by Cathleen Williams, Homeward Street Journal
Maggie, an activist and advocate for the unhoused community, is a single mom who grew up in Venice, California. (Maggie is a pseudonym, to protect her privacy.) Today, few can afford to actually rent in Venice—Maggie lives in an oversized van: “Barely legal,” she says.
When her daughter became delusional, hallucinating, paranoid, reaching a crisis point in her struggle with mental health disability, Maggie called 911. “I thought she might get help,” Maggie told Street Sheet. “No way I could care for her. Turns out she suffers from schizophrenic symptoms. She was taken to the county hospital under 5150. Staff promised she would be referred to another facility for care. They said they would let me know. That didn’t happen.” Maggie’s daughter was pushed out onto the street. “I lost her,” Maggie says.
When Maggie finally found her daughter, who had been missing for over six months, she felt she had no choice but to put her under conservatorship. “It was horrible,” Maggie remembers. “She was forced into treatment in a psychiatric hospital. When I went there, her shoes were gone, overflowing toilets, I think she might have been raped. The staff didn’t react. They stayed behind glass, in their offices. You have no rights, you are overmedicated to keep you docile, you are vulnerable to violence, and the quality of care is atrocious.”
Fierce and protective, Maggie took her daughter out of the hospital, against medical advice. “I was terrified she would jump out of the car on the freeway. I got her into a program, they took her off her meds, found some that worked, then I got her into a board and care. It’s one of the last ones standing—you know that whole system has collapsed, right? I am the mom, though, who refused to see my daughter get thrown away.”
What’s Going On
On the one hand, the chaos of serious mental illness. On the other, the rising use of force against the mentally disabled. There’s no coordination to get people into housing, as Maggie emphasizes in our interview, and for many, simply no place to go. Thousands of mentally disabled people eligible for release—800 in the city of Los Angeles alone—are unnecessarily held in jail and inpatient locked facilities, subject to strap-down restraints and abuse, costing county taxpayers $6 million per month. Less restrictive living arrangements, generally offered by private businesses—like board and care facilities, or, the better alternative, supportive housing and voluntary community based services—have become unprofitable, and therefore unsustainable.
It’s a “war zone of triaging for scarce beds,” explains Alex Barnard, author of “Conservatorship: Inside California’s System of Coercion and Care for Mental Illness,” in the California Spotlight podcast.
It Starts With 5150
If you are unhoused and struggling with mental health disability, your experience may well begin with “5150.” Like “sweeps” and police violence, mental health laws are tools to “disappear” people from the street. Any individual is subject to being forcibly removed and taken to an emergency room if they are deemed “gravely disabled” under Welfare and Institution Code 5150, but for unhoused people it means trauma.
California has a high rate of these short-term emergency holds, according to Alex Bernard. In 2021, over 120,000 adults were reportedly subjected to 5150s—and the true number is likely far higher.
The use of this tool for removal is deeply racialized. In San Francisco, for example, where 6% of the population is African-American, 50% of the people who were subjected to eight or more 5150 holds were Black.
Yet the 5150 process usually leads to no treatment or change, Barnard wrote in his recent book: only 25% of the people picked up on 5150s are actually admitted to a hospital. Most, like Maggie’s daughter, are released after a few days. Joanna Swan, who works with the Los Angeles Community Action Network, among other organizations, says that people who are 5150’d aren’t entitled to any legal protections.
“You have zero legal rights, no right to a lawyer for 72 hours, everything depends on a psychiatrist you’ve never met,” she says. “The police often get involved, they take you far from your community, and when you are released, you’re stranded, you’ve lost any stuff you might have. No one is checking in on you, whether you have a follow-up appointment or medication.”
Peggy Lee Kennedy, a Venice resident and co-founder of the Venice Justice Committee, has seen the 5150 process up close. “It’s used to disappear people,” she says, explaining that once authorities declared a state of emergency for COVID-19, they exercised 5150s for the people they wanted to get rid of but couldn’t remove otherwise. “The city of Venice cleared the boardwalk in July 2021 with cops in riot gear,” she says. “Suddenly they brought out hidden restraint chairs—they strapped people down and carted them off. Some we never saw again. Cops don’t give you a ride back. That never happens. You are going to be displaced. You are going to lose everything, even your medications. Once discharged, do you even know where you are?”
The New Laws
Against this landscape of arbitrary abuse and scarce resources, the California Legislature recently enacted three new laws that increase the potential for the use of force and the construction of locked facilities, following a national trend. Two of the new laws, Senate Bill 43 and the CARE Court Act, make conservatorships easier to impose and broaden their reach to new groups of people. Coercive approaches also shape the language and projected implementation of Proposition 1, which California voters narrowly passed in March 2024.
“Neither SB 43 nor the Care Court Act provided any new funds for housing or services,” Samuel Jain, a senior attorney at Disability Rights California, explained to Street Sheet. “CARE court was allocated $88 million in last year’s budget, more than $100 million this year. The money is devoted to an entirely new court that orders people into existing programs. Cuts will have to be made elsewhere.”
Gov. Gavin Newsom promised mental health advocates that Prop. 1 would focus on housing and high-quality, community-focused and voluntary treatment. At the last minute, he made changes that stripped away protections against involuntary commitment, clearing the way for construction of locked facilities. California’s legislative analyst has estimated that the changes will reduce services under California’s Mental Health Services Act (“Prop 63”) by $700 million. Disability Rights California, opposing the legislation, asked the key question: “How can any solution that decreases services hope to succeed?”
Across the state, experts, advocacy groups and other grassroots organizations are still working toward a participatory, non-coercive, comprehensive system of adequate housing and appropriate services. People can stabilize and recover.
Kennedy explains the endgame succinctly. “We’re going to insist on funding community-based housing solutions—places where people have community,” she says. “We are communal. It’s so important.”
CARE Court
The CARE Court Act sets up a new court system that opens another door or process that can lead to conservatorship. It applies to people diagnosed with schizophrenia or other psychotic disorders, who are at risk of harming themselves or others, or unlikely to survive on their own.
Although the law does not mention homelessness, it targets people who visibly disrupt public spaces and are categorized as “service resistant”. The impact will fall most heavily on unhoused African Americans and upon low income and working class people. As one community advocate from the Oakland area told Street Sheet, “You have a loss of rights as you move down the chain economically.” Black people in particular are over-diagnosed with schizophrenia.
Under the CARE Court Act, a wide range of people—family members, first responders and police—can initiate the process by filing a petition to bring the person before the court. Judges are empowered to set up “care plans” and ultimately enforce these plans by placing the person into a conservatorship.
As Samuel Jain, senior attorney with Disability Rights California, observed, “There is a ‘coercive hammer’ within the system—if there is a lack of compliance, then there is referral for conservatorship, a presumption that the person should be conserved.”
SB 43
In addition to CARE court, the law that governs conservatorships (Lanterman-Petris-Short Act or LPS) was amended by SB 43 in January 2024 to expand the reasons a person can be conserved as “gravely disabled,” because they are unable to care for their basic needs (food, clothing, shelter). It adds severe substance use disorder as a reason someone cans be placed on an involuntary hold, and adds an inability to provide for one’s personal safety or medical needs to the original definition.
Proposition 1
Voters narrowly passed Proposition 1 in March 2024 following a glossy advertising campaign that counted drug companies and the state’s prison guard union among its major funders.
Prop 1 includes a $6.2 billion bond component, mostly for building new facilities, and requires a larger percentage of existing funding to be used for “housing interventions” while reducing allocations for community-based services. It “potentially injects a huge amount of money into the system to build massive locked facilities,” Jain told Street Sheet.
