Newsom signs CARE Court proposal to help the mentally ill


Brian Lungren and his family wonder what could have spared him some of the 13 years he spent at Napa State Hospital in treatment for mental illness and serious drug and alcohol addiction.

Ever since Brian, or Bri in his family, was diagnosed with schizoaffective disorder, bipolar, his parents have tried everything to save him from an emotionally painful years-long spiral of drug use, incarceration and homelessness.

Her father, Brian Lungren Sr., counted nine temporary, involuntary psychiatric detentions, and up to three unsuccessful attempts at court-ordered guardianship.

It wasn’t until a judge found Brian not guilty by reason of insanity for stabbing another patient with a butter knife at an Auburn treatment center in 2007 that the family was given hope for his eventual recovery. Brian was sent to Napa State Hospital in 2008, after languishing in county jail for several months.

“We tried to give him the best possible help. But we had no recourse,” Lungren Sr said.

Similar stories influenced Governor Gavin Newsom’s decision this year to introduce a sweeping new proposal to order mental health and addictions treatment for thousands of Californians, dubbed the Community Assistance, Recovery and Recovery Court. empowerment (CARE).

On Wednesday, Newsom signed the proposal into law.

“It’s a new paradigm. It’s a new approach,” Newsom said, joined by local officials and families, before signing the bill.

Bri Lungren with her siblings.

(Courtesy of the Lungren family)

CARE Court supporters call it a major transformation in the state’s approach to treatment, a way to divert Californians struggling with addiction and serious mental illness from incarceration and homelessness – while avoiding more restrictive court-ordered guardianship.

An estimated 7,000 to 12,000 of California’s most vulnerable residents are expected to qualify for CARE Court, those at greatest risk of death or deterioration due to their condition.

To initiate a CARE plan, family members, first responders, medical professionals, and behavioral health care providers, among others, can first ask a judge to order an adult assessment. with a diagnosed psychotic disorder who is in serious need of treatment and, often, housing.

If the person meets the criteria, the judge would order a series of hearings and assessments to begin writing an individualized CARE plan, which could include medication, social services and stabilization treatment, as well as suitable housing. to his needs.

A plan would provide, for up to two years, a clinical team, a lawyer and a volunteer coach, a role intended to help individuals understand the options available to them during their treatment so that they can make decisions with some level of autonomy.

The governor and his administration have been careful to describe CARE Court as voluntary because those who qualify can still technically decline to participate.

This did little to dampen intense opposition from a wide network of influential civil rights and disability organizations. They spent much of this year’s legislative session criticizing the CARE tribunal as a way to criminalize mental illness and take away basic freedoms from already marginalized groups.

Legal challenges to the law are expected.

In a scathing letter to Newsom last month, dozens of human rights organizations claimed that CARE Court is ignoring California’s core problems – a lack of affordable housing and support services – to foster a new system that “will only lead to the institutionalization and criminalization of those already isolated on the streets.”

“We fundamentally believe this is a bad idea, one that will be worse in implementation and will have disastrous effects for homeless people,” said Brandon Greene, director of the racial and economic justice program at the ACLU of Northern California.

San Diego County mental health consultant Anita Fisher rejects these arguments.

Fisher said his 44-year-old son, Pharoh, is a doting older brother, sports fan and movie fanatic – until he stopped taking his schizophrenia medication.

“He’s paranoid. He [has] delusional thoughts. He left the house. He begins to medicate himself with illicit drugs, which renders him homeless. Which leads us to wait for him to be arrested. That’s when I can start advocating for his care again,” she said.

After more than two decades trapped in this rut, Fisher said she supports CARE Court even in her “imperfect state.”

“I’ve visited my son in jail and jail more times than I’ve ever in a hospital setting. It shows you there’s a problem,” Fisher said. stop saying, well, it’s a choice. How can that be a choice… for someone who gives up their rights when they don’t understand they’re sick?

Brian Lungren Sr. agreed.

