{"id":310345,"date":"2026-05-11T14:26:11","date_gmt":"2026-05-11T14:26:11","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-ca\/310345\/"},"modified":"2026-05-11T14:26:11","modified_gmt":"2026-05-11T14:26:11","slug":"care-court-offers-help-to-sacramento-residents-with-psychotic-disorders-but-is-it-enough","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-ca\/310345\/","title":{"rendered":"CARE Court Offers Help to Sacramento Residents With Psychotic Disorders \u2014 But Is It Enough?"},"content":{"rendered":"

<\/a><\/p>\n

This story is part of our May 2026 issue. To read the print version, click here.<\/a><\/p>\n


\n
\n
\nA man is yelling for help. He looks to be about 65, is
\n unkempt and in a wheelchair that he can only roll backward with
\n unsteady feet. I\u2019ve seen him before on my street. Sometimes he
\n says hello; other times he\u2019s engaged with unseen entities. Today,
\n he says that God has abandoned him, and he wants to die. He howls
\n in pain and asks someone to call 911. I look around and realize
\n that I am that someone, and I oblige, even as he ignores my pleas
\n to stay put. There\u2019s a fecal odor coming from the trash bag he
\n carries, and flies circle relentlessly. I wonder, not for the
\n first time, how a human being could reach such a state in an
\n abundant society.\n<\/p>\n

\n A firetruck arrives, and I watch from a distance as EMTs approach
\n the man. He shakes his head, refusing their efforts. The EMTs get
\n back into their engine, and the man disappears into the streets.\n<\/p>\n

\n About a week later, I see him again \u2014 this time, cleaned up in a
\n hospital gown. He\u2019s clear-eyed as he explains that his caseworker
\n got him to the hospital, where he was given a proper meal and
\n scheduled for surgery. \u201cYou have a caseworker?\u201d I ask, but his
\n lucidity is fleeting.\n<\/p>\n

\n I see him a few more times, in varying states of filth and
\n clarity, then never again.\n<\/p>\n

\n For those who live in Sacramento or most any urban center in
\n America, this story may ring familiar. For those who don\u2019t, the
\n apparent ease with which city dwellers walk past someone
\n exhibiting psychosis may seem like apathy. But many will tell you
\n it\u2019s a learned helplessness instilled by decades of
\n live-and-let-live policies concerning mental health and substance
\n use.\n<\/p>\n

Related:\u00a0The Crusading
\n Doctor: Sacramento-based WellSpace Health thrives with a unique
\n approach to homeless and mentally ill patients<\/a><\/p>\n

\n In recent years, however, leaders have changed their tune,
\n responding to a growing sentiment that intervention may sometimes
\n supersede autonomy when it comes to humane outcomes for people
\n with mental illness and their communities.\n<\/p>\n

\n Recent legislation signals that the priority is getting people
\n into treatment, but whether that translates to large-scale impact
\n is less clear.\n<\/p>\n

How we got here<\/p>\n

\n In the mid-20th century, public opinion was turning against
\n psychiatric hospitalization as the standard of care. Concerns
\n about horrendous conditions inside state-run hospitals had
\n entered the national zeitgeist, fueled by reports of patients
\n with very few legal rights living in abject filth and suffering
\n inhumane treatments. Outrage coincided with the advent of
\n antipsychotic drugs, leading to deinstitutionalization in favor
\n of community treatment centers.\n<\/p>\n

\n At least, that was the vision. Pres. John F. Kennedy promised a
\n robust system of community treatment centers, but following his
\n death in 1963, only about half were built, and funding was
\n insufficient.\n<\/p>\n

\n Yet deinstitutionalization continued. In 1967, Gov. Ronald Reagan
\n signed the Lanterman-Petris-Short Act, which placed strict limits
\n on involuntary commitment and effectively emptied the state\u2019s
\n mental hospitals. Among its provisions is the 5150 hold, which
\n permits involuntary placement in a psychiatric facility for up to
\n 72 hours while the detainee is assessed for further treatment. To
\n be detained, an individual must be deemed a danger to themself or
\n others or \u201cgravely disabled,\u201d a designation that carries a heavy
\n burden of proof.\n<\/p>\n

\n \"\"<\/a><\/p>\n

\n Then-California Gov. Ronald Reagan with his family in 1967, the
\n year he signed the Lanterman-Petris-Short Act, which placed
\n strict limits on involuntary commitment and effectively emptied
\n the state\u2019s mental hospitals. (Public domain photo)\n<\/p>\n<\/p>\n

\n The result is the world we inhabit now, one where streets and
\n prisons serve as de facto psych wards. This reality became even
\n more visible in 2011, when Gov. Jerry Brown signed legislation to
\n reduce the state\u2019s crowded prison population.\n<\/p>\n

\u201cCreatures of the law\u201d<\/p>\n

\n California\u2019s current governor has one eye on the 2028
\n presidential election, and a triad of the state\u2019s most visible
\n crises \u2014 mental health, drug use and homelessness \u2014 is a pressure
\n point.\n<\/p>\n

