In recent years, the state has increasingly responded to disability, homelessness, and substance use through courts, police, and forced treatment. The next administration must choose a different path.
This article was co-authored by Tremmel Watson, a Public Policy Analyst with Disability Rights California (DRC), and Kate Caldwell, Director of Research & Policy at the Center on Racial & Disability Justice (CRDJ) at the University of California, Los Angeles. Read this piece on DRC’s Substack and CRDJ’s Medium account.
This November, Californians will elect a new governor who will inherit powerful systems and a clear opportunity to decide how to use that power. These current systems punish and use force against some of the state’s most vulnerable residents — people with disabilities, people experiencing homelessness, and people experiencing a mental health crisis. The next administration’s challenge is to build a state that can mobilize those systems just as effectively before a crisis, in ways that center and expand self-determination, rather than state control.
The War on Drugs criminalized substance use, drove mass incarceration, and increased racial disparities. It never truly ended. Today, California is repeating that punitive approach by adapting new language and new systems that use the court system, coercion, and confinement. State leaders increasingly describe these interventions by using a rhetoric of public safety, modernization, accountability, and compassionate care. However, for disabled people, the result is often greater exposure to state control rather than better access to the resources people need.
The word “carceral” is used broadly here, not to mean that every policy discussed below is the same as jail or prison. It refers instead to policies and practices that respond to social and health needs through confinement, policing, courts, forced treatment, surveillance, or the threat of loss of liberty. Some of California’s most consequential recent disability policies operate through civil courts or healthcare systems, even as they give the state more power over disabled people’s lives.
How California Got Here
California’s current turn toward coercion is the product of decades of policy choices about who gets care, who gets controlled, and what happens when voluntary systems fail. The state’s landmark Lanterman-Petris-Short Act, enacted in 1967, was designed in part to end inappropriate, indefinite involuntary commitment and safeguard the rights of people subjected to psychiatric confinement. Over time, however, California also built new pathways for court involvement in mental health care. Laura’s Law, enacted in 2002, authorized court-ordered outpatient treatment in participating counties for some people with serious mental health disabilities.
The pace of change has accelerated. The 2022 CARE Act created a new civil mental health court process through which certain family members, first responders, providers, and others can petition for treatment, services, and housing supports for people who meet specified psychiatric criteria. Although the law does not itself authorize forced medication, a CARE plan can be court ordered. In 2023, SB 43 broadened California’s definition of “gravely disabled,” expanding the circumstances in which a person may be subjected to involuntary detention or conservatorship and adding severe substance use disorder to the law. Then, in 2024, voters approved Proposition 36, which made certain repeat drug-possession offenses felonies and created a “treatment-mandated felony” process.
What connects these policies is not how they operate, but what they increasingly authorize: greater state intervention when disability, substance use, or unmet support needs become visible as crisis. CARE Court is civil, Proposition 36 is criminal, and SB 43 operates through California’s involuntary treatment and conservatorship system. These policies now sit alongside one another in a state that has increasingly turned to courts, compulsory treatment, and enforcement when unmet disability, behavioral health, substance use, and housing needs become visible as crisis. The Newsom administration has itself presented CARE Court, conservatorship reform, Proposition 1, and homelessness enforcement as connected parts of a broader behavioral health and homelessness strategy.
How Unmet Need Becomes State Control
That broader pattern is what concerns us. Rather than ensuring that voluntary, community-based supports are easy to obtain before a crisis, California too often waits until a person’s unmet needs become visible in public and then responds with systems that can take away choice. A person who could not find accessible housing, needed therapy, substance use treatment, peer support, or intensive community services may instead be faced with police officers, judges, evaluators, mandated appearances, locked settings, or jail.
For years the state has known that the problem extends beyond a lack of authority to intervene. In 2020, the California State Auditor’s review of the Lanterman-Petris-Short Act concluded that existing law already gave counties sufficient authority to provide short-term involuntary treatment and found no evidence in the cases it reviewed to justify expanding the commitment criteria. What the audit did find was a serious failure to connect people to ongoing care. Nearly 7,400 people in Los Angeles County had experienced five or more short-term involuntary holds over a three-year period, but only 9% were enrolled in the most intensive community-based services available.
