Governor Gavin Newsom, who as mayor of San Francisco over a decade ago championed a controversial policy for the city's poor dubbed Care Not Cash, is now proposing a new solution for the problem of untreated mental illness in the streets of California cities.

In a proposal that is likely already raising hackles at the ACLU, Newsom tells the Chronicle's Heather Knight this week that he's damn angry about the ongoing epidemic of mental illness, which is part and parcel of the state's epidemic of homelessness.

"I’m increasingly outraged by what’s going on in the streets,” Newsom says. “I’m disgusted with it."

Newsom implies he wants civil rights advocates to step out of the way, and for politicians to stop stymying efforts to bolster conservatorship under the auspices of respecting the rights of people who can't care for themselves.

"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 tells the Chronicle.

Homeless advocates will be the first to tell you that San Francisco's homeless problem lines up with the plague of homelessness that swept the nation in the 1980s — especially in urban centers — after Ronald Reagan decimated the budget of HUD and contributed to the defunding of mental hospitals. Homelessness has been complicated by the rise of various drugs, with fentanyl and meth being the biggest culprits on the streets of SF lately. (And when we're talking about mental illness, even those without a history of psychosis can experience meth-induced psychosis.)

Newsom's proposal, which some are inevitably going to argue sounds a lot like criminalizing mental illness, will involve judges and the courts. He's suggesting that there be an arm of the Superior Court of California called "Care Court," and in this court, an individual suffering from a mental illness would be brought before a judge either because they recently committed a crime, because an involuntary psychiatric hold is ending, or because they've been referred there by a family member or outreach worker.

The person would be assigned a county case worker and a clinical team, and they may be court-ordered to take medication — though taking the medication would remain voluntary. And they may be compelled to see a psychiatrist or enter a board-and-care facility.

If the person refused to comply with the court's directives, their criminal case would then proceed, if there was a crime committed; or they may be placed in conservatorship.

Newsom is also adding an extra $2 billion to the state's budget to address homelessness and mental health, for a total of $14 billion — $4.5 billion of which is earmarked for mental health treatment. And, Knight notes, a 1% income tax on the wealthy that was passed by voters in 2004, called the Mental Health Services Act, will generate another $3.8 billion this year for county mental health services.

Knight cites an alarming figure from 2021: Judges across California found 4,531 people incompetent to stand trial on felony charges last year, meaning they were too severely mentally impaired to understand the nature of their crimes — and two-thirds of them were homeless. Also, "nearly half had received no mental health treatment in the previous six months."

Will Newsom face the usual storm of pushback when it comes to respecting the rights of those who are psychotic or experiencing temporary psychosis? Probably. But he is hoping that he'll have support from the legislature, and he's expecting to get his Care Court proposal passed by June.

Photo by Justin Sullivan/Getty Images