Will Involuntary Hospitalization Help People With Psychiatric Disabilities?

CW: Psychiatric Disabilities

The Community Assistance, Recovery, and Empowerment (CARE) Court, supported by Gov. Gavin Newsom and heavily supported in the Legislature, works as follows: family members, first responders, and others can petition a newly formed court to intervene in the life of someone with schizophrenia or other untreated psychiatric disabilities.

The new law will make it simpler to get court-ordered behavioral treatment plans for people suffering from serious mental illness through CARE Court.

This is how it works. A family member, behavioral health clinician, or law enforcement officer petitions a court on behalf of a person who has untreated schizophrenia or another psychotic illness. A court can then order a clinical evaluation, followed by a care plan that may include treatment, medication, and housing.

If the individual fails to complete treatment, the state may choose to monitor them for an extended period of time. The state of California has begun implementing this process in an effort to address homelessness statewide. San Diego is one county that will begin using the CARE Act in the fall of this year.

The court can order an evaluation and propose treatment based on the individual’s circumstances. Medication cannot be forced to be taken, but the individual must attend meetings to see if progress is being made on a treatment plan that is tailored to the individual. Implementing the CARE Act has been a difficult task because, eventually, all 58 California counties will be required to provide similar services.

Advocates in other states are worried about similar laws. Gov. Phil Murphy of New Jersey enacted a similar law earlier this month.

People facing mental health crises may face extended involuntary commitment stays in hospitals and emergency rooms

The previous involuntary commitment rule enabled hospitals to hold people in need of emergency mental health treatment for up to 72 hours — three days — while a judge decided what to do regarding the patients’ psychiatric treatment options.

Under the new law, hospitals can seek a court order allowing them to keep a patient for up to a total of six days if the holding hospital or emergency department can demonstrate that no short-term care or psychiatric facility with available beds can be found.

However the new law is opposed by nearly 50 statewide and national organizations. In an open letter published in late July, they asked Murphy to veto the bill, arguing that emergency rooms are ill-equipped to deliver specialized mental health care, perhaps causing more trauma for patients.

We are extremely disappointed that the governor signed the bill, as we believe that the bill infringes on the rights of individuals with mental health disabilities but was passed quickly without a review of whether it was needed,” said Mary Ciccone, the director of policy for Disability Rights New Jersey, one of the groups that signed the letter.

I’m addition, the New Jersey Psychiatric Rehabilitation Association called the bill “narrow”.

The letter also expressed worry about racial inequities, saying that research show that patients of color are more likely to be deemed a ‘danger’ and involuntarily committed when compared to their White peers.

For example, according to a study published earlier this year by the American Psychological Association Black and Hispanic patients are more likely to receive psychotherapy and less likely to be given psychotropic medications than White patients.

Everyone deserves access to mental health care. Eliminating stigmas about mental health is long overdue. Unfortunately, involuntary stays in a hospital will only make the mental health crisis in America worse.


Gibbons, Sammy. “Mental Health Advocates Raise Alarm over New NJ Involuntary Commitment Law.” NorthJersey.Com, North Jersey Media Group , 22 Aug. 2023, http://www.northjersey.com/story/news/health/2023/08/22/new-jersey-mental-health-crisis-law-alarms-social-service-groups-involuntary-confinement-hospitals/70623537007/.

Olfson, Mark, et al. ‘Racial-Ethnic Disparities in Outpatient Mental Health Care in the United States’. Psychiatric Services, vol. 74, no. 7, American Psychiatric Publishing, July 2023, pp. 674–683, https://doi.org10.1176/appi.ps.20220365.

Westervelt, Eric. “Parts of California to Have Care Court for Those with Untreated Severe Mental Illness.” NPR, NPR, 27 Mar. 2023, http://www.npr.org/2023/03/27/1166340490/parts-of-california-to-have-care-court-for-those-with-untreated-severe-mental-il.

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