“Do you think 13 years in a public hospital – which my son had to go through because there was no warrant, hammer, force, whatever definition you wanted to use – you think that’s Was it better for him as a person, do you think it was better for society, was it better for the taxpayers? Obviously the answer is no,” he said.

Once an extreme skier who racked up competitive victories and sponsorships from equipment and apparel companies, Brian became unrecognizable to his family as he deteriorated into mental illness and drug addiction.

The Lungrens were in a more capable position than most California families. Lungren Sr. is a lobbyist at a top firm in Sacramento and the brother of former state attorney general and US congressman Dan Lungren. Brian’s mother, Nancy, had a long career in all corners of Sacramento government and worked in the administrations of former governors. Arnold Schwarzenegger and Jerry Brown.

And yet, Brian’s struggles persisted.

“Thirteen years of a young man’s life has been put on hold because groups have opposed any kind of reasonable warrant/force for people who really need help,” Lungren Sr said.

The CARE Court’s implementing proposal, Senate Bill 1338, passed through the Legislature with only two votes in opposition, in the Assembly. The Senate sent the bill to Newsom in late August with a unanimous 40-0 vote.

But concerns remain, particularly about whether California has the infrastructure to implement a new justice system and hire and train the number of mental health workers needed for the surge in cases, in especially in rural communities. Proponents worry that there is not enough affordable, supportive housing available for this population.

Newsom pointed to billions in the state budget to create CARE Court and hire qualified professionals. He has set aside $63 million to help local governments and courts with implementation, and touted the $14.7 billion he has allocated over the past two years to alleviate homelessness. in California. His administration said $1.5 billion included in that pot is available for so-called transitional housing, temporary shelter for homeless people with behavioral health issues.

Newsom also agreed to stagger the law’s implementation by more than a year. Glenn, Orange, Riverside, San Diego, San Francisco, Stanislaus, and Tuolumne counties are to have CARE Court in place by October 1, 2023, and the rest of the state’s 58 counties by December 1, 2024.

Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Assn. of California, said negotiations are still ongoing with Newsom’s administration on how to fully fund CARE Court beyond the initial investments.

“I think the key to our success will be, how will California engage with this long-term issue?” said Doty Cabrera. “Our work in roaming innovation is far from over. We should see this as a beginning, not an end. »

A family poses with Santa with the text "Merry Christmas 2019."

The Lungren family at Christmas 2019.

(Family photo)

CARE Court will not help everyone.

“It can’t help Bri right now. He lost 13 years at Napa State,” Lungren Sr. said. “It’s going to help other Bris. And other relatives. And other sisters, and other brothers. This will keep families together.

(Lungren Sr.’s firm represents the California Chapter of the National Alliance on Mental Illness, a major supporter of CARE Court.)

Last year, Brian was transferred from Napa State Hospital to a “regressive” mental health rehabilitation center. If all goes according to plan, he should be transferred in the next few months to a parole program, the next step once a patient or parolee has stabilized after a long stay in a public hospital and has been judged. eligible for outpatient treatment.

He thinks CARE Court could have speeded up his recovery.

“I say [my family] tried to help me a lot, as much as they could, while facing my hostility because of my instability. When I became schizoaffective, everything was new to me. I had no idea what was going on,” Brian said in a recent Zoom interview with The Times.

Brian has spent the last year in treatment working on ways to identify what he calls his “triggers”, as well as the feelings and thoughts that could lead to a relapse or threaten his progress. His family has a copy of that plan, he said, so they too can recognize those warning signs and intervene.

“Right now, I’m on my baseline. I am completely stable. I’m sober. I am consistent. I do what I have to do. People ask me things and I do them. I’m dependable,” Brian said.

Brian should continue to attend his Alcoholics and Narcotics Anonymous meetings. He hopes to volunteer for the American Society for the Prevention of Cruelty to Animals and spend more time with his sister, Alanna, and brother, PJ.

He can’t wait to eat hot chocolate with his family at Christmas.

Los Angeles Times

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