How Gov. Gavin Newsom\u2019s ambitious plan to force more people into mental health treatment left many families still searching for help.<\/p>\n
Families of people with serious mental illness, behavioral health experts and policymakers have been asking this question for years. People dealing with psychosis often struggle to address basic needs like food, shelter and hygiene. But their paranoia or delusions can lead them to reject family members and support. About half of people with serious mental illness<\/a>\u00a0do not believe they are sick.<\/p>\n California Gov. Gavin Newsom set out to solve this chronic challenge when he introduced CARE Court in 2022 \u2014 an ambitious plan to roll out courts that could more easily get people with serious mental illness off the streets and compel them into treatment.<\/p>\n \u201cThis is critical help for exhausted and financially stressed families that have been trying to help relatives stuck in dark, unimaginable pain on their own,\u201d he said in his 2024 State of the State address<\/a>.<\/p>\n Many families \u2014 desperate after watching their loved ones cycle through incarceration and homelessness for years \u2014 cheered the new initiative. But advocates and some behavioral health experts said forcing someone into treatment was a step too far.\u00a0<\/p>\n To unpack how CARE Court has turned out so far, Marisa Kendall and her colleagues at the nonprofit newsroom CalMatters dug into the numbers<\/a>, spoke to families who\u2019d used these courts<\/a>, and interviewed first responders, policymakers and mental health advocates for a series called Courting Disappointment<\/a>. We talked with Kendall about what she and her colleagues learned, including why so many of the families who initially supported CARE Court have now turned against it.<\/p>\n We hope you\u2019ll find a quiet moment to listen to the full episode or read the transcript. We start the episode with June Dudas, who turned to CARE Court after spending 40 years trying to help her schizophrenic cousin. Dudas\u2019 hopes and heartbreaks exemplify the struggles many families are grappling with as they attempt to help some of the country\u2019s most vulnerable and hard-to-reach people.<\/p>\n Episode Transcript<\/p>\n Dan Gorenstein (DG): America\u2019s homeless problem can feel intractable.\u00a0<\/p>\n The number of people on the streets is at an all-time high<\/a>.\u00a0The worst off are struggling with mental illness and addiction.\u00a0<\/p>\n Newsclip: Nowhere is that problem more visible than California.<\/p>\n \u200aNewsclip: \u200aCalifornia is home to the nation\u2019s largest homeless population<\/a>.<\/p>\n \u200aNewsclip: One in four has a serious mental illness.<\/p>\n DG: Four years ago, California Gov. Gavin Newsom proposed a controversial solution: make it easier to force people into treatment.<\/p>\n Gavin Newsom<\/a>: I mean, we could hold hands, have a candlelight vigil, talk about the way the world should be or we could take some damn responsibility to implement our ideals. And that\u2019s what we\u2019re doing differently here.<\/p>\n DG: He called it CARE Court. In this new court, a judge could order treatment<\/a> for people who didn\u2019t want help.\u00a0<\/p>\n To many families of people living on the streets, it felt like someone was finally listening.<\/p>\n Marisa Kendall (MK): People were expressing hope for the first time in years, sometimes decades.<\/p>\n DG: But a few years in, those hopes have soured.\u00a0<\/p>\n June Dudas (JD): \u200aI felt like someone just punched me in the gut and said, you fool, you fool. Why did you get your hopes up?<\/p>\n DG: Today, how California\u2019s bold new program to help people with serious mental illness failed to meet expectations and what it means for the families left searching for help.<\/p>\n From the studio at the Leonard Davis Institute at the University of Pennsylvania, I\u2019m Dan Gorenstein. This is Tradeoffs.<\/p>\n *****<\/p>\n DG: CARE Court came at a point of desperation.\u00a0<\/p>\n Nationwide, people with serious mental illness are jailed 2 million times<\/a> a year.\u00a0<\/p>\n That\u2019s why so many families welcomed this new court.\u00a0<\/p>\n Finally, they hoped, there would be a way to compel their loved ones into treatment instead of jail.\u00a0<\/p>\n To understand why so many who initially cheered Care Court have now become disillusioned, I called up June Dudas.<\/p>\n June. Hi. Nice to meet you.<\/p>\n JD: Good morning. Nice to meet you too.<\/p>\n DG: You know how some cousins grow up like siblings? That\u2019s how June described her relationship with her cousin Ed.<\/p>\n JD: \u200aBefore he got ill, I would\u2019ve gone to him for anything because I\u2019d know he\u2019d always be in my corner. He was just that kind of person.\u00a0<\/p>\n DG: Ed changed when he and June were in their 20s.\u00a0<\/p>\n Schizophrenia took over his mind. Voices only he could hear caused him to fly into unprovoked rages.<\/p>\n JD: It\u2019s so opposite. It\u2019s like almost like a Jekyll and Hyde.<\/p>\n DG: June has spent 40 years trying to help her cousin Ed get and stick with treatment, to break the cycle of homelessness, incarceration and state mental hospitals that he\u2019s been trapped in.<\/p>\n She told me about a harrowing day last March that typifies how hard it\u2019s been.