Newsom's big mental health plan

It's bold. It's controversial. It just might work.

You’ve heard the expression “Go big or go home.”

And if those are the choices, we can definitely say that Gov. Gavin Newsom is not in the mood to go home.

Throughout his political career Newsom has shown a fondness for the grand gesture. Although at times they can be more gesture than grand.

Back in December he created a media splash with a bit of political jujitsu about the ridiculous Texas abortion law. That law allows citizens to turn in those who violate the state’s draconian abortion statute, and collect a bounty of $10,000 for doing so.

Newsom announced that California would do the same, only the focus would be on illegal firearms. Concerned citizens could turn in anyone who “manufactures, distributes or sells” illegal weapons. And he dared the U.S. Supreme Court, which let the Texas law stand, to rule against the gun law.

It’s a clever idea but it kind of created the impression that Newsom was making it a law just by saying so. Actually it needed approval from the legislature, which introduced it last month.

Still, it must be said that Newsom’s big picture, outside-the-box thinking has paid off. He’s nothing if not innovative. San Francisco’s Care Not Cash program, instituted when he was mayor, was one of the few fresh takes to address homelessness.

And now he’s got another good idea, which he is calling Care Court.

The plan is to take on one of the most heartbreaking and difficult problems in California cities — the profoundly mentally ill. As anyone who’s lived in San Francisco for even a short time knows, there are people on the street who are so far in the depths of their mental illness that they can not only not care for themselves, but they can be a danger to others.

You’ve probably got your own stories of people wandering the street, barefoot or without adequate clothing for the elements, screaming to the skies. In our neighborhood a woman rushes at pedestrians, shouting profanities.

Earlier this year a resident in our building was attacked by her. She threw punches and yelled insults. Luckily the resident wasn’t injured. But she has no idea what triggered the attack.

And if you need any more evidence, this Heather Knight column is a horror story of mental illness and people who are completely out of control. Read it and cringe.

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Newsom’s Care Court has lots of moving parts, but at the end of the day it drills down to one important principle — it is cruel and inhuman to leave these people on the street. They should be given treatment and care.

And this is important — if they are not willing to accept help, it will be mandated. In extreme cases, they will be housed involuntarily.

It is an understatement to say that the idea is controversial. There have been attempts to address the same points through State Sen. Scott Wiener’s bill SB 1045. It said that an individual who had been placed under an emergency psychiatric hold eight times in one year, would be eligible for a conservatorship.

That means they would be under the protection of the county, and could be confined for their own protection and mandated to take their medications. (Although not force fed them.)

But in fact, almost no one in San Francisco has been conserved under the bill. Mental health activists made the familiar argument that it was “criminalizing mental illness,” and judges have proved to be reluctant to grant conservatorships.

But as Newsom’s plan outlines, often it is family members who are begging to get help for their mentally distraught son, daughter or spouse. One of the ways a person could be referred to Care Court is if a family member believes the person is unable to care for themselves.

As we know, this is a long-standing problem. We’ve all heard the stories of how then-Govenor Ronald Reagan in 1967 announced plans to “end the inappropriate, indefinite and involuntary commitment of persons with mental health disorders.”

Longtime California political columnist Dan Walters has a good summary here.

Reagan wasn’t trying to throw people out on the street. There was supposed to be an elaborate mental health program that would treat the severely ill. But funding dried up, the hospitals closed and we’ve now had decades of dysfunction.

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Newsom spoke for many when he spoke to the current state of affairs:

“There’s no compassion with people with their clothes off defecating and urinating in the middle of the streets, screaming and talking to themselves. I’m increasingly outraged by what’s going on in the streets. I’m disgusted with it.”

That has to ring true to many Californians. Will Care Court make a difference? We will have to see. But if it could find help and treatment and get the profoundly mentally ill into safe, if mandated, housing and care, it would be a game changer.

In fact, it was a bit of a surprise he didn’t talk Care Court up a a little more in his State of the State speech this week. There was just a quick mention and then on to other things, like the now familiar tweaking of Texas and Florida.

On the other hand, the real surprise of the speech was that it came in under 20 minutes. Veteran Newsom watchers, if offered a prop wager of over or under an hour, would surely have bet the over.

Say what you will about the governor, he’s still surprising us.

Contact C.W. Nevius at cwnevius@gmail.com. Twitter: @cwnevius