San Francisco to Launch Care Court Next Week for Those Struggling with Serious Mental Health Issues

San Francisco is among the first group of counties in California to implement program under new state law to help connect persons with behavioral health challenges to essential care
September 27, 2023

San Francisco, CA – Starting in October, San Francisco will be one of the first seven counties in California to implement the Community Assistance, Recovery and Empowerment (CARE) Act, a state law to help those with mental health disorders access wraparound care and stabilized housing. The CARE Act, which passed the State Legislature and was signed by Governor Newsom last year, includes a new civil court process that provides community-based behavioral health services to residents who are living with untreated schizophrenia or other psychotic disorders. While participation in the program is voluntary, it will provide another tool to engage those who are not currently seeking care.  

CARE Court allows for a wide range of individuals who can make a referral or directly submit a petition for a client or loved one. This will remove barriers to care and allows first responders, family members, people who live with the respondent, and behavioral health providers, among others, to directly petition the court. If the person subject to the petition meets the qualification threshold, the Court will oversee the development of a CARE Plan for each individual. The plan will consist of holistic components, which can include treatment and housing plans. CARE Court participants may be eligible to receive prioritized housing placements and care by way of the State’s Bridge Housing Grant, which has allocated $32 million over four years towards new stabilizing housing options in the City. 

Many people who would benefit from help may not recognize that they need it. CARE Court goes upstream prior to more restrictive conservatorships or incarceration. For example, persons can be referred to the program while they are under a 72-hour psychiatric hold, known colloquially as a “5150.” Also, those in the conservatorship process or in the early stages of some criminal cases, can be diverted to CARE Court instead as a way to focus on behavioral health and get them into the right level of treatment. The participant will have a court-ordered CARE Plan or voluntary agreement for up to 12 months, with the possibility to extend for an additional 12 months, and the court will provide consistent oversight. 

“Too many people in our City are suffering without being able to access the care and support they need to get their lives on the right track,” said Mayor London Breed. “While this program is voluntary, it provides direct access for people to get connected to services and for them to be referred to that care by those who know them best. We are committed to finding ways to strengthen our entire behavioral health system, from voluntary to involuntary options, and CARE Court is part of that program and we are ready to accept people and get them the help they need.” 

CARE Court is the result of a law championed by Governor Gavin Newsom to help address challenges in getting people with mental health and substance use issues into treatment. The law was passed last year, and the implementation date is set for October 1st. Over the last several months, the Mayor’s Office, the San Francisco Department of Public Health (SFDPH), the City Attorney’s Office, the Department of Homelessness and Supportive Housing (HSH), the Public Defender, the San Francisco Superior Court, and non-profit legal aid providers have worked to prepare for implementation. Starting on October 2nd, San Francisco will be ready to accept its first CARE Court petition. 

“CARE Court provides a tool for the City to help people with serious mental health issues, like untreated schizophrenia or other psychotic disorders,” said Director of Health, Dr. Grant Colfax. “This additional tool is another access point to help people have more stable and healthy lives.”   

Expanded Behavioral Health Support 

The CARE Court effort will be one of many interventions within the Behavioral Health system of care to support people with untreated mental health and substance disorders.    

During the last several years San Francisco has added over 350 new mental health and substance use disorder treatment beds to the 2,200 existing beds, and another 50 are in the pipeline. These beds range from withdrawal management (detoxing from substances), crisis stabilization for people experiencing a psychiatric emergency, intensive mental health and substance use disorder treatment, long-term residential care and support, and step-down care for people transitioning out of long-term treatment. On average, these beds are at 87% utilization and there is availability for new people to get placed daily.  

SFDPH has added evening and weekend hours to the Behavioral Health Access Center, where anyone can walk in to access mental health and substance use disorder treatment. The City has also taken a comprehensive, multi-department approach to help people in crisis on our streets, coordinating Police, Fire, Emergency Management, Public Health, and Homelessness and Supportive Housing. San Francisco has also expanded street care teams to provide medical and behavioral health care to people experiencing homelessness in streets, parks, and encampments. 

CARE Court is one of various efforts Mayor Breed has supported to provide services to people who are in the most desperate need of care, including Senate Bill 43. Under the Bill, which is awaiting signature by Governor Newsom, individuals could be compelled to treatment by adding severe substance use disorder as a basis for grave disability conservatorship. 

More information about the CARE Act may be found at  For details on CARE Court, visit this link: