How Gov. Gavin Newsom’s ambitious plan to force more people into mental health treatment left many families still searching for help.
Families of people with serious mental illness, behavioral health experts and policymakers have been asking this question for years. People dealing with psychosis often struggle to address basic needs like food, shelter and hygiene. But their paranoia or delusions can lead them to reject family members and support. About half of people with serious mental illness do not believe they are sick.
California Gov. Gavin Newsom set out to solve this chronic challenge when he introduced CARE Court in 2022 — an ambitious plan to roll out courts that could more easily get people with serious mental illness off the streets and compel them into treatment.
“This is critical help for exhausted and financially stressed families that have been trying to help relatives stuck in dark, unimaginable pain on their own,” he said in his 2024 State of the State address.
Many families — desperate after watching their loved ones cycle through incarceration and homelessness for years — cheered the new initiative. But advocates and some behavioral health experts said forcing someone into treatment was a step too far.
To unpack how CARE Court has turned out so far, Marisa Kendall and her colleagues at the nonprofit newsroom CalMatters dug into the numbers, spoke to families who’d used these courts, and interviewed first responders, policymakers and mental health advocates for a series called Courting Disappointment. We talked with Kendall about what she and her colleagues learned, including why so many of the families who initially supported CARE Court have now turned against it.
We hope you’ll find a quiet moment to listen to the full episode or read the transcript. We start the episode with June Dudas, who turned to CARE Court after spending 40 years trying to help her schizophrenic cousin. Dudas’ hopes and heartbreaks exemplify the struggles many families are grappling with as they attempt to help some of the country’s most vulnerable and hard-to-reach people.
Episode Transcript
Dan Gorenstein (DG): America’s homeless problem can feel intractable.
The number of people on the streets is at an all-time high. The worst off are struggling with mental illness and addiction.
Newsclip: Nowhere is that problem more visible than California.
Newsclip: California is home to the nation’s largest homeless population.
Newsclip: One in four has a serious mental illness.
DG: Four years ago, California Gov. Gavin Newsom proposed a controversial solution: make it easier to force people into treatment.
Gavin Newsom: I mean, we could hold hands, have a candlelight vigil, talk about the way the world should be or we could take some damn responsibility to implement our ideals. And that’s what we’re doing differently here.
DG: He called it CARE Court. In this new court, a judge could order treatment for people who didn’t want help.
To many families of people living on the streets, it felt like someone was finally listening.
Marisa Kendall (MK): People were expressing hope for the first time in years, sometimes decades.
DG: But a few years in, those hopes have soured.
June Dudas (JD): I felt like someone just punched me in the gut and said, you fool, you fool. Why did you get your hopes up?
DG: Today, how California’s bold new program to help people with serious mental illness failed to meet expectations and what it means for the families left searching for help.
From the studio at the Leonard Davis Institute at the University of Pennsylvania, I’m Dan Gorenstein. This is Tradeoffs.
*****
DG: CARE Court came at a point of desperation.
Nationwide, people with serious mental illness are jailed 2 million times a year.
That’s why so many families welcomed this new court.
Finally, they hoped, there would be a way to compel their loved ones into treatment instead of jail.
To understand why so many who initially cheered Care Court have now become disillusioned, I called up June Dudas.
June. Hi. Nice to meet you.
JD: Good morning. Nice to meet you too.
DG: You know how some cousins grow up like siblings? That’s how June described her relationship with her cousin Ed.
JD: Before he got ill, I would’ve gone to him for anything because I’d know he’d always be in my corner. He was just that kind of person.
DG: Ed changed when he and June were in their 20s.
Schizophrenia took over his mind. Voices only he could hear caused him to fly into unprovoked rages.
JD: It’s so opposite. It’s like almost like a Jekyll and Hyde.
DG: June has spent 40 years trying to help her cousin Ed get and stick with treatment, to break the cycle of homelessness, incarceration and state mental hospitals that he’s been trapped in.
She told me about a harrowing day last March that typifies how hard it’s been.
Ed was getting out of his most recent prison stay. Within 24 hours, June’s Aunt Joanne texted her. Ed was outside.
JD: He’d been released like at 9:30 in the morning, up past Sacramento and he just beelined it to her house.
DG: Ed’s mental illness has convinced him that he needs to kill Joanne, his 84-year-old mother.