\u00a0<\/p>\n Ed was getting out of his most recent prison stay. Within 24 hours, June\u2019s Aunt Joanne texted her. Ed was outside.\u00a0<\/p>\n JD: \u200aHe\u2019d been released like at 9:30 in the morning, up past Sacramento and he just beelined it to her house.\u00a0<\/p>\n DG: Ed\u2019s mental illness has convinced him that he needs to kill Joanne, his 84-year-old mother.<\/p>\n Joanne has had a restraining order against her son for years.<\/p>\n So when Ed showed up, June did what she\u2019s done so many times before.<\/p>\n She drove the 10 minutes to her aunt\u2019s house and called 911.<\/p>\n JD: I sat in my car, away from the house because I didn\u2019t want Ed to know I was there. \u200aI watched him and saw him on the front porch just talking to himself and being really erratic and my aunt in the meantime is locked in her bathroom. <\/p>\n \u200aI\u2019m texting her on the phone because she refuses to talk on the phone to me. It\u2019s such a small house, it\u2019s old, and she\u2019s just convinced that he\u2019s gonna hear her. I\u2019m telling her, you need to go get your water. He\u2019s at the end of the driveway. He\u2019s not gonna hear you.<\/p>\n DG: \u200aIt seems like in this moment, right, you and your aunt are in between a rock and a hard place. Like you don\u2019t want him to be arrested, but at the same time, your aunt is all but like a hostage in her bathroom.<\/p>\n JD: Yes. And every single time we would have the same conversation. Every single time she would say, I hate that we have to call the police. And every time I would tell her, I understand that. I don\u2019t wanna have to call the police either, but it\u2019s the only hope we have of him getting help. And you can\u2019t live like this.\u00a0<\/p>\n DG: \u200aThat day must have been agonizing.\u00a0<\/p>\n JD: It was mostly just so incredibly disappointing. I\u2019m just watching him pace and I\u2019m just like I can\u2019t even believe this. I can\u2019t believe all this time and money and, everything has been invested into this human being. And he\u2019s probably worse than he was before. It was just so frustrating and just incredibly sad.<\/p>\n DG: The situation June is describing is exactly why California created CARE Court. Thousands of families across California say they\u2019ve tried everything to help their loved one get well. CARE Court was supposed to put them in front of a civil court judge and a treatment team, instead of jail.\u00a0<\/p>\n The same scene kept happening to June and her aunt over and over again for the next several months. Ed on the porch. Joanne texting June. June calling the police.\u00a0<\/p>\n Scared for her aunt, heartbroken for her cousin, June finally reached her breaking point one Sunday morning in July.<\/p>\n She called a crisis line for families of people dealing with mental illness.\u00a0<\/p>\n JD: I said, I just, I don\u2019t know what to do.\u00a0<\/p>\n He\u2019s used weapons repeatedly. And his voices tell him to kill his mother. And he\u2019s been diagnosed with schizophrenia and bipolar disorder. I\u2019ve explained. Every time I call 911, they hear my spiel, but it hasn\u2019t made a difference.<\/p>\n She said, well, have you heard about. CARE Court. And I said, no, what is that?<\/p>\n She told me that it was a program that could force him into treatment and I\u2019m thinking, why didn\u2019t somebody tell me this before when every single time I\u2019m calling I\u2019m saying this and they\u2019ve had so many 9-1-1 calls.<\/p>\n DG: CARE Court was a little more complicated than June was told.\u00a0<\/p>\n She\u2019d have to submit a detailed application<\/a>, and Ed would have to meet a narrow set of criteria to qualify.<\/p>\n But the ability to force someone like Ed into treatment \u2014 that was how the program was pitched.<\/p>\n June was ecstatic, so ecstatic that when she got a text from her aunt later that day, saying Ed was back on the porch. June felt a flicker of hope.\u00a0<\/p>\n JD: \u200aI went, okay, okay. Well, if we can get the police to show up in time and they can arrest him, then he can be in jail and they can do the assessment. I was like, okay, okay. This is actually good news.<\/p>\n DG: June spent half of a two-week vacation pulling together Ed\u2019s Care Court application.<\/p>\n She struggled with some of the items she needed to build her case.<\/p>\n His hospitalizations hadn\u2019t been recent enough. The psychiatrist who had diagnosed Ed had long since passed away.<\/p>\n She dug through years of emails to piece together her cousin\u2019s mental health history and arrest record.<\/p>\n After she sent it off, a county clinician went to the jail to assess Ed first-hand.<\/p>\n JD: \u200aWhen I heard that somebody from the county was actually gonna go down to the jail and sit across from him, I just was so happy that somebody would actually see him who was going there with an eye on helping him. It was just the best feeling. I thought it can only get better from here.<\/p>\n DG: Right. I mean, Ed meets all the criteria. He\u2019s got schizophrenia, isn\u2019t clinically stable enough to take care of himself. But that clinician, she doesn\u2019t ultimately recommend him for CARE Court.<\/p>\n Why?\u00a0<\/p>\n JD: She said well, the criteria for CARE Court, was that he had to voluntarily, join the program.