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The California Legislature is considering creating a “CARE Court” to fast track determinations of mental competency to mandate treatment.
The Community Assistance, Recovery, and Empowerment (CARE) Court Program is being proposed to both the California Assembly (AB2830) and State Senate (SB1338).
This bill is being strongly opposed by many disability rights organizations with letters from Human Rights Watch and a coalition led by Disability Rights California.
What is your opinion?
1. Homelessness in California
Address housing and you address a large number of problems. If you drive around California cities and actually look around, you’ll find streets lined with RVs, campers, and cars where those who can’t find or afford housing are living rough. This is in addition to those who are living both homeless and car-less on the streets.
2. Grossly underfunded disability and mental health services
Since the first Great De-institutionalization under Reagan, home and community based services have never been adequately funded. Also, the because Disability Services are funded as Benefits (like welfare) and not Insurance, disabled people are essentially forced NOT to work, build assets, or even get married to protect their meager services.
3. Second class citizens (or worse)
In addition to being denied the actual right to participate in our economy, disabled people are already subject to punitive court action through Conservatorships which can casually strip them of their rights (and it can happen to anyone) with minimal oversight or recourse – as seen most recently in the FreeBrittany case for Brittany Spears… unfortunately, most people subject to conservatorships don’t have millions of fans and fame to help them.
4. … and then there’s Race
Diagnoses of mental illness are quite disproportionate by race. This starts in our schools with “Emotional Disturbance” diagnosis falling on African American boys far out of their proportion of the population and proceeding through adulthood.
CARE Court promotes a system of involuntary, coerced treatment, enforced by an expanded judicial infrastructure, that will, in practice, simply remove unhoused people with perceived mental health conditions from the public eye without effectively addressing those mental health conditions and without meeting the urgent need for housing. We urge you to reject this bill and instead to take a more holistic, rights-respecting approach to address the lack of resources for autonomy-affirming treatment options and affordable housing. – Human Rights Watch
“There’s no compassion with people with their clothes off defecating and urinating in the middle of the streets, screaming and talking to themselves,” Newsom said. “There’s nothing appropriate about a kid and a mom going down the street trying to get to the park being accosted by people who clearly need help.” (Knight)
What can be done?
Let’s start working the pervasive problems rather than the rare symptoms
1. Get really serious about addressing housing
Housing people is the right thing to do. And, many studies have shown that it is also much cheaper overall to guarantee housing rather than provide services on the street
2. Fully fund Home and Community Based Services
Providing a solid safety net for all disabled, mentally ill, and elderly people so that they can live in their communities will help many people and radically reduce the number of people whose condition will decline to where they are perceived to be a “public nuisance”.
3. Transition to Universal Disability Services Insurance
Change our model for mental health and disability services so that people can work and participate in our society as much as possible instead of continuing our “Poverty by Design” benefits system
4. End Mental Health and Disability Hot Potato
California has many overlapping, gap-filled, competing and mostly confusing systems for supporting disabled, elderly, and mentally ill people. Finding services, separately applying to each agency, working the different systems would be exhausting for a healthy person who doing this as a full-time job. No one is in control. No one is accountable. This new CARE Court is a patch on top of a Rube Goldberg Device held together by tape and band aids.
These systems need to be combined, integrated, and made accountable before we contemplate adding yet another system.
Human Rights Watch’s Opposition to CARE Court – https://www.hrw.org/news/2022/03/24/human-rights-watchs-opposition-care-court#
Disability Rights California & Coalition’s Letter in Opposition to CARE Court – https://www.disabilityrightsca.org/latest-news/disability-rights-california-coalitions-letter-in-opposition-to-care-court
Exclusive: Gavin Newsom has a bold new mental health plan, inspired by the misery on S.F. streets. Will it work? Heather Knight, San Francisco Chronicle – https://www.sfchronicle.com/sf/bayarea/heatherknight/article/Gavin-Newsom-Care-Court-mental-health-16973070.phpmore
I hate the word hope. I always have.
