Gina Perez of San Fernando, whose homeless mentally ill adult son disappeared for months last year and had two “5150” involuntary psychiatric holds in recent months, had hoped that the new CARE (Community Assistance, Recovery and Empowerment) Court would finally be the answer to her prayers.
Perez and others who have struggled unsuccessfully for years to find help for their loved ones who need psychiatric treatment believe that mandated confined care and medication are the only remaining solutions.
But she found that CARE Court – which was launched in LA County in December to oversee court-ordered treatment specifically for people with schizophrenia and other psychotic disorders – doesn’t offer the promised remedies that Perez and other families had been told to expect.
“As it turned out, at the end of the day the client still has to participate voluntarily,” she said.
Without needed support, Perez has had the same regular weekly routine for years. Most days – whether it’s a work day or her day off – she takes time to look for her son Joseph Lee Zamora, 44, in his usual spots, to give him food, clean clothes and other essentials.
Lately, Zamora – who chooses to spend his days living on the streets in the northeast San Fernando Valley, coping with the ravages of untreated schizophrenia and substance use disorder – has been staying in a shopping center near Foothill Boulevard and Hubbard Street in Sylmar.
Zamora has been stuck in a seemingly endless cycle of schizophrenic episodes, substance use and homelessness for two decades. Perez said her current hope is that a co-conservatorship with the LA County Department of Mental Health (LACDMH) will be approved via the Office of Public Council. The primary goal is to finally compel her son to get the help he needs, she said.
“I would be a co-conservator if it works out,” explained Perez, who has been a tireless advocate for her son. “This way, I [would] have the capacity to speak with the doctors and be engaged in his care or treatment plan. … I would not necessarily dictate anything, but just to be informed.
“I have been pushing for this,” she continued, noting she feels it’s the only remaining option to help save her son, whose situation is exacerbated by a condition called “anosognosia,” which makes a person unable to recognize or acknowledge they have an illness or health problem.
Perez had been holding out hope for CARE Court. Before it was rolled out, Perez had been under the impression that CARE Court would be able to mandate confined care for gravely disabled individuals, like her son, who always declines medications or therapy to treat his conditions.
Perez said her son sometimes engages with social workers from Homeless Outreach and Mobile Engagement (HOME), a program of LACDMH to assist unhoused adults living with persistent severe mental illness. HOME team members conduct clinical assessments and offer referrals to available services, including psychiatric care, substance abuse treatment and homeless shelters.
But Zamora, who is also diabetic, consistently refuses psychiatric treatment and other support. Since the beginning of the year, he has been hospitalized and released twice on 5150 holds – an involuntary psychiatric evaluation for up to 72 hours for individuals posing a danger to themselves or others.
Sometimes the person Zamora poses a danger to is his own mother. She often lets him nap in her car after eating a meal, but that can lead to him waking up extremely agitated or even violent. If the episode continues for a lengthy period or starts to worsen, which can happen if he’s particularly tired or self-medicating, she explained, Perez sometimes calls the police for help.
“I just encourage him to get out of the car, but he can get to the point where he’s yelling and he [doesn’t stop], and I don’t feel safe,” said Perez.
Why CARE Court Isn’t the Solution
“Nothing with him is voluntary at this point,” she said. “His social workers said CARE Court is not an option for him, because there is no feasibility of him carrying out anything; he’s not going to do it.”
The goal of CARE Court, according to proponents, is to “streamline care” by facilitating a multi-step treatment plan for adults living with schizophrenia and other psychotic disorders. The CARE Court process is 100% voluntary; individuals have to be willing and active participants in their own care, according to Dr. Nilsa Gallardo, clinical program manager for the LACDMH.
“There was a misperception that people had about CARE Court – that [it] could compel someone into treatment,” explained Gallardo during a Zoom town hall about CARE Court on July 9. “What we do is we work with the families. We try our best to explain to them that it is voluntary, that’s why we spend so much time doing outreach to the individuals, even though very often – when we have our teams out there [trying to engage them] – they basically tell us … ‘I want nothing to do with you.”
The goal and hope, she explained, is that through repeated attempts over time, they can gain the trust of those individuals and encourage them to accept the services being offered and choose to participate in the year-long program available to those who qualify, she said.
“It’s difficult, and we just try to explain it to the families,” added Gallardo, noting that if individuals refuse care, they refer families to NAMI (National Alliance on Mental Illness) or other organizations that can “provide them with the support that they need in working with their loved ones.”
For Zamora, repeated outreach efforts by his family, law enforcement and social workers have been in vain – they have consistently failed for years, said Perez.
“I wish there was some magic elixir, but there isn’t – that’s why I’m pushing for co-conservatorship,” she said, adding, “I’m absolutely hopeful.”