<\/p>\n \u200aShe was the first person who told us that he also has another diagnosis of Anosignosia, if I\u2019m pronouncing that correctly, which means that he doesn\u2019t even realize he is sick.<\/p>\n So she\u2019s telling me even though he doesn\u2019t realize he\u2019s sick and he\u2019s very, very sick, I have to recommend dismissal because he won\u2019t volunteer for a program that he doesn\u2019t think he needs.<\/p>\n And I said, you know, that sounds crazy. Right? That doesn\u2019t make any sense at all. And she said that\u2019s the way the program is set up.<\/p>\n DG: I mean this is literally the opposite of what you were told on that crisis line.<\/p>\n June, in that moment, did you feel duped?\u00a0<\/p>\n JD: I felt like someone just punched me in the gut and said, you fool, you fool. Why did you get your hopes up?<\/p>\n I just fell apart. I\u2019m like, I can\u2019t even believe this. All of that for nothing. I did all of that work for nothing. I got my aunt\u2019s hopes up. How do I call her? How do I call her and tell her that we\u2019re nowhere and that the people we thought cared and were going to help him. Can\u2019t and won\u2019t.<\/p>\n DG: You and your aunt had one more chance to be heard. You went before a care court judge to plead for Ed to be forced into treatment. We asked you to record Joanne reading from the testimony she gave that day.<\/p>\n Joanne: Each time he is released I live in fear of what he might do to me. The night he threatened me with a weapon and then chased me into the street at 3 a.m. is etched in my memory. Despite an abundance of love and all of the money I could afford on my low income, he\u2019s deteriorated further and further.<\/p>\n DG: That\u2019s testimony that\u2019s presented in court and still the judge said she could not force Ed to go into treatment. June, what did it mean to you to listen to your aunt repeat 40 years of history, only to be told there was nothing to be done for Ed?<\/p>\n JD: \u200aI was sitting next to her. She is home bound and disabled, so they let her do her testimony virtually.\u00a0<\/p>\n And then to watch the judge then explain that she could do nothing, that the law would let her do nothing, even though she saw the danger to my aunt, the fear that my aunt had.<\/p>\n My head was swimming with how did we end up here? What, what is this program even for? My aunt just slumped in her chair.<\/p>\n And then, you know, the judge asked her, you know, do you have any other questions? And my aunt said, well, yeah, what do I do when he shows up again?<\/p>\n And it just broke my heart because I felt like I\u2019d failed her. I thought I must not have filled it out the right way.<\/p>\n I, there must have been something else I was supposed to say or somebody else I could have talked to. But this can\u2019t be how this is supposed to work.<\/p>\n DG: What are you feeling right now in this moment, June?<\/p>\n JD: Like, it\u2019s just a nightmare, you know? I mean, he gets out, he\u2019s getting up jail soon, and I, I feel like the nightmare of 2025 is just gonna repeat again in 2026 and I dunno how to stop it.<\/p>\n \u200aAnd then I just feel like the people that have the power to do something just don\u2019t care enough or just don\u2019t have the backbone enough to make the changes to the law that need to be made to protect these people. And that just is so cruel.\u00a0<\/p>\n DG: \u200aAs you just said, Ed\u2019s gonna get outta jail in March. This is after violating his restraining order 21 times last year. 21 times. And I know you\u2019ve decided to go visit him to try to convince him personally to get help. Do you have any thoughts about how you\u2019re gonna try to approach this?<\/p>\n JD: \u200aI just really, I want to approach him as somebody who cares about him, because I feel like the system just, wants to lock him in a cell<\/p>\n And it\u2019s not their problem anymore. I just want him to know that somebody cares about him and that we all do. But I\u2019m afraid. That he\u2019s just going to reject me. So, my objective is really just to try to get him to trust me enough that we can have a conversation about the hell that he\u2019s living in, in his mind. Maybe I can get him to see that through treatment he could have a better life.\u00a0<\/p>\n DG: Final question, June. Who do you think Ed could be if he got the help he needed?<\/p>\n JD: The only thing I can go back to is the second time he got out of Patton State Mental Hospital. They\u2019d forcefully medicated him for over two years.<\/p>\n And he was just, he was Ed, he was the best version of Ed that he could possibly be. He was sweet and loving and full of life and so happy to. Be out experiencing the world again, and to get to spend time with family<\/p>\n That\u2019s the person I picture.<\/p>\n DG: \u200aJune, thanks so much for taking the time to talk to us on Tradeoffs.<\/p>\n JD: Thank you so much.<\/p>\n DG: When we come back, we\u2019ll talk to CalMatters reporter Marisa Kendall, who explains why CARE Court is falling short of so many families\u2019 expectations.\u00a0<\/p>\n BREAK<\/p>\n DG: Welcome back. I wanted to better understand why June\u2019s experience with CARE Court turned out the way it did, so I turned to CalMatters reporter Marisa Kendall.\u00a0<\/p>\n CalMatters is a nonprofit newsroom covering all things California.\u00a0<\/p>\n