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Because We Don’t Live in a Perfect World

SB 1338 has been on my mind since California Governor Gavin Newsom unveiled the policy known as the Community Assistance, Recovery, and Empowerment (CARE) Court in March 2022. Cutting through the verbiage from both supporters and opponents, CARE Court essentially creates a system of court-ordered medical treatment for up to twenty-four months when an individual—often unhoused and living with a psychotic disorder—is deemed unable to make medical decisions in their own best interest.

Photo by Matt Collamer on Unsplash

In the months that followed, organizations such as Human Rights Watch and the ACLU raised objections to the policy. I found myself dumbfounded by many of their arguments.

Some critics claimed there was insufficient evidence supporting SB 1338. Yet the evidence that the current system of social services and voluntary interventions is failing can be seen within the first few steps into Skid Row in downtown Los Angeles—a fifty-block district designated since 1976 to contain much of the county’s homeless population.

In truth, critics do not even need to walk through Skid Row.

Human and legal rights attorneys and advocates should spend a day walking and riding the L.A. Metro system. Start at Union Station and travel the lines branching toward Long Beach, Santa Monica, and North Hollywood. Spend a day observing what commuters see every day.


They should walk through homeless encampments without access to water or toilets. They should witness someone squatting in the middle of a crowded subway car to relieve themselves. They should see people eating from trash cans, screaming at everyone and at no one, or wandering into traffic. They should see people sleeping in trash bins or collapsed on scorching concrete in the middle of the street.

They should see the naked woman walking down a boulevard in full view of traffic. They should see pedestrians threatened, sometimes with sexual violence. They should see the father pulling his young daughter away as a man with his genitalia exposed approaches them.

In the decade I have lived in Los Angeles without a car, I have witnessed every one of these scenes.

Before raising objections from afar, those who argue against policies such as CARE Court should witness these conditions themselves—the inhumane living environments and the danger that untreated mental illness can pose both to those suffering from it and to the people around them.


Los Angeles Mayor Karen Bass once framed the issue in a way that struck me as honest. Not every homeless person becomes homeless because of mental illness, and not every homeless person suffers from mental illness. Yet she also acknowledged something simple and human: living on the streets would break almost anyone.

Imagine the mental narratives one must construct simply to survive a night on the sidewalk. Imagine digging through trash for food or relieving yourself in public. Imagine the fear, anxiety, anger, and humiliation one must suppress day after day just to endure.

To believe that the trauma of living this way—layered on top of an existing psychotic disorder such as schizophrenia—would not impair someone’s ability to make medical decisions in their own best interest is naĂŻve at best and negligent at worst.

Because we do not live in a perfect world.

And in an imperfect world, pretending that suffering does not exist is not compassion.

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