California.\" width=\"1800\" height=\"1200\" data-lazy- data-lazy- data-lazy-src=\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2026\/06\/shutterstock_2321944293-scaled.jpg\"\/>The Orange County Courthouse in Santa Ana, California. Credit: Mike Ledray \/ Shutterstock<\/p>\n<p>They work at one of the most challenging intersections in American mental health care: With their calm, grounded demeanor, they approach people with schizophrenia and other severe psychotic disorders who <a target=\"_blank\" href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC4140620\/\" rel=\"nofollow noopener\">do not know<\/a> they are sick, distrust institutions or experience paranoia so acute that even a greeting can feel like a threat.<\/p>\n<p>Before schizophrenia overtook Jimmy Barela\u2019s life, he had worked as a dental assistant and truck driver, married and raised two children. Over the years, he drifted through shelters, hospitals, jail and conservatorships that never lasted. Police and crisis teams often refused to intervene unless he became violent.<\/p>\n<p>Before CARE, Estrada would call 911 or Orange County\u2019s Mobile Crisis Assessment Team (CAT), \u201calways talking to a different person, always starting over.\u201d Estrada recalls a particularly harrowing incident when her son was running into oncoming traffic during a psychotic episode and she called police. \u201cThey came and gave him a traffic ticket! A traffic ticket!\u201d she repeats, shaking her head at the absurdity, noting that she then had to resolve the tickets for her son. \u201cPeople like him,\u201d Estrada says, \u201cyou can keep him in a clinic, but eventually they have to come out.\u201d<\/p>\n<p>CARE provided reliable, steady outreach in Banda and Bowie, which made a crucial difference for the family.\u00a0<\/p>\n<p>\t\t\t\tWeighed down by negative news?<br \/>\n\t\t\t\tOur smart, bright, weekly newsletter is the uplift you\u2019ve been looking for.<\/p>\n<p>HOPE HAPPENS HERE, oversized block letters declare on the fence outside the Hub Resource Center in Orange. Behind the fence, a young woman in a wheelchair rolls toward a picnic table for a meal. A man drags his laundry toward the washer. A small group gathers for Bible study. Banda often brings clients like Jimmy Barela here first so they can take a shower, get a free meal and wash their clothes. \u201cIt\u2019s all about building trust,\u201c he says. \u201cYou don\u2019t start by telling someone they have to come to court with you. You start by offering them food and asking them what they need. The client leads the conversation.\u201c<\/p>\n<p>That philosophy, supported by <a target=\"_blank\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24881685\/\" rel=\"nofollow noopener\">research<\/a>, has shaped Orange County\u2019s version of CARE. While the state law allows judges to <a target=\"_blank\" href=\"https:\/\/calmatters.org\/health\/mental-health\/2025\/12\/care-court-faq\/\" rel=\"nofollow noopener\">order treatment<\/a> in limited circumstances, Orange County has largely chosen another route: an intensely voluntary model built around relentless outreach, repeated visits \u2014 and a willingness to keep showing up even after a person says no or relapses. \u201cDon\u2019t give up\u201d is Banda\u2019s most important motto: \u201cWe\u2019ll try as often as we can.\u201d<\/p>\n<p>Veronica Kelley, director of the Orange County Health Care Agency, is unequivocal about the philosophy behind it. \u201cCoercion does not work if we want to change things long-term,\u201d she says. The work begins, she argues, not with a summons or a bench appearance, but with a question: \u201cWhat do you need?\u201d<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-27143\" src=\"data:image\/svg+xml,%3Csvg%20xmlns=\" http:=\"\" alt=\"A woman speaks in a courtroom. She has blond hair and wears a green blazer.\" width=\"366\" height=\"411\" data-lazy- data-lazy- data-lazy-src=\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2026\/06\/KelleyOCHealthCareAgency.jpeg\"\/>For Veronica Kelley, the work begins with a question: \u201cWhat do you need?\u201d Courtesy of OC Health Care Agency<\/p>\n<p>Kelley, who was driven to work in mental health due to addiction in her family, says she learned this lesson long before CARE existed. If a person is housed, it could take about 20 visits before trust forms; if unhoused, nearly 40. But once the relationship is established, Kelley says, 90 percent enter voluntary treatment.<\/p>\n<p>Banda spends his days driving between San Clemente and La Habra looking to connect with one of his 26 clients, checking psychiatric wards and visiting the almost invisible spaces where crisis lives: makeshift shelters behind a dumpster, tents under a bridge, jail cells or family homes where relatives have spent years bracing for the next breakdown. Every CARE client is offered housing alongside treatment. \u201cPrograms like CARE Court are needed because this population gets overlooked,\u201d says Banda. \u201cThe program has given attention to this diagnosis of severe psychotic disorders.