In 2022 the California Senate passed Senate Bill (SB) 1338 which initiated the Community Assistance, Recovery, and Empowerment (CARE) Act. Later, on Oct. 1, 2023 the legislation went into effect in seven counties: Glenn, Orange, Riverside, San Diego, San Francisco, Stanislaus and Tuolumne. On Dec. 1, 2023, it went into effect in Los Angeles.
This legislation allows for people to file petitions in civil courts that initiate CARE cases for other persons in the community who have been diagnosed with schizophrenia spectrum disorder or other psychotic disorders, otherwise known as respondents. Though this did not originally cover Bipolar Type I, on Jan. 1, 2026 the CARE Act will expand to cover this mood disorder.
CARE petitioners can report others who have schizophrenia or a psychic disorder when the person is “unlikely to survive safely in the community without supervision and the person’s condition is substantially deteriorating,” or, “the person is in need of services and supports in order to prevent a relapse or deterioration that would likely result in grave disability or serious harm to the person or others, as defined in Section 5150,” the Judicial Branch of California said. The initiation of a CARE case causes a trial that could last years until the court settles on a voluntary CARE agreement or a court-ordered CARE plan. These plans include treatment, housing support, medication and other services.
Alongside the aforementioned requirements, in order to be eligible as a respondent to a CARE petition, an individual must be over 18, have a diagnosis of schizophrenia spectrum disorder or a psychotic disorder, not be living in a voluntary treatment program and currently “experiencing a mental illness that is severe in degree and persistent in duration, which may cause behavioral functioning which interferes substantially with the primary activities of daily living,” the Judicial Branch of California said.
The Judicial Branch of California said that this program “creates a new pathway intended to deliver mental health treatment and support services upstream to the most severely impaired Californians who often experience homelessness or incarceration without treatment.” Critics say otherwise. In part 2, we will explore the potential pitfalls of the California CARE act. In part 3, we will then compare initial concerns over the act to the actual data from the first nine months of implementation as presented in the July 2025 Annual Report.
Works Cited
“CARE Act – California Health & Human Services.” California Health & Human Services, https://www.chhs.ca.gov/care-act/.
Department of Health Care Services. The Community Assistance, Recovery, and Empowerment (CARE) Act Annual Report July 2025. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.dhcs.ca.gov/Documents/CARE-Act-Annual-Report-2025.pdf.
Judicial Branch of California. “Adult Civil Mental Health.” California Courts Judicial Branch of California, http://courts.ca.gov/programs-initiatives/families-and-children/behavioral-health/adult-civil-mental-health#:~:text=When%20Did%20the%20CARE%20Act,implemented%20by%20December%201%2C%202024.
Pleasants, Gregory. “Conditions of Confinement in the Mental Health System.” LAW 403: Mental Health Law, Feb. 6, 2024, University of Southern California, Los Angeles. Lecture.