San Francisco County is set to implement a new mental health initiative called Care Court on October 1, 2025, aimed at providing court-ordered treatment for individuals with schizophrenia spectrum diagnoses. Dr. Angelica Alameda, a key figure in the planning of this program, presented an overview during a recent government meeting, highlighting its unique approach to mental health care.

Care Court, established through Senate Bill 1338, allows a wide range of petitioners—including family members, treatment providers, and first responders—to seek court intervention for individuals who are not receiving adequate voluntary treatment and are at risk of deteriorating. The program is designed to be a less restrictive alternative to conservatorship, focusing on supporting individuals in the community rather than placing them in locked facilities.

The eligibility criteria for Care Court include individuals over 18 who have a diagnosis of schizophrenia or other psychotic disorders and are not clinically stabilized. The program aims to engage approximately 3,000 individuals in San Francisco, based on estimates of the local population suffering from these conditions.

Dr. Alameda emphasized the collaborative efforts among various stakeholders, including the Department of Public Health, the mayor's office, and the Department of Homelessness and Supportive Housing, to ensure a comprehensive support system for participants. The program will not involve involuntary treatment, and individuals can voluntarily agree to participate in care plans while having the option to identify a care supporter to assist them throughout the process.

As the implementation date approaches, the Department of Public Health is focused on developing operational workflows and addressing potential challenges such as funding and staffing shortages. The initiative aims to create a seamless system of care that minimizes gaps in services and communication, ultimately enhancing the support available to those in need.

The Care Court program represents a significant step forward in addressing mental health challenges in San Francisco, with the potential to improve the lives of many individuals struggling with severe mental health issues. As the city prepares for its launch, ongoing collaboration and planning will be crucial to its success.