\n As the nation\u2019s most populous state, California has more unhoused
\n people than any other: A 2024 point-in-time count found 187,084
\n individuals. Within that population, 27 percent said they\u2019d been
\n hospitalized due to a mental health condition, and 65 percent
\n reported a history of using amphetamines, cocaine or
\n non-prescribed opioids regularly, according to a 2023 survey
\n conducted by UC San Francisco.\n<\/p>\n

\n \"\"<\/a><\/p>\n

\n An encampment in Oakland. (Shutterstock photo)\n<\/p>\n<\/p>\n

\n In the first year of his second term, Gov. Gavin Newsom signed
\n Senate Bill 43, which broadens the criteria for \u201cgravely
\n disabled,\u201d adding severe substance use disorder as a qualifying
\n condition alongside mental illness and chronic alcoholism.\n<\/p>\n

\n While it\u2019s a meaningful change, it hasn\u2019t significantly altered
\n the landscape in Sacramento.\n<\/p>\n

\n Initially, there was trepidation that SB 43 would overwhelm
\n emergency rooms, but that hasn\u2019t been the case, according to
\n Sacramento County Behavioral Health Director Ryan Quist. That\u2019s
\n because law enforcement officers often can\u2019t tell the difference
\n between a mental health crisis and substance-induced psychosis,
\n taking drug cases to the ER before jail. \u201cWe were already seeing
\n the full volume of folks at the emergency departments prior to
\n the law changing,\u201d he says.\n<\/p>\n

\n Nor has there been an influx of individuals deemed gravely
\n disabled, because substance use disorders and mental illness are
\n often co-occurring.\n<\/p>\n

Related:\u00a0The
\n Capital Region Is in the Vanguard of Autism Research and
\n Treatment<\/a><\/p>\n

\n But there\u2019s another new law that\u2019s wielding more weight. In 2022,
\n Newsom signed the CARE Act \u2014 a significant step toward the
\n community-based treatment system that deinstitutionalization
\n promised but never delivered.\n<\/p>\n

\n An acronym for Community Assistance, Recovery and Empowerment,
\n the CARE Act establishes a civil court process, known as CARE
\n Court, through which people diagnosed with a qualifying psychotic
\n disorder can access wraparound treatment and support services.
\n What makes CARE Court distinctive is that referrals can come from
\n virtually anyone \u2014 a family member, first responder or roommate \u2014
\n not just a doctor.\n<\/p>\n

\n The law has been criticized by some, including Disability Rights
\n California, for potential discrimination and civil rights
\n concerns. Judges can impose a court-ordered \u201cCARE plan\u201d if an
\n individual refuses treatment, but that outcome is rare, according
\n to a 2025 report from CalMatters, and some counties have forgone
\n CARE plans altogether. In Sacramento County, the program is
\n \u201cstrictly voluntary.\u201d\n<\/p>\n

\n CARE Court treads more softly than originally proposed. The
\n initial legislative draft included substance use as a qualifying
\n disorder. Additional amendments further narrowed eligibility,
\n increased the burden on petitioners, prioritized voluntary
\n treatment over court-ordered plans and gave counties the freedom
\n not to provide certain services.\n<\/p>\n

Related:\u00a0Perspective:
\n The Ever-Growing Sacramento Homeless Crisis<\/a><\/p>\n

\n Statewide, enrollment numbers are lower than projected. All
\n counties were required to implement CARE Court starting in
\n December 2024, and rollout has been slow. As of July 2025, just
\n 2,421 petitions had been filed statewide, and only 528 had
\n resulted in treatment agreements or plans, according to a
\n CalMatters survey.\n<\/p>\n

\n Whether the law oversteps or doesn\u2019t do enough is a matter of
\n perspective, says Sacramento County Superior Court Judge Lawrence
\n Brown, who presided over CARE Court in its first year. \u201cWe\u2019re
\n just creatures of the law. We will use the tools that have been
\n provided. If the tools are expanded, we\u2019ll use those tools as
\n well.\u201d\n<\/p>\n

\n \"\"<\/a><\/p>\n

\n Sacramento County Superior Court Judge Jennifer K. Rockwell
\n presides over the county\u2019s first CARE Court graduation ceremony
\n March 17, with graduate Lorenzo Leon and supporters in
\n attendance. (Photo courtesy of Sacramento County)\n<\/p>\n<\/p>\n

\n According to Quist, 144 CARE Court petitions had been filed in
\n Sacramento County as of March 1. No data was provided on how many
\n have resulted in treatment. The biggest challenges have been the
\n paperwork for petitioners and securing more permanent housing for
\n those who complete the program. \u201cThe central issue is that we
\n don\u2019t have affordable housing for those that need it,\u201d Quist
\n says.\n<\/p>\n

\n Even so, Sacramento County outperforms those of a similar size on
\n homelessness and behavioral health metrics. The unsheltered
\n population is down by over 40 percent since 2023, according to a
\n state dashboard, while more than 2,500 people are in full-service
\n partnerships that provide 24\/7 support for those with severe
\n mental illness. The county has also been adding beds to its
\n psychiatric care facilities, according to Quist.\n<\/p>\n