Joanne has had a restraining order against her son for years.
So when Ed showed up, June did what she’s done so many times before.
She drove the 10 minutes to her aunt’s house and called 911.
JD: I sat in my car, away from the house because I didn’t want Ed to know I was there. I watched him and saw him on the front porch just talking to himself and being really erratic and my aunt in the meantime is locked in her bathroom.
I’m texting her on the phone because she refuses to talk on the phone to me. It’s such a small house, it’s old, and she’s just convinced that he’s gonna hear her. I’m telling her, you need to go get your water. He’s at the end of the driveway. He’s not gonna hear you.
DG: It seems like in this moment, right, you and your aunt are in between a rock and a hard place. Like you don’t want him to be arrested, but at the same time, your aunt is all but like a hostage in her bathroom.
JD: Yes. And every single time we would have the same conversation. Every single time she would say, I hate that we have to call the police. And every time I would tell her, I understand that. I don’t wanna have to call the police either, but it’s the only hope we have of him getting help. And you can’t live like this.
DG: That day must have been agonizing.
JD: It was mostly just so incredibly disappointing. I’m just watching him pace and I’m just like I can’t even believe this. I can’t believe all this time and money and, everything has been invested into this human being. And he’s probably worse than he was before. It was just so frustrating and just incredibly sad.
DG: The situation June is describing is exactly why California created CARE Court. Thousands of families across California say they’ve tried everything to help their loved one get well. CARE Court was supposed to put them in front of a civil court judge and a treatment team, instead of jail.
The same scene kept happening to June and her aunt over and over again for the next several months. Ed on the porch. Joanne texting June. June calling the police.
Scared for her aunt, heartbroken for her cousin, June finally reached her breaking point one Sunday morning in July.
She called a crisis line for families of people dealing with mental illness.
JD: I said, I just, I don’t know what to do.
He’s used weapons repeatedly. And his voices tell him to kill his mother. And he’s been diagnosed with schizophrenia and bipolar disorder. I’ve explained. Every time I call 911, they hear my spiel, but it hasn’t made a difference.
She said, well, have you heard about. CARE Court. And I said, no, what is that?
She told me that it was a program that could force him into treatment and I’m thinking, why didn’t somebody tell me this before when every single time I’m calling I’m saying this and they’ve had so many 9-1-1 calls.
DG: CARE Court was a little more complicated than June was told.
She’d have to submit a detailed application, and Ed would have to meet a narrow set of criteria to qualify.
But the ability to force someone like Ed into treatment — that was how the program was pitched.
June was ecstatic, so ecstatic that when she got a text from her aunt later that day, saying Ed was back on the porch. June felt a flicker of hope.
JD: I went, okay, okay. Well, if we can get the police to show up in time and they can arrest him, then he can be in jail and they can do the assessment. I was like, okay, okay. This is actually good news.
DG: June spent half of a two-week vacation pulling together Ed’s Care Court application.
She struggled with some of the items she needed to build her case.
His hospitalizations hadn’t been recent enough. The psychiatrist who had diagnosed Ed had long since passed away.
She dug through years of emails to piece together her cousin’s mental health history and arrest record.
After she sent it off, a county clinician went to the jail to assess Ed first-hand.
JD: When I heard that somebody from the county was actually gonna go down to the jail and sit across from him, I just was so happy that somebody would actually see him who was going there with an eye on helping him. It was just the best feeling. I thought it can only get better from here.
DG: Right. I mean, Ed meets all the criteria. He’s got schizophrenia, isn’t clinically stable enough to take care of himself. But that clinician, she doesn’t ultimately recommend him for CARE Court.
Why?
JD: She said well, the criteria for CARE Court, was that he had to voluntarily, join the program.
She was the first person who told us that he also has another diagnosis of Anosignosia, if I’m pronouncing that correctly, which means that he doesn’t even realize he is sick.
So she’s telling me even though he doesn’t realize he’s sick and he’s very, very sick, I have to recommend dismissal because he won’t volunteer for a program that he doesn’t think he needs.
And I said, you know, that sounds crazy. Right? That doesn’t make any sense at all. And she said that’s the way the program is set up.
DG: I mean this is literally the opposite of what you were told on that crisis line.
June, in that moment, did you feel duped?
