Against the bleak backdrop of a cold November afternoon in San Francisco, Erica Stone faces a heart-wrenching dilemma. Her twenty-eight-year-old daughter, Monica, has been battling schizophrenia-induced psychosis since she was sixteen. Homeless and living just north of Market Street, Monica adamantly rejects her mother’s offers of psychiatric hospitalization, as she has done on many past occasions. Gripped with anxiety over her daughter’s safety, Monica’s refusal to seek treatment weighs heavily on her mind.
In years past, Erica would have been forced to return home after leaving Monica food and a sleeping bag, heart heavy with her daughter’s continued refusal to accept treatment, yet without any available recourse. However, a recent development in California’s mental health legislation has reshaped this narrative. As of December 1, 2023, the Community Assistance, Recovery, and Empowerment (“CARE”) Act grants Erica the ability to petition Monica into court-ordered treatment.1Community Assistance, Recovery, and Empowerment (CARE) Act, ch. 319, 2022 Cal. Legis. Serv. 1 (West 2024) (codified as amended at Cal. Welf. & Inst. Code §§ 5970–5987 (West 2024)). Now fully implemented across all fifty-eight California counties, the Act establishes a network of civil CARE Courts that can order those suffering from schizophrenia and related psychotic disorders into treatment programs at the community level.2Mary Kekatos, California’s CARE Court Program to Tackle Mental Illness Starts Next Month. What You Need to Know, ABC News (Sept. 25, 2023, 11:10 AM), https://abcnews.go.com/Health/californias-care-court-program-tackle-mental-illness-starts/story?id=103461370 [https://perma.cc/5DTX-8VTP].
Once Erica submits a petition on Monica’s behalf, affirming her eligibility for the CARE program as an individual with untreated schizophrenia, the petition undergoes evaluation by a CARE Court.3Id. For Monica to qualify for assistance through the CARE Act, the court must find that Monica is unlikely to survive safely in the community without supervision or that she is a threat to herself or others without support.4Manuela Tobias & Jocelyn Wiener, California Lawmakers Approved CARE Court. What Comes Next?, CalMatters (Sept. 14, 2022), https://calmatters.org/housing/2022/09/california-lawmakers-approved-care-court-what-comes-next [https://perma.cc/Q2RN-P5Y9]. If the court finds either of these to be true, the Act empowers the court to create a “Care Plan” for Monica that lasts up to twelve months, with the possibility to extend the plan for an additional year.5Id. This Plan may include provisions necessitating Monica’s relocation to emergency housing, mandatory participation in behavioral health treatment, and court-ordered stabilization medications.6Jocelyn Wiener & Manuela Tobias, CARE Court: Can California Counties Make It Work?, CalMatters (July 14, 2022), https://calmatters.org/health/2022/07/care-court-california [https://perma.cc/9ZPG-FSBY].
Created with the goal of connecting Californians suffering with schizophrenia and other related psychotic mental illnesses with treatment “before they end up cycling through prison, emergency rooms, or homeless encampments,” the CARE Act promises to advance upstream diversion from more restrictive conservatorships or incarceration.7Governor Newsom Statement on Introduction of CARE Court Legislation, Governor Gavin Newsom (Apr. 7, 2022), https://www.gov.ca.gov/2022/04/07/governor-newsom-statement-on-introduction-of-care-court-legislation [https://perma.cc/YQ3H-REB6]. However, if Monica fails to comply with her CARE program, she may be referred to conservatorship proceedings with a new factual presumption that no suitable alternatives to conservatorship are available.8Cal. Welf. & Inst. Code § 5979(a)(3) (West 2024) (“[T]he fact that the respondent failed to successfully complete their CARE plan . . . shall create a presumption at that hearing that the respondent needs additional intervention beyond the supports and services provided by the CARE plan.”).
This Note explores the implications of the CARE Act on California’s existing mental health landscape, while also pointing out certain deficiencies in the Act as it exists today. Part I of this Note explores the inner workings of the CARE Court framework, as well as the grounds for challenging a law as “vague” under the Due Process Clause of the Fourteenth Amendment. Part II argues that the CARE Act’s current eligibility criteria are unconstitutionally vague and are thus likely to result in arbitrary and discriminatory court enforcement. Part III goes on to propose possible amendments to the CARE Court framework that aim to protect against these potentially speculative and arbitrary judicial determinations. Part IV acknowledges the inherent limitations of these proposed amendments within the broader context of systemic change while underscoring the short-term necessity of these amendments in defending individuals’ due process rights.
