VSCalifornia Governor Gavin Newsom has proposed a court program that would force homeless people with serious mental illnesses and substance abuse disorders into treatment. The move comes in response to the worsening humanitarian crisis for people living on the streets, but has raised concerns among disability rights and civil liberties advocates.
The plan would create a “care court” requiring people with serious mental health conditions, such as schizophrenia, to accept treatment while requiring counties to provide services, Newsom said Thursday when the program was announced. .
If people don’t follow through with the forced treatment, they could be placed in conservatorship, a court-appointed form of guardianship that deprives people of their rights to make fundamental decisions about their lives and care.
The homelessness crisis has become the main issue in political races across the state as there are more encampments and more visible signs of people struggling with mental illness on the streets. Some officials have responded with sweeps of tent communities and new policies prohibiting camping in certain places and individuals from sleeping outdoors. The announcement also follows scrutiny of the California guardianship system surrounding the case of pop star Britney Spears, who spent nearly 14 years under a court-appointed conservatorship she says was abusive and controlling.
According to the legislation, the court program would create a mental health branch in county civil courtrooms and counties could face penalties if they fail to provide services. California Health and Human Services (HHS) Secretary Mark Ghaly called it a new “framework” to address “one of the most heartbreaking, heartbreaking, yet treatable challenges we face in our communities. and in our streets.
Ghaly estimated that 7,000 to 12,000 people in California could be eligible. Those arrested or charged could be diverted from the criminal justice system to care court, officials said. Relatives, first responders and others could also refer people to the program, which would not be restricted to homeless people.
“The really important part of the Care Court model is that the court has a responsibility not only to oversee and ensure that the individual is participating in the treatment plan, but that government partners, counties and others, prioritize this people.”
As of January 2020, over 150,000 people were considered homeless in California.
“It’s morally reprehensible”
Officials did not release details on timing or funding. But the announcement quickly raised alarm bells among advocates for homeless people and people with disabilities, who have long opposed involuntary care. Some claim it is ineffective and can violate people’s constitutional rights. Others have said it is counterproductive to use the courts as an answer to the homelessness crisis.
“Subjecting homeless people to forced treatment is extremely draconian, and it would take us back to the bad old days of confinement, coercive treatment and other disenfranchisements targeting people with disabilities,” said policy analyst Eve Garrow. and attorney at the ACLU of Southern California. “It’s morally wrong.”
The problem, said Garrow, was that existing voluntary programs were not sufficiently accessible or effective for “people living on the streets where they must endure extreme deprivation, exposure to violence and the daily trauma of harassment from law enforcement agencies, all of which contribute to and exacerbate mental disorders”.
Guardianships are for the elderly and severely disabled people who the courts find unable to care for themselves, but the Spears case has highlighted how guardianships can erode the most basic rights of individuals – and how difficult it can be to end arrangements.
Jasmine E Harris, a University of Pennsylvania law professor and disability rights expert, said Newsom’s announcement reflected trends across the country, including a growing movement of families pushing for a involuntary treatment in response to the opioid crisis.
But studies have suggested that coercive treatment is often ineffective, and that housing and other services are the most appropriate response for homeless people in crisis, Harris said. She also noted that federal disability rights regulations state that services must be provided in the “least restrictive environment” possible.
“Community services and treatment, when meaningful, will almost always be superior to a restrictive setting where the individual loses all power,” Harris said. “If you expand the power of individuals to be brought to justice or to be disenfranchised, it’s really a slippery slope.”
Garrow noted a 2011 study on involuntary treatment and homelessness, which found forced care had no significant difference in outcomes compared to standard care. A 2014 psychiatric epidemiological review also concluded that the empirical evidence did not support coercive treatment.
“I am disgusted by our streets”
When asked if the Care Court program would expand the use of guardianships for homeless people, HHS spokesperson Sami Gallegos said in an email that the program would seek to “divert people in the need for the pathway to guardianships” focusing on “community placements with robust services, including housing.” is available”.
Harris said the lack of investment in community alternatives often creates a trap: “Even if you say guardianship is ‘the nuclear option,’ if you don’t have any other options available, the nuclear option becomes the only option.”
Newsom told the San Francisco Chronicle there was no time to debate people’s civil rights when communities were faced with “undressed people defecating and urinating in the middle of the streets, screaming and talking to themselves. “.
“I am increasingly outraged by what is happening on the streets,” he said. “I’m disgusted with it.”
Amid growing concern about escalating gun violence and homicide rates, advocates argue that homeless people are themselves victimized at disproportionately high rates.
Ananya Roy, director of the UCLA Luskin Institute on Inequality and Democracy, said the court’s proposal was concerning and part of a trend in California to criminalize homelessness.
“There is apparently a lot of compassion for the homeless,” Roy said, “but it comes with a deliberate and forced state of stripping the homeless of their rights in the name of saving them and doing the good.”