Governor Gavin Newsom’s expanded mental health reform law, aimed at involuntary treatment for severe mental illness and substance use disorders, is facing criticism for falling short of initial expectations during its early rollout.
Across 12 of 19 major California counties, 1-year mental health conservatorships increased by less than 5% or even declined following the law’s implementation. Some families who pinned their hopes on ‘CARE Court,’ a court-monitored treatment referral program, are expressing renewed disappointment.
The nonprofit journalism foundation CalMatters analyzed pre-implementation and recent conservatorship data from 19 of the top 25 most populated California counties that submitted comparable figures, publishing their findings on the 11th.
The analysis revealed that total conservatorships across the target counties grew by a mere 4%. Orange County, which applied the new standards starting this January, saw a 2% increase, while Santa Barbara County, an early adopter in July of last year, experienced a 1% decline. Notably, cases where severe substance use disorder served as the sole basis for a conservatorship amounted to only six individuals across three counties.
Previously, Governor Newsom enacted Senate Bill 43, allowing the state to involuntarily detain and hospitalize individuals suffering from severe mental illness or drug addiction. At the time, Newsom argued the legislation would help address California’s surging homelessness crisis and reform the mental health system.
Newsom also significantly broadened the legal definition of ‘Grave Disability,’ the threshold for involuntary treatment. Previously, this was strictly limited to individuals unable to provide for basic survival needs like food, clothing, and shelter due to severe mental illness or chronic alcoholism.
However, clear limitations have emerged in translating short-term protective measures in the field into long-term treatment.
In Los Angeles County, authorities issued over 500 involuntary 72-hour psychiatric holds between January and June of this year specifically citing severe substance use disorder.
Addressing this, health department officials explained that patients frequently regain temporary independence once the drugs wear off during the hold period, meaning they no longer meet the legal criteria for a conservatorship and are consequently released.
Tragic incidents have also occurred amidst these systemic gaps. Tony Pereira died in February from a police shooting in Walnut Creek while experiencing a severe mental health crisis. Pereira’s mother shared that she had pleaded with Contra Costa County authorities for months to help her son resume antipsychotic medication that had previously worked for him, but treatment referrals through CARE Court ultimately failed. She expressed deep regret, believing her son’s life could have been saved had the county aggressively utilized the revised law.
Conversely, frontline authorities and related organizations maintain a cautious stance. Some counties explained that conservatorships carrying a mandate of compulsion decreased simply because they expanded voluntary treatment services during the same period. Additionally, some voices positively evaluated that the new law has improved coordination between mental health departments and addiction treatment services.
Disability rights advocacy organizations have likewise suggested that the long-term effectiveness of the policy requires further observation, given that many counties only began fully applying the new standards this January.
