California recently expanded eligibility for its Community Assistance, Recovery, and Empowerment (CARE) Court program. Senate bill 27, signed into law last October, added a type of bipolar disorder to the list of qualifying conditions starting January 1st.1
CARE Court eligibility expansion in California represents a major shift in how the state approaches serious mental illness. It allows family members, first responders, and mental health clinicians to petition the courts for mandated mental health treatment, along with nurse practitioners and physician assistants.2
Previously limited to schizophrenia and other psychotic disorders, California’s SB 27 mental health law now includes bipolar type I with psychotic features – and also raises questions about treatment access and civil rights.
This article will help you explore the new CARE Court eligibility, along with how the program works and how rights are protected.
Founded in 2010, A Mission For Michael (AMFM) offers specialized mental health care across California, Minnesota, and Virginia. Our accredited facilities provide residential and outpatient programs, utilizing evidence-based therapies such as CBT, DBT, and EMDR.
Our dedicated team of licensed professionals ensures every client receives the best care possible, supported by accreditation from The Joint Commission. We are committed to safety and personalized treatment plans.
What Is the CARE Court?
The Community Assistance, Recovery, and Empowerment Court program was first launched in 2023 as an alternative to criminal justice involvement or psychiatric hospitalization for people with severe, untreated schizophrenia.3
California mental health court programs like CARE aim to connect people to treatment and services before a crisis situation escalates. CARE Court operates as a civil legal process, instead of a criminal proceeding. People can request court-ordered mental health treatment in the state for someone who appears to be unable to care for themselves due to mental illness.
The person receives a court-appointed public defender and undergoes a clinical evaluation. If the court determines someone meets eligibility criteria, it then creates a voluntary agreement (if the person is willing). Alternatively, it might issue a court order requiring participation in treatment (if deemed necessary by the evaluation and the court).4
CARE Court interventions can include everything from enhanced treatment services to more restrictive interventions, with the ability to extend timelines, modify plans, or graduate participants from the program as they stabilize.
Who Was Eligible for CARE Court Before the Expansion?
CARE Court was originally designed for people diagnosed with a schizophrenia spectrum or other psychotic disorder. It focused on conditions where the symptoms of psychosis impaired someone’s ability to provide for basic needs.
Per the original guidelines, qualifying diagnoses include schizophrenia, schizophreniform disorder, schizoaffective disorder, and brief psychotic disorder.
Additionally, per the original eligibility criteria, the person must be unlikely to survive safely in the community without supervision, based on a clinical assessment and determination.
They must also be at risk of having their condition worsen without intervention, along with having previous participation in mental health or addiction treatment within the past three years to demonstrate that voluntary approaches had been tried.
CARE Court Interventions
Court-mandated mental health treatment in California emphasizes that the least-restrictive interventions be prioritized, escalating only when these approaches fail.
Initial interventions can include outpatient psychiatric services with regular medication management appointments, with case managers coordinating care and connecting people to community resources. Participants can also receive assistance in securing stable housing.
If someone doesn’t engage with voluntary services or their condition worsens, the CARE Court can order more intensive interventions. This may include attendance at a partial hospitalization program (PHP) or a residential treatment facility.
Why CARE Court Eligibility Was Expanded for Bipolar Type I
California’s SB 27 mental health law is intended to address gaps in the original CARE Court framework. Legislators recognized that severe manic episodes in bipolar disorder can create similar risks as schizophrenia spectrum disorders, with people often engaging in behaviors that can threaten their well-being.5
Bipolar I disorder involves manic episodes that can be severe enough to require hospitalization or cause major impairment, with many people experiencing psychotic features such as delusions or hallucinations.6
For this reason, the CARE Court expansion specifically applies to bipolar type I with psychotic features. Bipolar type II, which features less severe hypomanic episodes, does not currently qualify.
What People Are Saying
Advocates supporting SB 27 have argued that earlier intervention can help to prevent deterioration and long-term conservatorships. They point to recent research showing that longer periods of untreated psychosis or mania can be predictive of worse long-term outcomes. Further, court-ordered treatment can help to engage people during severe mood episodes that might impair their insight into needing professional help.7
Critics, however, worry that the new involuntary mental health treatment law may be overextended.8 Bipolar disorder usually involves periods of wellness between episodes of mania and depression. This leads to questions about whether court orders are necessary to serve people who might otherwise engage with services once their manic episode has resolved.
What SB 27 Means for People Living With Bipolar Disorder
CARE Court bipolar disorder eligibility will create new pathways to treatment, depending on your individual circumstances. We cover the potential benefits and practical considerations below.
The Potential Benefits of CARE Court Access
People experiencing severe manic episodes with psychotic features might refuse medication or dismiss loved ones’ concerns, engaging in increasingly dangerous behaviors. Court-ordered treatment provides family members and providers with a legal mechanism for intervention when someone is unable to recognize that they need help.
CARE Court can help prevent the escalating consequences many people with bipolar I disorder can face. Early intervention during manic episodes may help to avoid job loss, financial consequences, damaged relationships, and legal issues that can accompany untreated mania.
Additionally, access to stable housing resources and wraparound services can help to directly address several factors that often destabilize the recovery process.
The program’s emphasis on access to services, rather than punishments, is also notable. For instance, someone arrested during a manic episode could face charges stemming from their behaviors that can create lasting consequences. CARE Court intervention could help to prevent justice system involvement.
