California is throwing more money at a mental health court that barely works

New Law Expands CARE Court in January

Governor Gavin Newsom promised his CARE Court program would revolutionize how California treats severely mentally ill homeless people.

He said it would help thousands.

Two years later, the numbers are in, and they are not good. The state spent roughly $713,000 per participant in the program’s first full year.

Fewer than 700 people have signed treatment agreements statewide.

Now a new law will expand the program anyway, and the reasons why reveal a lot about how California tackles its biggest problems.

Newsom Promised 12,000 People Would Get Help

When Newsom stood at a San Jose treatment center in March 2022, he pitched CARE Court as the answer to a crisis that previous programs had failed to solve.

The concept was simple: let family members, first responders, and doctors petition a judge to place someone with severe mental illness into a court-supervised treatment plan.

His administration estimated between 7,000 and 12,000 Californians would qualify. The program launched in seven counties in October 2023 and rolled out statewide by December 2024.

The Actual Numbers Are Brutal

Through October 2025, California courts received just 3,092 CARE Court petitions statewide. Only 684 of those resulted in treatment agreements or plans.

That is roughly 5% of the low end of what Newsom projected. San Diego County expected 1,000 petitions in year one and got 384 over nearly two years.

The gap between promise and reality is so wide that some county courts refused to release their data because the sample sizes were too small to publish.

Los Angeles Got Six Graduates in Two Years

Los Angeles County, home to about 75,000 homeless people, was supposed to be CARE Court’s proving ground.

Officials predicted the county could enroll 4,500 people in the first year alone. Instead, LA saw about 700 petitions over two years, roughly 18% of what the state projected.

As of late November 2025, exactly six participants had graduated from the program in LA County. Sixteen others chose to stay enrolled for an additional year.

The Cost Works Out to $713,000 Per Person

California spent $88. 3 million on CARE Court in fiscal year 2022-23 and another $71.3 million the following year.

A legislative analysis calculated that with only about 100 participants receiving services in 2023-24, the cost per person came to approximately $713,000.

One disability rights attorney pointed out that amount could buy someone a house, yet CARE Court does not actually pay for housing or treatment.

The money funds the court process itself.

Judges Cannot Force Anyone to Take Medication

Even when a CARE Court judge orders a treatment plan, the program has no enforcement mechanism. Clinicians cannot make participants take their medications.

Nobody gets punished for refusing treatment. Only 22 court-ordered CARE plans have been imposed statewide, because most counties prefer keeping the program entirely voluntary.

Some families who pushed for CARE Court now call it toothless. One San Diego mother who advocated for the program later described it as a total failure.

Families Thought This Would Save Their Loved Ones

When Newsom introduced CARE Court, he spoke directly to families struggling with mentally ill relatives.

He mentioned his own four children and said he could not imagine the heartbreak of watching a loved one suffer while the system fails them.

Many families interpreted this to mean the program could compel treatment. It cannot. One Concord mother filed a petition hoping CARE Court would help her son.

Years later, police still show up at her home, and she says the program gave her family false hope.

Almost Half of All Petitions Get Thrown Out

About 45% of CARE Court petitions are dismissed statewide. San Francisco has tossed 65% of its cases, the highest rate among major counties.

Petitions fail for various reasons: the person does not have the right diagnosis, they cannot be located, they are already receiving treatment, or they simply do not meet the strict eligibility criteria.

Originally, only people with schizophrenia or similar psychotic disorders qualified. Someone with severe bipolar disorder did not make the cut.

The New Law Adds Bipolar Disorder

Senate Bill 27, signed by Newsom in October 2025, expands CARE Court eligibility starting January 1, 2026. People who experience psychosis as a result of bipolar disorder can now enter the program.

The law also streamlines the court process by combining two early hearings into one and allows criminal courts to refer defendants directly to CARE Court if they are deemed incompetent to stand trial.

The bill passed with nearly unanimous bipartisan support and no votes against.

Even the Bills Author Says This Wont Change Much

Senator Tom Umberg, the Santa Ana Democrat who wrote SB 27, has acknowledged the expansion probably will not dramatically increase participation.

Counties are uncertain how many new people might qualify.

San Diego estimated the change could boost its numbers by anywhere from 3. 5% to 48%, a range so wide it reveals how little anyone knows.

The California Behavioral Health Directors Association opposed the bill, warning that flooding the program with new cases would stretch already limited resources.

Critics Call It Expensive Political Theater

Disability Rights California has fought CARE Court since the beginning, filing a lawsuit challenging its constitutionality in 2023.

The ACLU of Southern California calls the expansion an effort to inflate petition numbers rather than fix underlying problems.

One advocate described the entire program as political optics.

Critics argue the real issue is that California lacks affordable housing and adequate community mental health services.

A court order, they say, does not create resources out of thin air.

The Crisis CARE Court Was Built to Solve Remains

California has more than 1.2 million adults living with serious mental illness. One in ten residents meets the criteria for a substance use disorder.

The state has the nation’s highest percentage of unsheltered homeless people, with two-thirds sleeping on streets, in encampments, or in cars.

A 7,000-bed shortfall in behavioral health facilities persists despite billions in spending. CARE Court was supposed to change that equation.

Two years and $160 million later, the math still does not add up.

This article was created with AI assistance and human editing.

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