JD: I felt like someone just punched me in the gut and said, you fool, you fool. Why did you get your hopes up?
I just fell apart. I’m like, I can’t even believe this. All of that for nothing. I did all of that work for nothing. I got my aunt’s hopes up. How do I call her? How do I call her and tell her that we’re nowhere and that the people we thought cared and were going to help him. Can’t and won’t.
DG: You and your aunt had one more chance to be heard. You went before a care court judge to plead for Ed to be forced into treatment. We asked you to record Joanne reading from the testimony she gave that day.
Joanne: Each time he is released I live in fear of what he might do to me. The night he threatened me with a weapon and then chased me into the street at 3 a.m. is etched in my memory. Despite an abundance of love and all of the money I could afford on my low income, he’s deteriorated further and further.
DG: That’s testimony that’s presented in court and still the judge said she could not force Ed to go into treatment. June, what did it mean to you to listen to your aunt repeat 40 years of history, only to be told there was nothing to be done for Ed?
JD: I was sitting next to her. She is home bound and disabled, so they let her do her testimony virtually.
And then to watch the judge then explain that she could do nothing, that the law would let her do nothing, even though she saw the danger to my aunt, the fear that my aunt had.
My head was swimming with how did we end up here? What, what is this program even for? My aunt just slumped in her chair.
And then, you know, the judge asked her, you know, do you have any other questions? And my aunt said, well, yeah, what do I do when he shows up again?
And it just broke my heart because I felt like I’d failed her. I thought I must not have filled it out the right way.
I, there must have been something else I was supposed to say or somebody else I could have talked to. But this can’t be how this is supposed to work.
DG: What are you feeling right now in this moment, June?
JD: Like, it’s just a nightmare, you know? I mean, he gets out, he’s getting up jail soon, and I, I feel like the nightmare of 2025 is just gonna repeat again in 2026 and I dunno how to stop it.
And then I just feel like the people that have the power to do something just don’t care enough or just don’t have the backbone enough to make the changes to the law that need to be made to protect these people. And that just is so cruel.
DG: As you just said, Ed’s gonna get outta jail in March. This is after violating his restraining order 21 times last year. 21 times. And I know you’ve decided to go visit him to try to convince him personally to get help. Do you have any thoughts about how you’re gonna try to approach this?
JD: I just really, I want to approach him as somebody who cares about him, because I feel like the system just, wants to lock him in a cell
And it’s not their problem anymore. I just want him to know that somebody cares about him and that we all do. But I’m afraid. That he’s just going to reject me. So, my objective is really just to try to get him to trust me enough that we can have a conversation about the hell that he’s living in, in his mind. Maybe I can get him to see that through treatment he could have a better life.
DG: Final question, June. Who do you think Ed could be if he got the help he needed?
JD: The only thing I can go back to is the second time he got out of Patton State Mental Hospital. They’d forcefully medicated him for over two years.
And he was just, he was Ed, he was the best version of Ed that he could possibly be. He was sweet and loving and full of life and so happy to. Be out experiencing the world again, and to get to spend time with family
That’s the person I picture.
DG: June, thanks so much for taking the time to talk to us on Tradeoffs.
JD: Thank you so much.
DG: When we come back, we’ll talk to CalMatters reporter Marisa Kendall, who explains why CARE Court is falling short of so many families’ expectations.
BREAK
DG: Welcome back. I wanted to better understand why June’s experience with CARE Court turned out the way it did, so I turned to CalMatters reporter Marisa Kendall.
CalMatters is a nonprofit newsroom covering all things California.
Marisa and her colleagues spent much of 2025 investigating this new initiative for a series called Courting Disappointment.
Marisa, we know that you also spoke with June Dudas for the stories that you reported. When did you start to get the sense that people were feeling duped by care court?
MK: Pretty soon after Care Court launched, we started getting these calls and emails from all these families who were saying, Hey, this is not what we thought it was.
This is not working.Some of these people were the very same people who really went to bat for Care Court when it first launched. The people who are the sickest on the street, the people who this program was initially supposed to help, it’s not helping because it’s voluntary and, and they can’t consent to treatment.
DG: So you all start digging into the data on how many people have actually gone through Care Court in its first two years. What did you learn?