Practical Considerations
California behavioral health legal reform through SB 27 won’t automatically result in CARE Court petitions for anyone diagnosed with bipolar disorder. Eligibility requirements include a type I diagnosis with psychotic features, notable and ongoing challenges, and a clinical determination that someone is unlikely to remain safe without intervention.
Family members or loved ones can also note that the CARE Court is only one treatment option. Voluntary treatment, intensive outpatient programs, and residential treatment all remain available without court involvement.
What’s more, the program’s ultimate success may depend on local implementation and available resources. CARE Court requires the availability of quality treatment services and care coordination from several entities, and California counties without these resources may struggle to provide the necessary care.
The Importance of High-Quality Care for Bipolar Disorder
While SB 27 expands the legal pathways to treatment, the quality of care you receive is still the most important factor in achieving long-term stability and recovery. For people with bipolar I disorder with psychotic features, a “one-size-fits-all” approach is rarely effective.
High-quality care should be unique, evidence-based, and designed for your circumstances. It often includes:
- Holistic, integrated care: It’s common for people with bipolar disorder to also be struggling with other mental health conditions, necessitating a spate of unique and holistic treatments – from yoga to art therapy – that speak to you and your treatment goals.
- Advanced psychopharmacology: Medication management often involves some combination of mood stabilizers and second-generation antipsychotics to manage acute psychotic symptoms and prevent future manic and depressive episodes.
- Evidence-based psychotherapy: Both individual and group therapy for bipolar disorder can help you better understand the condition and the patterns it creates in your life. They can also help you stabilize your daily routines and increase your insight and resilience. Treatment modalities like CBT, DBT, and EMDR feature years of research backing their effectiveness in helping people recover.
- Family psychoeducation: Bipolar disorder and other co-occurring conditions can impact the whole family, so quality treatment facilities help teach families how to recognize the signs of psychotic symptoms and appropriate interventions. They can also attend to healing any relationships that have frayed over the years.
- A full spectrum of care: High-level California treatment centers can provide you or your loved one with a total spectrum of care, from residential treatment to outpatient and aftercare services. This can help you rebuild your life and secure the tools for long-term wellness.
Find the Help You Need at A Mission For Michael
The state of California is working to more effectively meet its citizens’ needs for high-quality, effective mental health treatment. A Mission For Michael has been proudly providing bipolar disorder and dual diagnosis treatment for years, featuring a full spectrum of care to meet your unique treatment needs.
AMFM utilizes the best of evidence-based and holistic interventions to help you or your loved one better understand your challenges and develop new coping methods. This is alongside providing psychiatric and medication management services by a licensed prescriber.
We’re dedicated to helping you meet your challenges head-on, offering full wraparound services and family support. Let us help you build a new path forward – contact us today to find out more.
Frequently Asked Questions About California’s CARE Court Expansion
How Does the Court Determine if Someone Qualifies?
In addition to a qualifying diagnosis, eligibility is based on a clinical evaluation by a licensed mental health professional. The court must find that the person is experiencing severe symptoms of a psychotic-related disorder and is unlikely to provide for and care for themselves as a result.
Additionally, the person must have a prior history of struggling with voluntary treatment options.
What Happens if a Participant Doesn’t Follow the Court Order for Treatment?
CARE Court is a civil process, not a criminal one – so the participant will not face jail time for any non-compliance. Having said that, if a person does not engage with their proposed treatment plan, the court may order a higher level of care or end the program. This could later be used as evidence in a conservatorship hearing.
Can a Family Member Start the CARE Court Process?
Yes, family members are among those who are legally permitted to file a petition with the CARE Court. Other eligible groups include first responders, mental health professionals, and nurses. This ensures that those closest to the person and most understanding of their treatment needs are empowered to help them access treatment, potentially before a crisis leads to an arrest or other serious consequences.
References
- Kendall, M. (2025, December 27). New California law expands Newsom’s mental health court. CalMatters. https://calmatters.org/housing/homelessness/2025/12/care-court-sb-27-new-law/
- King, V. (2026). California expands Care Court under Senate Bill 27. KRCR. https://krcrtv.com/north-coast-news/eureka-local-news/california-expands-care-court-under-senate-bill-27
- California Health and Human Services. (n.d.). CARE Act. https://www.chhs.ca.gov/care-act/
- CARE Act Resource Center. (2023). Frequently Asked Questions – CARE Act Resource Center. https://care-act.org/library/faqs/
- Digital Democracy. (2025). SB 27: Community Assistance, Recovery, and Empowerment (CARE) Court Program. (2025). Digitaldemocracy.org. https://calmatters.digitaldemocracy.org/bills/ca_202520260sb27
- National Institute of Mental Health. (2025). Bipolar disorder. Www.nimh.nih.gov; https://www.nimh.nih.gov/health/publications/bipolar-disorder
- NAMI (n.d.). CARE Act & Care Court – NAMI Greater Los Angeles County. Namiglac.org. https://namiglac.org/resources/community-resources/care-act-care-court/
- Mental Health America of California. (2025, October 21). SB 27 (UMBERG) Care Court Expansion – Oppose – Mental Health America of California. https://mhac.org/policy-position/sb-27-umberg-care-court-expansion-oppose/