I did more than hope in 2008 when I filed a formal complaint with the U.S. Department of Education over Michigan’s alleged violations to the “highly qualified teacher” provision in both the No Child Left Behind and the Individuals with Disabilities Education Act. A complaint that took nine months to investigate and led to Michigan having to change the teacher certification requirements for all secondary special education teachers.
Working Differently or Not at All: COVID-19’s Effects on Employment among People with Disabilities and Chronic Health Conditions
“COVID-19 is accentuating pre-existing structural disadvantages and inequalities. Although employment levels and income have rebounded for individuals and households who were more advantaged prior to the pandemic, this is not the case for lower income households and less advantaged groups. Many continue to remain insecure with fears of falling off an income cliff. We not only point to the crucial role of employment for economic security but also illustrate that it is not the only factor. This becomes all the more salient during crises that generate exogenous shocks to social, political, and economic systems, whereby individuals cannot necessarily rely on labor market supports alone.”
Maroto ML, Pettinicchio D, Lukk M. Working Differently or Not at All: COVID-19’s Effects on Employment among People with Disabilities and Chronic Health Conditions. Sociological Perspectives. May 2021. doi:10.1177/07311214211012018
Findings from an online survey on the mental health effects of COVID-19 on Canadians with disabilities and chronic health conditions
“Increased anxiety, stress, and despair were associated with negative financial effects of COVID-19, greater concerns about contracting COVID-19, increased loneliness, and decreased feelings of belonging…Findings address how the global health crisis is contributing to declining mental health status through heightened concerns over contracting the virus, increases in economic insecurity, and growing social isolation, speaking to how health pandemics exacerbate health inequalities.”
David Pettinicchio, Michelle Maroto, Lei Chai, Martin Lukk. Findings from an online survey on the mental health effects of COVID-19 on Canadians with disabilities and chronic health conditions, Disability and Health Journal, Volume 14, Issue 3, 2021.
Students with mental health, emotional, or behavioral needs, like all children, need to be understood, supported, and appreciated in their schools and communities. Specialized services and supports may be required to help these children succeed at school, and problems at school can create or increase mental health needs. As schools have resumed in-person learning for most students this year, it’s become clear that mental health is a significant area of need. United States Secretary of Education Miguel Cardona recently released a startling statistic in a report on school age children’s mental health needs. The report stated that before the COVID-19 pandemic, about 1 in 5 students was struggling with their mental health–an already concerning number–but researchers now estimate it has increased to close to 8 out of every 10 students!
Students are returning to school after more than a year of isolation from their peers and other social supports. Many families are dealing with financial crises including housing or job losses. Many children have experienced their own illness or that of a family member. They may have even lost family members including parents or other loved ones. These traumatic events are likely to affect a child so significantly that they will struggle with school and learning. Students with disabilities went without or were provided very reduced school-based resources and supports during remote learning, including mental health services or other help that they need to learn. All these factors create significant risk of an increased need for mental health screening and services at a time when schools are dealing with the continuing risk of COVID-19 and shortages of school staff, including nurses, counselors, and teachers.
Originally published by the Disability Rights Education and Defense Fund (DREDF) on 29 October 2021. Used with Permission.
Problems with mental health can influence school attendance, academic performance, graduation and dropout rates, behavior and discipline problems and health and safety risks. Unmet mental health needs affect not just individual students but also families, schools and communities and need to be addressed as early as possible. And problems at school often increase a student’s needs for mental health support. It’s a two-way street.
For children with disabilities or suspected disabilities, it’s important to determine if and how mental health challenges might be creating difficulties at school. Sometimes the signs of a problem are obvious, but they can be hard to see. A student may withdraw, act out, struggle to learn, resist going to school, or show other signs of stress through their behavior. They may put all their energy into getting through the school day, only to fall apart at home because they are so stressed. A child who did not previously qualify for special education or a 504 plan may need to be evaluated to determine if they are now eligible for that help. Teams may need to adjust existing IEP or 504 plans so that mental health support can be added, increased or provided differently.