\u201d<\/p>\n<p>Orange County\u2019s first CARE Court graduate \u2014 a woman with a history of substance use who had never completed treatment before \u2014 has become a symbol of what the program can achieve. She was initially too disoriented to understand why anyone was approaching her but gradually accepted help after repeated visits. With time and patience, she moved into transitional housing and eventually improved enough to begin seeing the possibility of a life beyond addiction.<\/p>\n<p>Jimmy Barela\u2019s example illustrates both the promise and peril of the program. When Banda and Bowie first encountered him at an Arco gas station, he was so unstable they immediately hospitalized him. \u201cThat\u2019s not how we usually do it,\u201d Banda says with a rueful smile, \u201cbut it was necessary. After that, he didn\u2019t speak to us for a month.\u201d Barela, sitting next to him, quietly nods.\u00a0<\/p>\n<p>Over the following six months, they slowly built trust and offered him various housing options, including a motel, a shelter and a halfway house. But Barela missed curfews, relapsed and drifted away. Only after months on antipsychotic medication did his thinking begin to stabilize. \u201cIt took us four months before he signed the care agreement,\u201d Banda recalls.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-27141\" src=\"data:image\/svg+xml,%3Csvg%20xmlns=\" http:=\"\" alt=\"A man holds a graduation certificate. His mom stands next to him.\" width=\"367\" height=\"489\" data-lazy- data-lazy- data-lazy-src=\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2026\/06\/JimmyBarela-scaled.jpg\"\/>Jimmy Barela (pictured with his mother, Janina Estrada) became Orange County\u2019s second CARE Court graduate in January 2026. Courtesy of Janina Estrada<\/p>\n<p>But eventually Barela started seeing a nurse, a doctor and a substance abuse counselor regularly. He now lives in a halfway house, where he enjoys outings to the beach and baseball games. \u201cI like it there,\u201d he says with a smile.<\/p>\n<p>In January 2026, he became Orange County\u2019s second CARE Court graduate. A picture shows him with his certificate and a cake. \u201cHe wouldn\u2019t be here without CARE Court,\u201d Estrada says, patting her son\u2019s back.\u00a0<\/p>\n<p>CARE also functions as an alternative to incarceration and conservatorship. \u201cIf someone commits a crime due to mental illness, CARE Court can get involved to provide treatment,\u201d Banda explains. \u201cIf there is no program like us in place, they have to stay in prison. We\u2019re intervening.\u201d\u00a0<\/p>\n<p>Still, the system\u2019s contradictions remain unresolved. Critics argue that a court-based model is never fully voluntary when it unfolds under judicial authority and the shadow of more restrictive options. Families, meanwhile, often voice the <a target=\"_blank\" href=\"https:\/\/calmatters.org\/health\/mental-health\/2025\/12\/care-court-families\/?series=care-court-california-mental-health-treatment\" rel=\"nofollow noopener\">opposite concern<\/a>: that CARE moves too slowly to save people in immediate danger.\u00a0<\/p>\n<p>California\u2019s struggle over how to treat severe mental illness has swung for decades between competing impulses: institutionalization, deinstitutionalization, coercion and neglect. Since the 1950s, when it was far <a target=\"_blank\" href=\"https:\/\/calmatters.org\/health\/mental-health\/2024\/02\/california-mental-health-history\/\" rel=\"nofollow noopener\">too easy<\/a> to lock away mentally ill patients, California has steadily narrowed the criteria for involuntary psychiatric treatment. The consequences are visible in encampments across most major California cities, though homelessness dropped last year by roughly <a target=\"_blank\" href=\"https:\/\/www.gov.ca.gov\/2026\/01\/08\/california-sees-drop-in-unsheltered-homelessness-bucking-national-trend-and-federal-headwinds\" rel=\"nofollow noopener\">nine percent.<\/a><\/p>\n<p>After he took office in 2019, Governor Gavin Newsom <a target=\"_blank\" href=\"https:\/\/www.gov.ca.gov\/2026\/03\/02\/governor-newsom-announces-new-care-court-accountability-measures-to-get-more-chronically-mentally-ill-off-our-streets-awards-291-million-in-funding-for-services-and-housing\/\" rel=\"nofollow noopener\">promised<\/a> to address the intertwined homelessness and mental health crises as a state priority. He championed CARE but has recently <a target=\"_blank\" href=\"https:\/\/calmatters.org\/health\/mental-health\/2026\/03\/newsom-threatens-counties-care-court\/\" rel=\"nofollow noopener\">criticized<\/a> its slow adoption, including in Orange County.