\u201cNo way to live\u201d<\/p>\n

\n Alicia Leon used to go long stretches without seeing her adult
\n son. One of the challenges of having a loved one with a psychotic
\n disorder is that they may be unaware of their condition and
\n distrustful of those who try to help. Alicia\u2019s son, Lorenzo, was
\n living on the streets when her petition for CARE Court was
\n granted last year.\n<\/p>\n

\n \"\"<\/a><\/p>\n

\n Lorenzo Leon enjoys a slice of cake at his graduation ceremony
\n and holds graduation presents with his mother, Alicia. (Photo
\n courtesy of Sacramento County)\n<\/p>\n

\u201cThere was some level of skepticism by
\n the mother as to if this was going to work,\u201d says Judge Brown.
\n \u201cAnd I suspect it was born of, probably, prior frustrations and
\n trying to get assistance for her son.\u201d\n<\/p>\n

\n According to Brown, CARE Court has changed the system by allowing
\n anyone to petition a judge directly. \u201cThis is, to me,
\n unprecedented to have a family member come directly and say, \u2018We
\n need help,\u2019\u201d he says.\n<\/p>\n

\n For Lorenzo, help was given. During his year in CARE Court, he
\n received psychiatric treatment and social services through a
\n dedicated team, checking in with the court each month. CARE Court
\n recipients are also provided with housing options, if needed. But
\n first, they must be located and accept care.\n<\/p>\n

\n Edward Pochay, a behavioral health peer specialist for Sacramento
\n County, spends a lot of time playing detective \u2014 tracking down
\n CARE Court recipients and introducing them to the program. He
\n reads up on their history and tries to understand their
\n perspective before making contact. In Lorenzo\u2019s case, it was a
\n matter of identifying the places he frequented and knowing his
\n preferred nickname. \u201cI would see him standing there and greet him
\n by that name, which brought a secret smile to his face. So I knew
\n we were on the right track,\u201d Pochay says.\n<\/p>\n

\n Lorenzo ultimately agreed to participate. When he left home, his
\n care team would find him and persuade him to come back. Pochay
\n says the lived experience of peer specialists like him makes them
\n uniquely able to establish rapport with people struggling with
\n mental illness, homelessness or substance use.\n<\/p>\n

\n \u201cA seed was planted. That person now knows there are people out
\n there willing to go to great lengths to offer services without
\n any negative encounter, that she can say no without
\n consequences.\u201d\n <\/p>\n

\u2014 Edward Pochay, behavioral health peer specialist,
\n Sacramento County<\/p>\n

\n But they aren\u2019t always successful. He describes a case where a
\n woman living in an encampment littered with used syringes refused
\n all help. \u201cI can be disappointed. I can be let down. But
\n frustration doesn\u2019t factor in, because I cannot imagine what they
\n are experiencing,\u201d Pochay explains. \u201cA seed was planted. That
\n person now knows there are people out there willing to go to
\n great lengths to offer services without any negative encounter,
\n that she can say no without consequences.\u201d\n<\/p>\n

\n Pochay believes voluntary participation is integral to recovery,
\n even if it takes many attempts before someone accepts help. He
\n recalls a recipient referred by law enforcement who was \u201cprimed
\n against the system\u201d but ultimately won over through persistent
\n contact. At a recent CARE Court appearance, he brought Judge
\n Brown a gift and asked him for a hug. \u201cYou could feel the silence
\n in the room for a moment. And then Judge Brown got up from his
\n bench, came around to the podium \u2026 and gave him a hug,\u201d Pochay
\n says. \u201cThat\u2019s what it\u2019s about.\u201d\n<\/p>\n

\n On March 17, Lorenzo Leon became Sacramento County\u2019s first-ever
\n CARE Court graduate. His mother and care team were present at the
\n courthouse to celebrate and share his cake. \u201cBeing on the street
\n is no way to live,\u201d Lorenzo said in a county press release. \u201cSo,
\n you know, I did what I have to do, straightened up so now I have
\n a place to live.\u201d\n<\/p>\n

\n For Pochay, true progress is measured in these moments. Another
\n milestone, he says, was when Lorenzo\u2019s mother started swimming in
\n the mornings. \u201cThat just fills my heart. She was consistently
\n seeing improvement in him to the point where she felt it was her
\n time to do something for herself.\u201d\n<\/p>\n

\n If you or someone you know is experiencing a mental health
\n crisis,
call the 988 Suicide & Crisis Lifeline.\n<\/p>\n

\n \u2013\n<\/p>\n

\n Stay up to date on business in the Capital Region:
\n Subscribe to the Comstock\u2019s newsletter
\n today.<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"This story is part of our May 2026 issue. To read the print version, click here. …\n","protected":false},"author":2,"featured_media":310346,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[32],"tags":[121,123,122],"class_list":["post-310345","post","type-post","status-publish","format-standard","has-post-thumbnail","category-sacramento","tag-sacramento","tag-sacramento-headlines","tag-sacramento-news"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/310345","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/comments?post=310345"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/310345\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/310346"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=310345"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=310345"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=310345"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}