Because we don't live in a perfect world...

SB1338 has been on my mind since California Governor Gavin Newsom unveiled this policy, known as the Community Assistance, Recovery, and Empowerment (CARE) Court back in March 2022.  Cutting through verbiage on both ends, supporters and those against the CARE Court, it is a court-ordered medical treatment and care for up to 24 months when a mainly unhoused individual with a psychotic disorder is found to be incapacitated to make medical decisions in their best interest. In the months that followed objections from organizations such as Human Rights Watch and ACLU, I was dumbfounded by their objections.

Photo by Matt Collamer on Unsplash

Their objections spoke of a lack of evidence in support of SB1338... The evidence that whatever social and aid services sans SB1338 aren't working is monumental within the first four steps into Downtown L.A. Skid Row, a fifty-block designated area since 1976 to contain the county's homeless population. Actually, they don't need to step into the Skid Row. Human and Legal Rights attorneys and advocates should spend a day walking and riding the L.A. Metro subway trains starting from Union Station, branching out to Long Beach, Santa Monica, and North Hollywood. 

They should walk through homeless camps without access to water and toilets. They should witness a homeless person or two squatting down in the middle of an occupied subway car to relieve themselves. They should witness a homeless person or two eating out of trash cans. They should witness a homeless person or two, screaming at everyone and at no one while unprovoked. They should witness a homeless person or two, sleeping in a trash can or just passed out in the middle of the street on scorching concrete. They should witness a homeless woman or two naked, walking down a street. They should witness a homeless person or two threatening pedestrians, sometimes with sexual violence. They should witness a father fleeing with his young daughter as a homeless man with his genitalia exposed approaches them. They should witness a homeless person or two running into oncoming traffic. 

In my decade of living in Los Angeles without a car, I have encountered all I listed what Human and Legal Rights attorneys and advocates should witness. Before they even raise a finger to object, they should witness inhumane living conditions and the danger some of our homeless population with mental illnesses pose to themselves and others. L.A. Mayor Karen Bass put it the best in her discussions about homeless people and mental illness. Not every homeless person became homeless because they suffer from mental illness and not every homeless person suffers from mental illness. However, she admitted that she would even become mentally ill if she lived out on the streets.

Imagine the false narratives you would have to build in your head to sleep out on a street, dig through trash cans for food, and relieve yourself in public. Imagine the anxieties, fears and anger you would have to suppress. Imagine the indignity and inhumanity you would have to endure to survive. To not think that the stress and trauma of living on the streets when added to an existing psychotic disorder such as schizophrenia can be detrimental and their capacity to make medical decisions in their own best interest can be impacted is simply foolish at best and outright negligent at worst. To not think that living everyday for months and years in fear, anxiety, and anger while living in hunger and unsanitary conditions can damage anyone's mental health is unrealistic.

Every human being should have the right to make decisions about their medical care, but we don't live in a perfect world where every human being has the mental capacity to make sound medical decisions in their own best interest. It is cruel for these organizations to be blinded to the indignities and inhuman conditions that the homeless people live in everyday or even suggest that a fully capacitated person would prefer it over receiving medical treatments. If the Skid Row was not in Los Angeles and with homeless people but rather on foreign soil with political refugees, they would be condemning the government and the NGOs on the ground for cruel living conditions. 

I live in a county with 75,518 homeless people according to the Los Angeles Homeless Services Authority. It isn't just Los Angeles. San Bernardino had a 26% increase, San Diego 22%, Kern 22% and Riverside 12% in the homeless population. It isn't just California. Chicago saw a 57% increase in its homeless population while Portland's homeless population increased by 20%. 

We simply can't live on ideologies. We live in a country with approximately 600,000 homeless people according to the Department of Housing and Urban Development. That is about 18 out of 10,000 people in the United States. It doesn't get more real than that.

I admit that SB1338 isn't perfect, but the social service systems prior to SB1338 utterly failed homeless people and in particular those with mental illness. Simply putting a roof over someone with a severe mental illness, in particular a psychotic disorder, without a long-term treatment plan is irresponsible. It only creates a vicious cycle of unmanaged symptoms, destruction, poverty, and homelessness. Rather than giving them meaningless rights that will most likely keep them undignified and living in inhumane conditions, I rather we give them a chance to gain their human dignity and provide humane living conditions with medical treatments so they can manage the symptoms of their illness and gain the capacity to make sound medical decisions in their best interest.

For those pondering about the Community Assistance, Recovery, and Empowerment (CARE) Court and its impact on the homeless population with mental illness, I would like to remind you about Mr. Jordan Neely's death, a homeless man with a history of mental illness and violence killed while being restraint on the New York subway train. Once Mr. Neely's history of mental illness and violence surfaced, people raised their voices that the system failed him. The system couldn't provide Mr. Neely with housing and medical treatment without his consent, and so it failed him. We can't blame the system while tying their hands and feet with ideological rights that prevent the system from providing medical treatments and care.

We should work to become kinder humans and stop seeing the world through our perfect lens. The CARE Court was created in hopes of preventing folks with psychotic disorders from living on the streets and being incarcerated due to their unmanaged symptoms. Streets and jails are no place for people who require intense medical treatments and care, and that should be more than enough reason for these organizations to work with the state and its local governments to offer resources to the homeless when in the CARE Court. Rather than raising their ideology-driven objections, they should provide legal resources to ensure fair rulings and treatments during the court proceedings. Let's be kinder by being real.