SAN FRANCISCO — California has taken a significant step to address the ongoing mental health crisis with the launch of the CARE Act Court program.
Designed to provide early intervention and support for individuals suffering from severe symptoms of untreated mental illness, the program aims to prevent more restrictive measures such as conservatorships or incarceration.
Judge Michael Begert, who presides over all CARE Act Court matters at the Superior Court on Polk Street, explains, "One major change is that a lot of different people can file a petition under this new law. It used to be that the decision to bring someone to court to address their mental health issues was in the criminal system, the District Attorney, the conservator, the department of public health."
This means that family members, roommates or any witnesses to an individual's mental health struggles can request a judge's intervention. If they meet the qualifications, the Court will oversee the development of a CARE Plan, with the Department of Public Health playing a crucial role in this process.
Dr. Angelica Almeida, Director of Adults and Older Adults at the Department of Public Health, highlights the department's responsibilities, which include consulting on cases and investigating petitions filed with the court.
She explains, "We'll be responsible for consulting on cases, so if anyone has questions, we can consult if someone is appropriate for Care Court. But also when petitions get filed with the court, the Department of Public Health will be responsible for investigating, providing reports back to the court."
San Francisco has been proactive in expanding mental health services, adding over 350 new treatment beds for mental health and substance use disorders to the existing 2,200 beds, with more in development.
These services encompass residential treatment, medication management, case management, therapy, and crisis services, among others.
The CARE Act Court program provides participants with access to these services for up to 12 months, with the potential for an extension. Importantly, the Court offers consistent oversight, prioritizing relationship-building between participants and judges rather than punitive measures.
Melanie Kushnir-Pappalardo, LCSW, emphasizes, "Because this is a civil court and not a criminal court, we can't force services. We really are focusing on the relationship building between the judge and the potential participant. In order to make them feel comfortable, we won't have the judge wear a robe or sit on a bench. We'll be having a conversation."
While conservatorships remain a last resort for individuals who refuse treatment, Judge Begert is optimistic that the CARE Act Court program can provide much-needed support before such measures become necessary.
He states, "If you come before a judge, even if I don't have the power to impose any kind of penalty on you. You're not going to go to jail … I'm not going to fine you, but I can say, you really need to do this. And I'm telling you, you have to do it. A lot of people will do that because we put some credibility in these institutions."
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