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Gov. Gavin Newsom’s new mental health court made big promises about how it would help get the sickest Californians off the streets.

Launched in 2023, the program allows people to petition a court to order treatment for someone experiencing psychosis.

To see how CARE Court is working so far, CalMatters requested data from every county in the state.

Here’s what we found:

CARE Court Is Reaching Far Fewer People Than Expected

The state initially estimated as many as 12,000 Californians could qualify for the program. Instead, just 2,421 petitions have been filed through July, according to the Judicial Council of California. Only 528 of those have resulted in people getting care through voluntary treatment agreements or court-ordered plans.

San Diego County anticipated receiving 1,000 petitions in the first year and establishing court-ordered treatment plans for 250 people. But in nearly two years, the county instead has received just 384 petitions and established 134 voluntary agreements. Los Angeles County saw 511 petitions filed, with 112 resulting in care agreements or plans. In 2023, LA officials predicted to news organizations the county could enroll 4,500 people in the first year.

It Can Be Hard to File in Court

Sources we talked to said it ended up being harder than expected to file petitions. Counties thought police, firefighters and other first responders would jump at the chance to file CARE Court petitions on behalf of the sick, unhoused Californians they encounter on the streets every day. But overworked first-responders didn’t have time to navigate the time-consuming process, said Amber Irvine, San Diego County’s behavioral health program coordinator.

In some cases, police and firefighters filed petitions when the program first started. But they were often dismissed – which made them reluctant to file more, said Crystal Robbins, who manages a treatment referral program for San Diego Fire-Rescue.

“We quickly found out that it wasn’t a useful tool for the people that we see,” she said.

A Lot of CARE Court Petitions Get Dismissed

About 45% of petitions filed statewide, although that number includes the handful of cases in which someone has successfully “graduated” from the program. The rate is even higher in some counties, such as San Francisco, where nearly two-thirds of petitions are thrown out.

That can be for a variety of reasons. Someone might not meet the narrow criteria to qualify for CARE Court. If the person is homeless, outreach workers might have a hard time finding them. Or, the person might simply refuse services. If that’s the case, CARE Court has few teeth to force them to comply.

Most Counties Aren’t Forcing People to Participate

The initial allure of CARE Court for many supporters was the promise of court-ordered treatment plans that would encourage sick people to accept the help they’d been resisting. But most counties are eschewing that aspect of the program, and instead providing treatment only if outreach workers can convince someone to comply. Courts have ordered just 14 people into treatment plans, according to the Judicial Council.

But Counties Say Numbers Don’t Tell the Whole Story

While this data shows how many people engaged in treatment through the official CARE Court program, it doesn’t count all the people who started the process and ended up getting services through another county program instead, said Michelle Doty Cabrera, executive director of the California Behavioral Health Directors Association.

“I would say that I think the whole idea of looking at the numbers, it sort of misses the point,” she said.

One of CARE Court’s successes, she said, has been in spreading the word about county services to people who might need them. As of December, people were diverted away from CARE Court and into other county services 1,358 times, according to a recent report from the Health and Human Services Agency.

A New bill Could Boost Care Court’s Numbers

Right now, only people with schizophrenia and other limited psychotic disorders qualify. If Sen. Thomas Umberg’s Senate Bill 27 passes, the program would expand to include people who experience psychotic symptoms as a result of bipolar disorder.

It’s unclear how many more people CARE Court could reach as a result. Umberg’s office has no estimate, and San Diego County says the bill could increase its numbers by anywhere from 3.5% to 48.1%.

That’s worrying for people like Irvine. Adding a lot more people into the program would give clinicians less time to spend with each client, Irvine said. And Umberg’s bill doesn’t come with money to hire more staff.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.