MK: Yeah, the most recent data I have showed that statewide, fewer than 700 people got voluntary treatment agreements and only 22 people got court ordered care plans. So what that means is basically nobody is actually getting the court ordered mandatory treatment plans.
DG: Why have so few people been ordered into treatment? What’s that about?
MK: So the plan that was first introduced changed. They made the eligibility requirements stricter. They made it harder to file a petition.
And, you know, many counties I talked to said we don’t believe in involuntary treatment. Politically. It is really hard to pass legislation that really broadens involuntary treatment just because of how controversial it is and how many groups are opposed to it.
So that’s why you see things like care court getting watered down. It can make it really hard to actually do something big that will create meaningful change.
DG: So what I’m hearing you say is after Newsom first announced this and people like June Dudas got excited, lawmakers made changes that made it harder to make people get treatment.
Marisa, is the state doing anything to get more people into treatment involuntarily? Like changes to make this process easier?
MK: there are several new changes to state law recently. One law, SB 27 went into effect this year that now allows people diagnosed with bipolar disorder who have psychotic symptoms to qualify for care court when before it was very narrowly tailored to people with you schizophrenia spectrum disorders.
There’s also a new law that expands who can qualify for a conservatorship which is like the end of the line like if you fail out of care court, you potentially could go into a conservatorship which would put you in a locked facility. It’s kind of early to tell, you know, how those will work. Um, but it’s possible they will make some sort of difference.
DG: As you mentioned earlier, involuntary commitment is really controversial.
What evidence, Marisa, do we have about the effectiveness of forcing people into treatment?
MK: Yeah. I went into reporting on this, definitely very skeptical of involuntary treatment because of the horrible history this country has with abusing it. And there are so many issues with it, so many concerns. So many ways that patients’ rights can be violated.
And experts that I spoke with do say, voluntary treatment is the gold standard. It’s more effective.
I spoke with a lot of people who had been locked in psych wards and they hated it. They didn’t ever wanna go back and they told me they would do anything to avoid being forced back into treatment.
DG: Okay, so the involuntary part of CARE Court’s promise is not really happening.
But you did talk to people, specifically in San Diego, who feel that Care Court is helping some agree to voluntary treatment. They had 10 folks complete treatment plans, the most in the state. What did the people in San Diego tell you?
MK: Yeah they told me they were just really spending a lot of one-on-one time with each care court participant. You know, they were spending months. Getting to know them, building their trust, like bringing them burritos or helping them get new phones or whatever so they could win that trust and get them to accept help.
DG: Building trust with people certainly makes sense, Marisa, but I also can’t help but think that June Dudas would roll her eyes and say something like that has not worked. You talked to a lot of families. What do they make of that argument? That they just need to patiently work to get people to agree to treatment?
MK: So there are people out there on the streets who if you spend enough time with them and, and you get to know them they will eventually say yes and trust you and accept treatment.
But for people who are too deep in their psychosis, that’s never going to work. There was another woman I spent a lot of time with, Jennifer Farrell, she’s retired and lives in Alameda County, and her brother who has schizophrenia has been in care court for the past year. And it just hasn’t worked for him. You know, he briefly got into housing, but then he fled that housing and disappeared.
She, at some points, was so angry with the situation that it would almost bring her to tears because in her mind, she did all the things she was supposed to do. She did everything in her power to try to get him help and it wasn’t working and he was still outside. And that’s heartbreaking when that’s your brother,
DG: What’s the big takeaway in your mind, Marisa? Like what can other states learn from California’s attempts to get care court off the ground?
MK: California has standards set in place for when someone can be eligible for involuntary treatment.
I think the problem is the state doesn’t make it easy enough for the people who need it to access that option, and it doesn’t make it easy enough for their families or even for the doctors. To get them down that path. So if the state accepts that involuntary treatment needs to be an option for some people, it needs to actually allow those people to access that service.
And right now it’s struggling with that. Right now. The people who need it, there’s a lot of roadblocks. They’re falling out of the programs. They’re not able to get down the right path.
DG: Marisa, thank you so much for taking the time to talk to us on trade offs.
MK: You are so welcome. Thanks for having me.
DG: You can find all of Marisa’s reporting on CARE Court at CalMatters.org. We’ll also put a link to the series in our show notes.
I’m Dan Gorenstein. This is Tradeoffs.