As California’s ambitious CARE Program expands across the state, Santa Clara County is preparing for its December 2 launch, joining other counties in implementing the new Community Assistance, Recovery, and Empowerment (CARE) Court system. The program introduces a civil court process designed to help adults with schizophrenia or other psychotic disorders access mental health treatment, aiming to reduce homelessness and prevent jail time.
However, despite its potential, the program faces challenges related to funding, workforce capacity, and public expectations.
CARE Program Overview
The CARE Program enables family members, behavioral health providers, or first responders to petition the court to assist individuals with severe mental health needs. The process works collaboratively to develop voluntary treatment plans involving the Santa Clara County Behavioral Health Services Department.
Key features of the program include:
- Voluntary Participation: Individuals can choose whether to engage in treatment, which creates potential barriers for broader impact.
- Outpatient Focus: Treatment is community-based rather than in-patient, limiting immediate visible outcomes.
- Exclusions: The program targets psychotic disorders but excludes other conditions such as bipolar disorder, major depression, PTSD, and autism.
Challenges in Implementation
Santa Clara County officials, while optimistic, recognize several hurdles that could impede the program’s success:
Unfunded Mandates
County Executive James Williams criticized the state’s lack of financial support for the initiative, stating, “New initiatives need to come with the resources to make them a reality.” Without dedicated funding, the county must reallocate resources from other critical services to sustain the program.
Staffing and Resources
The program requires trained behavioral health workers, court personnel, and housing resources. Supervisor Susan Ellenberg expressed concerns about capacity, highlighting existing gaps in inpatient and outpatient treatment slots.
Managing Expectations
Ellenberg cautioned that the program’s limited scope might not satisfy public expectations for resolving widespread homelessness and mental health crises. “The overall impact may not be visible to the average resident,” she noted.
Lessons from Southern California
Counties that launched CARE early, such as Los Angeles and San Francisco, offer insights into the program’s practical challenges and successes:
- Los Angeles County has processed 308 petitions, resulting in 28 CARE agreements and four CARE plans. Officials have found the process slow but impactful, emphasizing the importance of “relentless engagement” to build trust with clients.
- San Francisco has received 47 petitions since implementation, though officials have not disclosed detailed outcomes.
LA County’s experience highlights the effort required to locate and maintain contact with individuals, especially those who are unhoused. Despite systemic obstacles, the program has demonstrated transformative effects for participants, particularly in stabilizing their lives and reducing hospitalizations.
Local Perspective and Readiness
Santa Clara County is learning from these experiences, adapting its approach to ensure a smoother rollout. Supervisor Otto Lee acknowledged the likelihood of lower-than-expected participation but emphasized the county’s readiness to serve residents who qualify.
Incoming Supervisor Betty Duong expressed cautious optimism, citing the benefit of observing other counties’ efforts. “That’s critical to our success,” she said, while acknowledging the strain of managing unfunded mandates.
Advocates Urge Patience
Mental health advocates like Rovina Nimbalkar, executive director of NAMI Santa Clara County, caution against expecting immediate results. “Transforming lives through mental health and substance use treatment is a gradual process that requires sustained effort,” Nimbalkar explained.
Looking Ahead
Santa Clara County’s CARE Program represents a step forward in addressing mental health challenges, though its impact will depend on consistent investment, collaboration, and public patience. While systemic results may take time, the potential for individual transformation offers hope for a more supportive approach to mental health care.
As the program begins, county leaders remain committed to adapting and improving the process, ensuring it meets the needs of the community while addressing the broader mental health crisis in Silicon Valley.
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