<\/p>\n<p>Kelley understands that frustration, but she resists the premise that force is the answer. Her larger complaint is structural. Orange County can offer services, but it cannot easily fix the housing shortage, the funding gaps or the fragmentation between public and private care. She describes CARE court as an \u201cunfunded mandate,\u201d with one-time state funding that could not be used for staffing. She estimates the county spends about $4 million a year to run the program, pulling staff from its existing assisted outpatient treatment operation to make CARE work. That arrangement has kept the system afloat. But it also exposes a deep truth: the law may have created a new pathway, yet the county still has to build and maintain the road.<\/p>\n<p>The county\u2019s own figures show how labor-intensive the model is. One of the biggest criticisms of the CARE model is that it doesn\u2019t reach as many people as hoped. Since its inception less than three years ago, Orange County has received 231 petitions from family members, first responders or health care providers. Of those, 79 clients are currently active, 27 have entered care agreements and six have completed the program. Dozens more remain in outreach, people not yet ready or not yet found.\u00a0<\/p>\n<p>Statewide, the gap between ambition and reality is even clearer. As of early 2026, more than 3,800 CARE petitions had been filed, resulting in <a target=\"_blank\" href=\"https:\/\/calmatters.org\/health\/mental-health\/2026\/03\/newsom-threatens-counties-care-court\/\" rel=\"nofollow noopener\">893 voluntary<\/a> agreements and 32 court-ordered treatment plans. Those figures fall far short of early projections that estimated 7,000 to 12,000 participants annually.\u00a0<\/p>\n<p>Banda defends the county\u2019s record by explaining the pace reflects the reality of the work. For supporters, that patience is the point. For critics, it reveals the limits of the system. For families like the Estradas, it is at least an attempt to answer a question that has haunted California for years: How do you help someone who does not believe they need help?<\/p>\n<p>The strain on families can be immense. Over years of trying to help her son, 62-year-old Janina Estrada lost her housing because neighbors and landlords complained about Jimmy\u2019s behavior during psychotic episodes. While she and her husband Florencio are on the waitlist for family housing, they live in a white transport van that they regularly pull up in front of Barela\u2019s halfway house to make sure he has eaten and taken his medication.\u00a0<\/p>\n<p>\t\t\t<img loading=\"lazy\" width=\"798\" height=\"170\" decoding=\"async\" src=\"data:image\/svg+xml,%3Csvg%20xmlns=\" http:=\"\" class=\"memb-banner-mob\" data-lazy-src=\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2025\/10\/memb-banner-mob.jpg\"\/><br \/>\n\t\t\t<img loading=\"lazy\" width=\"650\" height=\"300\" decoding=\"async\" src=\"data:image\/svg+xml,%3Csvg%20xmlns=\" http:=\"\" class=\"memb-banner-desk\" data-lazy-src=\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2025\/10\/memb-banner-desk.jpg\"\/><\/p>\n<p>\t\t\t\t\t\tWait, you&#8217;re not a member yet?<\/p>\n<p>\n\t\t\t\t\t\tJoin the Reasons to be Cheerful community by supporting our nonprofit publication and giving what you can.\n\t\t\t\t\t<\/p>\n<p>\t\t\t\t\t<a class=\"donate-link\" href=\"https:\/\/reasonstobecheerful.world\/membership\/\" rel=\"nofollow noopener\" target=\"_blank\">Join<\/a><\/p>\n<p>The family measures success differently now. For Jimmy, the turning point was being welcomed back into his son\u2019s family. A smile unfolds over his face as he recalls holding his granddaughter, seven-month-old Adeline.<\/p>\n<p>What Orange County has built is not a cure, and its leaders do not claim otherwise. The success, Kelley says, is not in hitting a target number of petitions. It lies in saving one life at a time, in helping one person accept treatment, in keeping one family from being abandoned by every system that should have helped sooner.<\/p>\n<p>In Banda\u2019s outreach car, we pass a blue van parked at a Chevron station in Garden Grove with the label \u201cBe Well,\u201d a city initiative to provide medical care on the street. It features the same slogan as the Hub in Orange: Hope happens here.<\/p>\n","protected":false},"excerpt":{"rendered":"One Thanksgiving, while most families gathered around dinner tables, Janina Estrada cruised the neighborhoods of Orange, California, searching&hellip;\n","protected":false},"author":2,"featured_media":723365,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[49,3335,48,84,393,394],"class_list":["post-723364","post","type-post","status-publish","format-standard","has-post-thumbnail","category-mental-health","tag-ca","tag-california","tag-canada","tag-health","tag-mental-health","tag-mentalhealth"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/723364","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/comments?post=723364"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/723364\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media\/723365"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media?parent=723364"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/categories?post=723364"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/tags?post=723364"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}