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From the Mayor's Desk

Many Suffering from Mental Health Illnesses Stuck in Cycle from the Streets to Hospitals. CARE Court will help.

homelessness and mental illness

Brian Black cycled in and out of hospitals and homelessness for 7 years before one Sunday morning March 1988 when voices in his head told him to jump off the Coronado Bridge. 

Miraculously, he survived. The traumatic incident led Brian and his family to finally diagnose the mental health problems he struggled with for years: paranoid schizophrenia.  

But Brian chose to ignore his diagnosis and instead of seeking treatment he continued to cycle in and out of hospitals and homelessness. His family tried to force him into care both in Orange County and San Diego County, but they were not able to keep him in any facilities long enough for it to make a difference. 

It took five more years of suffering and other suicide attempts before Brian walked into a jewelry store in La Mesa with a steak knife and a plan to end his life via police-assisted suicide. He was shot five times by a La Mesa police officer, but again, survived. 

Brian's family fought hard to keep him out of prison, and they were ultimately successful. A San Diego judge ordered Brian into a locked facility where he was required to take court-ordered medicine to treat his schizophrenia. The court’s decision turned Brian's life around.  

He got better, eventually was let out of the facility and graduated college, got married and became an activist who helped keep other people suffering from mental illness stay out of prison. He continued to take his medication every day of his life up until he died in a car accident in 2008. 

Brian’s sister, Laurie Black, a well-known civic and political activist, told me she thinks about her brother every time she sees someone suffering on San Diego’s streets, clearly caught in the fog of a severe mental illness. She says her brother needed the court’s intervention to finally comprehend the seriousness of his diagnosis and accept the help he needed.  

Laurie says her family’s experience makes her hopeful that the state’s new CARE Court program, which launches in San Diego County on Oct. 1, will help people like her brother well before they go to dangerous extremes like he did.  

Experiences like Brian’s are why I worked with legislators and pushed so hard for the signing of Senate Bill 1338, the bill that establishes CARE Court. The program offers a new pathway to deliver mental health and substance use services to people like Brian who are diagnosed with schizophrenia or other psychotic disorders and not able to get the treatment they need on their own.  

The new law requires counties to provide comprehensive treatment to those suffering from severe mental illness. It also creates a process for families, clinicians, first responders, and others to file a petition with the civil court to connect people suffering from these severe mental illnesses to court-ordered voluntary treatment if they meet criteria and would benefit from the program.  

Beginning in October, the County of San Diego Behavioral Health Services will work to engage people in CARE Court with a CARE Plan that will be developed in partnership with County BHS, the petitioned individual and an assigned legal counsel.  

The end goal is to get people currently suffering from severe mental illnesses — many who are suffering publicly on our streets — connected to behavioral health treatment, stabilization medication, a housing plan, and other services as needed for 12 months or more time when necessary.  

CARE Court is a major step forward and will make an impact on both our mental health and homelessness crisis, but we cannot stop here. Conservatorship reform, which is currently awaiting the governor's signature, is another huge step forward, but we still need to keep working and continue doing more on mental health in California. 


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