By Todd Schirmer

In Marin County, addressing the needs of individuals with severe behavioral health conditions remains a priority.

One of the most significant recent developments in behavioral health legislation is the Community Assistance, Recovery and Empowerment Act. Approved by California lawmakers, the CARE Act creates a new court serving individuals with severe, untreated mental health disorders, primarily schizophrenia spectrum or other psychotic disorders.

It aims to connect them with treatment plans and support services overseen by the court, helping to break cycles of repeated hospitalizations, homelessness and incarceration.

In Marin, CARE will be implemented through a collaborative approach. The court will oversee judicial proceedings, while the Marin Behavioral Health and Recovery Services Division will create treatment plans and connect individuals to necessary resources. The Public Defender’s Office will advocate for individuals’ rights, and county counsel will represent the county. The legal self-help center will assist in filing petitions. This structure aims to provide support for individuals who may otherwise fall through the gaps of traditional behavioral health systems.

Referrals to CARE can come from family members, clinicians, first responders, and community-based organizations, creating multiple points of entry. After a referral, Health and Recovery Services representatives will conduct a formal assessment to determine eligibility and create a treatment plan. This process ensures that those who need help can access it, regardless of where they start. At all phases of the program, the goal is voluntary engagement in treatment.

There are some common misconceptions. One myth is that CARE is involuntary treatment that will strip individuals of their rights. In reality, while CARE includes court oversight, it is designed to be collaborative, incorporating input from the individual and their support network, and focuses on self-determination and voluntary engagement.

Another misconception is that it will provide a quick fix for social issues like homelessness or incarceration. While CARE is an important tool, it is not a universal solution for all behavioral health-related challenges and we expect a relatively small group of individuals to be referred to and benefit from the program.

Will CARE work in Marin County? The answer is yes. However, while CARE has the potential to provide structured treatment pathways for some individuals, it is not a cure-all. In 2018, Marin launched the “Assisted Outpatient Treatment” program, also known as “Laura’s Law.” Our experience with this program showed that court-mandated programs can help stabilize some people, especially with assertive outreach and extended periods of engagement. CARE, similar to the treatment program, will likely benefit certain individuals, but cannot address the full range of community needs without substantial systemic support.

For CARE to succeed, it must be accompanied by adequate ongoing funding, staffing and resources. With a range of services and flexible treatment options, Marin can successfully meet its diverse community needs.

Additionally, state-level efforts should allow counties flexibility to tailor programs to their specific populations. While CARE provides a foundation, each county has distinct challenges and resource gaps. For example, Marin’s high standard of living and high scores on health indexes often conceal substantial health disparities and difficulties meeting the high demand for the community’s behavioral health needs.

To ensure the success of programs like CARE, resource allocation needs to be carefully considered. State mandates alone will not solve the behavioral health crisis; programs need tangible support — staffing, facilities and funding — to be effective. Expanding a continuum of treatment and housing options, up to and including state hospital beds, and securing sustainable funding for long-term behavioral health programs must be a priority. Programs like CARE are a step in the right direction when included as part of a broader system that includes preventive measures and enhanced crisis response.

CARE represents an important development for Marin and other California communities. This is a new tool that will be valuable in encouraging some members of our community into comprehensive behavioral health care. However, it will not address every issue related to behavioral health care. For true progress, we must invest in supportive infrastructure, adaptable programs, and flexibility tailored to local needs.

This approach, supported by adequate state and local resources, will better position Marin to meet our residents’ needs and create a compassionate, effective behavioral health care system that truly serves the entire community.

Todd Schirmer is director of the Marin County Behavioral Health and Recovery Services Division.