Mandatory Treatment for Mentally Ill Homeless People Raises Questions in Santa Barbara

Santa Barbara County’s new mental health czar, Toni Navarro, is taking a wait-and-see approach to the new multibillion-dollar statewide proposal unveiled last week by Governor Gavin Newsom that would allow county judges throughout California to order mentally ill homeless people into treatment.

The proposal — announced with great fanfare but few details — is regarded by some as a bold new initiative and a potential game changer when it comes to the plight of those both chronically without homes and afflicted with debilitating psychotic disorders. But Navarro — who’s been at the helm of the county’s Department of Behavioral Wellness for the past three months — has more questions than answers about the program. 

“This is still the first of many conversations,” she cautioned.

No actual legislation has been proposed yet, she noted, nor any actual dollar amounts — other than “the billions and billions” alluded to in last week’s grand unveiling. Mostly, Navarro expressed concern that whatever package emerges has a significant increase in funding for agencies providing the frontline services. It’s not enough to create “the four walls” of new infrastructure, she stated. Funding for services is essential. 

Right now, Navarro said, more than 30 percent of the budgeted positions of her department are currently unfilled. The pinch is felt most acutely, she added on direct-service positions, for therapists and practitioners. 

“COVID taught the world that mental health matters,” she stated. 

Schools are now spending serious money to address the mental-health-care needs of students, but this has put county agencies like Navarro’s under competitive strain. Lobbyists for county governments have objected that the sanctions Newsom’s proposal would impose on counties that do not participate are both onerous and counterproductive. But the California District Attorneys Association came out in favor of the mandatory-treatment approach. 

Likewise, it’s not clear how the new court-ordered treatment Newsom has envisioned would dovetail with existing mental health courts. And civil libertarians have questioned both the constitutionality and effectiveness of court-mandated treatment. But no one doubts that a huge problem exists and that it’s not being adequately addressed. 

“Here in Santa Barbara, we see that housing continues to be a priority for people struggling with persistent mental illnesses and who are unhoused. But we also need money to provide the support services,” she said. And how many people fall into these camps in Santa Barbara? “This is exactly what we are trying to figure out,” Navarro said. “Who are the highest utilizers with the highest needs?” 

To the extent any program currently exists that utilizes the leverage of state judges to compel treatment, it’s Laura’s Law, which Governor Newsom wrote off as a well-intentioned flop. According to Newsom, only 218 individuals had been ordered by a judge to seek treatment. Supporters of the program in Santa Barbara counter that only a handful of state counties have opted in. They contend the chief virtue of Laura’s Law is not the number of court orders issued but the increased, more aggressive outreach it mandates for public agencies like the county’s Department of Behavioral Wellness. 

Current county data shows that three individuals a month are referred for the intense level of intervention called for under Laura’s Law. Of those, 41 percent accept voluntary treatment, 22 percent receive ongoing attempts at engagement, and 7 percent were actually ordered by the court to undergo treatment. Another 30 percent either left the county or refused to engage in services.

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