The Individuals with Disabilities Act (IDEA) requires that an IEP (Individualized Education Program) be created in all areas of need for an eligible student, regardless of disability category they are in. Often, the mental health needs of disabled children and youth are overlooked because school staff assume that whatever problems or needs occur are the result of their known disability or problems at home. They may tell a family that “all children with autism struggle with that behavior” for example, when parents try to explain a new issue. A child’s needs should never be determined based on stereotypes about their known disability or assumptions about their home situation and can only truly be assessed by reviewing available data and the evidence collected as part of an evaluation. Regardless of the source of the problem, if it is so significant that the child is struggling to attend, participate, learn, and behave at school, an evaluation is the only way to determine whether they qualify for services and support under existing education and disability laws. The process involves testing as well as input from parents, the student, educators, and outside professionals and direct observation and timelines apply for how quickly it must be done. Both formal and informal data helps the team determine what kind of services, supports, and help will best benefit a student in achieving their education goals. An evaluation should be whenever concerns arise, regardless of whether the student is in preschool, high school, or somewhere in between.
When requesting a mental health evaluation, make sure you document your concerns and give examples when you request the evaluation. Here is a sample letter to use as a guide: Requesting an ERMHS (Educationally Related Mental Health Services) Assessment. Different states and school districts may use different terminology for this type of evaluation but our sample letter gives you instructions about how to describe the problems you’re seeing. Another resource is our School Reintegration/Transition Plan Sample Letter for students who are struggling to return to school after a health, including mental health crisis: And our free online training this month focuses on mental health needs, behavior and discipline—find complete details in the training information provided below.
It is essential that schools, healthcare providers and families work together to ensure that students get the mental health support they need to attend, participate, and succeed at school. Recognizing the increased need, extra state and federal funding is going to schools to address it. Parents and other stakeholders need to weigh in on how these funds are used. There are many ways to do this, including writing to the superintendent and school board, attending public meetings to speak, or participating in budget and funding decision making committees. Contact your school leadership to learn more about these opportunities.
Disability is part of human diversity, and mental health is an important consideration for all of us. We hope these resources assist you in making sure that all students get the help they need to learn and succeed at school.
Mental Health Resources:
- Kids’ mental health crisis is at a critical point, Education Secretary Cardona says NPR report October 19, 2021
- The Mental Health Crisis In Our Schools NPR Special Series
- For Kids, Anxiety About School Can Feel Like ‘Being Chased By A Lion’
- Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs (PDF) US Department of Education, Office of Special Education Programs
- Supporting and Protecting the Rights of Students at Risk of Self-Harm: U.S. Department of Education’s Office for Civil Rights (OCR) and the U.S. Department of Justice. A joint 3-page fact sheet to help support students with mental health disabilities, their families, and their schools in the era of COVID-19.
- Letter to Educators: Students at Risk for Self-Harm or Suicide. The Office of Civil Rights also released a letter to educators highlighting the civil rights obligations of schools and postsecondary institutions to students with mental health disabilities.
- Mental Health Services FAQ – Announcements & Current Issues CA Department of Education
- Navigating the Education System – Children’s Mental Health Pacer Center
- Connect to Care: Resources from The UC Davis Child Mind Institute
- Family Resource Center, which features over 700 resources on kids’ mental health, learning disorders, and common parenting challenges — all in English and Spanish.
- The latest newsletter, Resources to Help our Kids Thrive, which connects you with stand-alone articles in English and Spanish, such as Should I get care for my child? and How to find a children’s mental health professional.
- The 2021 Children’s Mental Health Report (also available in Spanish), which focuses on the effects of the COVID-19 pandemic on children’s mental health.
- 12 Tips for Parent Involvement in IEP Meetings
- Q&A about Part B of IDEA: Parent Participation
- Developing Your Child’s IEP: The Parent’s Role
- The Important Role of Parents in Special Education | Quick Guide: What is independent study in California?
- CA Department of Education: Parents’ Rights
- DREDF – Special Education Resources
- Find Your Parent Center
- Key Definitions in IDEA | A Reference List
- OSEP English-Spanish Glossary
- Parents’ Rights – Quality Assurance Process (CA Dept of Education)
- Sample Letters and Forms -Disability Rights Education & Defense Fund