The governor’s office reports that Proposition 1 has already exceeded goals by delivering 6,919 mental health residential treatment beds and 27,561 outpatient slots. This addresses the frequent complaint that there are not enough psychiatric care facilities to provide extended treatment for the seriously mentally ill, who often are back on the streets after a 72-hour or other short-term hold. Yet, the CARE Act and CARE Court, which were designed to take advantage of the expanded facilities, are reportedly struggling. Gov. Gavin Newsom has flagged Fresno and other counties as underperforming on filing petitions to start the CARE Court process for individuals who would benefit from the new and expanded facilities.
What accounts for this underperformance?
First, there seems to have been little public education about CARE Court and the CARE Act generally. People will not use CARE Court if they don’t know about it or how to use it. Educational outreach should be frequent and designed to reach all audiences. Government and court websites and forms must be accurate and current. In this regard, as of May 17, 2026, the former and more restrictive definition of “gravely disabled,” which allows for certain involuntary holds and affects CARE Court eligibility, was still on the relevant websites of Fresno County and the Fresno County Superior Court. That definition was limited to whether a person, due to a mental illness, was unable to meet his/her needs for food, clothing or shelter. The new definition that was effective on Jan. 1, 2026, now broadly covers “A condition in which a person, as a result of a mental health disorder, a severe substance use disorder, or a co-occurring mental health disorder and a severe substance use disorder, is unable to provide for their basic personal needs for food, clothing, shelter, personal safety, or necessary medical care.”
Another Jan. 1, 2026, expansion of CARE Court eligibility has not been well publicized. A seriously mentally ill person can now be the subject of a CARE Court petition if the person (1) has a diagnosis of schizophrenia spectrum or other psychotic disorders, or (2), newly added, “bipolar I disorder with psychotic features, except psychosis related to current intoxication.”
The expansions should increase the number of individuals who are eligible for CARE Court, such as the person lying in urine on the sidewalk in front of a business. But they are to no avail if people don’t know about the availability of CARE Court or encounter outdated and confusing government websites.
Second, before first responders can file CARE Court petitions, they must have had repeated encounters with an individual. With the expanded definition of “gravely disabled,” multiple contacts should not be necessary. The legislature should remove this requirement.
Third, query how many first responders have been trained on CARE court and the changes. Many first responders who lack time to prepare a petition may not know that they can ask the county to do it. How many people know that they can ask the first responder to file a petition?
Fourth, CARE Court medication orders are not enforceable. Voluntary compliance is unlikely with a severe psychotic. Medication is essential to prevent grave disability and catastrophic harm to self or others.
A bill in the legislature proposes an unduly complex means to enforce a medication order. By a simple amendment, the CARE Court law should give the judge three options, as the judge finds appropriate, for an individual who fails or refuses to obey a medication order: (1) hold the person in contempt of court, or (2) order the person to be involuntarily held and forced to take the medication for up to 30 days, or (3) immediately commence proceedings for a year-long involuntary conservatorship of the person under existing law. The second option of a “mini conservatorship of the person” would hopefully avoid the third option.
Let’s use the new treatment facilities without delay.
Daniel O. Jamison is a retired attorney. He is the author of the forthcoming book from McFarland & Company, Inc., Publishers, titled, “The Birth of Jim Crow: Racism, Reconstruction and the Pivotal Supreme Court Cases of 1857-1908.” Jamison’s op-eds have been widely published around the nation.