CARE Court is a civil court program in California designed to connect people with severe psychotic disorders to mental health treatment, housing, and support services before they end up homeless, hospitalized, or incarcerated. Created by the CARE Act (Community Assistance, Recovery, and Empowerment Act), it gives families, first responders, and other concerned parties a legal pathway to get help for someone who is unable to seek it on their own. All 58 California counties have been operating CARE Court programs since December 2024.
How CARE Court Works
CARE Court is not a criminal court. It’s a specialized civil court process built specifically to help people with schizophrenia and other psychotic disorders access treatment. The core idea is “upstream intervention,” meaning the goal is to reach people before their situation deteriorates to the point where they’d face conservatorship (losing the right to make their own decisions) or jail time.
Someone files a petition on behalf of the person they believe needs help. If the court agrees the person qualifies, a county behavioral health team meets with that individual to understand their situation and develop a personalized plan. That plan can include clinical services, medication, and housing. The court then reviews and approves the plan, and the county is legally obligated to follow through on it.
Who Qualifies
Eligibility is limited to people who meet all three of these criteria:
- Diagnosis: The person has a schizophrenia spectrum or other psychotic disorder.
- Functional impairment: The mental illness is severe and persistent enough to substantially interfere with basic daily activities, and the person is unable to maintain stable, independent functioning without ongoing treatment and support.
- Safety risk: The person is unlikely to survive safely in the community without supervision and their condition is getting worse, or they need services to prevent a relapse that would likely result in grave disability or serious harm to themselves or others.
This is a narrow set of criteria. CARE Court is not available for people with depression, anxiety, substance use disorders alone, or other mental health conditions that don’t include psychosis.
Who Can File a Petition
A range of people can start the process by filing a petition with the court. County behavioral health agencies can file directly, and when someone else files, the court can order the county behavioral health agency to investigate the case. California has created training resources specifically for “system partners,” including first responders, social workers, and healthcare providers, to help them navigate the petition process. Family members and others close to the individual can also petition.
Between the program’s initial launch and June 2024, courts received 556 petitions in the first nine months. After all 58 counties went live in December 2024, the pace increased dramatically: 1,063 petitions were filed in just the six months from December 2024 through May 2025.
Legal Rights for Participants
Because CARE Court involves court-ordered treatment, the law builds in significant protections for the person at the center of the process (called the “respondent”). If the case is not dismissed early on, the court appoints an attorney at no cost. The respondent can also replace that attorney with one of their own choosing at any time.
Respondents have the right to receive notice of all hearings, present evidence, call and cross-examine witnesses, and appeal decisions. They also receive copies of the petition and any court-ordered evaluations.
Beyond legal counsel, respondents can choose a personal supporter to help them through the process. This supporter is a volunteer, someone like a friend, family member, faith leader, or a person with their own lived experience in mental health, who helps the respondent understand what’s happening and communicate their preferences. The goal is to preserve the person’s ability to make their own choices to the greatest extent possible, even within a court-supervised framework.
What a CARE Plan Includes
Once the court determines someone qualifies, the county behavioral health agency works with the respondent, their attorney, and their supporter to develop a CARE agreement. This plan is personalized, but its components generally fall into three categories: clinical treatment services, medication, and housing. The specifics depend on the individual’s needs and circumstances.
The court reviews and approves the plan. If both sides agree on the terms, it becomes a CARE agreement. If they can’t reach agreement, the court can order a CARE plan instead. Either way, the county is legally bound to deliver the services outlined in it.
What Happens When Counties Don’t Deliver
One of the more distinctive features of CARE Court is that it holds county governments accountable, not just participants. If a county fails to provide the services required by a court-ordered plan, the court can impose penalties including fines. In serious cases, the court can appoint an outside manager to take over and ensure the person receives the care they were promised.
This accountability mechanism addresses a long-standing frustration in California’s mental health system: families and individuals being told services exist on paper but finding them unavailable in practice.
What Happens If a Participant Doesn’t Comply
If a respondent stops participating in the CARE process or doesn’t follow their plan, the court can terminate their participation. But termination isn’t simply the end of the road. It can trigger more restrictive interventions.
The most direct action a court can take is to detain the person for an involuntary inpatient evaluation. Even without detention, leaving CARE Court creates a legal presumption that carries weight in future proceedings. Specifically, if a conservatorship hearing happens within six months of the person’s termination from CARE, their failure to complete the plan becomes evidence that they need intervention beyond what the CARE plan offered. In practical terms, not completing the CARE process can make it easier for a court to impose a conservatorship later.
This is one of the most debated aspects of the program. Supporters argue it provides a necessary safety net for people in crisis. Critics, including legal scholars at Loyola Law School, have argued it effectively coerces participation by making the alternative worse.
Early Results
CARE Court is still in its early stages, and comprehensive outcome data is limited. By June 2024, nine months into implementation, 101 CARE agreements or court-ordered plans had been approved out of 556 petitions filed. The state’s 2025 annual report did not include graduation rates, meaning there isn’t yet solid data on how many people have successfully completed the full process and sustained recovery afterward.
The sharp increase in petitions after all counties came online in late 2024 suggests growing awareness and use of the program. Whether that translates into meaningful reductions in homelessness, hospitalization, and incarceration for people with severe psychotic disorders will take more time to measure.