California too often looks at a person in crisis and sees a problem to manage or clear from public view rather than a human being worth supporting. Trauma, disability, poverty, and substance use are deeply intertwined. Crisis is never the beginning of the problem. Rather, it is the point at which years of unmet needs finally become impossible for the state to ignore.
California could have made it easier for people to get what they needed before reaching a crisis point, and to remain connected to support afterward. Intervention does not necessarily resolve every underlying condition. A person who enters crisis without stable housing, healthcare, or adequate support may leave a hospital, court, or jail carrying additional trauma and new barriers to employment, housing, healthcare, and stability. Without meaningful support, the same pathway can begin again.
The result is a system that can be more effective at responding to visible crisis than preventing it. Further, the pathway from unmet need to state control is not experienced equally. The same inequities that shape access to housing, healthcare, income, and voluntary services also shape who is most exposed to policing, institutionalization, and the criminal legal system.
Race & Disability Shape Who Bears the Harm
Race, disability, poverty, and homelessness are not separate experiences neatly sorted into different systems. They overlap in people’s lives and may compound the likelihood that unmet need is interpreted as disorder, danger, noncompliance, or criminal behavior. California’s own policing data show disparities along both race and disability.
According to the Racial and Identity Profiling Advisory Board’s 2026 report, officers reported using some type of force in 43.27% of stops of people they perceived to have a disability, compared with 9.71% of stops of people perceived not to have a disability. The same report found that force was reported more often in stops of people perceived as Native American, Black, or Hispanic/Latino, and that Native American and Black people had the highest arrest rates among the racial and ethnic groups analyzed.
Those findings should not be combined into a statistic about Black disabled people or Native disabled people that the data do not provide. But that limitation is part of the problem. State data are too often siloed—recording race in one place, disability in another, housing status somewhere else, and court or institutional involvement yet somewhere else. What these systems do not show is what happens at their intersections; how racialized disabled people can disappear inside aggregate numbers even while public policy is shaping their lives.
We also know that the populations exposed to these systems already overlap. A UCSF Benioff Homelessness and Housing Initiative analysis found that Black Californians make up about 7% of the state population but more than 26% of people experiencing homelessness. Disability and chronic health needs are also widespread among unhoused Californians. UCSF’s statewide study of health and homelessness found that 34% of unhoused adults reported difficulty with at least one activity of daily living (ADL). While 83% reported having health insurance, only 52% had a regular place to receive care and 39% had a primary care provider.
These numbers do not tell us everything we need to know about racialized disabled Californians. They tell us why California needs to ask better questions. Who gets voluntary support before crisis? Who encounters police instead? Who is placed on an involuntary hold, brought into court, displaced from an encampment, or incarcerated? Who receives housing and sustained community support afterward? And who cycles back through the same systems?
Without answers to those questions, California cannot know whether its response to crisis is reducing inequity or reproducing it.
Sweeps Make Survival Harder
California’s response to homelessness shows how quickly unmet need can become a target for enforcement. After the U.S. Supreme Court’s 2024 decision in Grants Pass v. Johnson allowed cities to enforce camping bans even when no shelter space is available, Governor Newsom directed state agencies to address encampments and urged local governments to do the same. An encampment “sweep” can sound like a neutral act of cleanup. For the people living through it, it can mean displacement and the loss or disruption of the few resources they have.
Sweeps do nothing to resolve homelessness and inflict harm on all unhoused residents. They can separate people from identification and other documents needed to secure housing, essential mobility aids, lifesaving medications, and harm reduction tools. For someone whose disability already makes it difficult to navigate inaccessible transportation, shelter systems, appointments, or replacement-benefit processes, losing those items can be devastating. It is extraordinarily difficult for a person to stabilize their life when the state repeatedly disrupts their means of survival.
The Missing Piece Is Voluntary Support
Resources exist on paper, but real access remains broken across multiple systems. California faces a severe housing affordability crisis, leaving disabled residents living on fixed, low, or no income priced out of housing, including working people who simply cannot keep up with market-rate rents. Voluntary treatment and community support remain difficult to access in many places, leaving people facing waitlists, workforce shortages, or unaffordable out-of-pocket costs when they actively seek help. Legal safeguards on paper offer little protection when there is nowhere accessible and affordable for a person to go; court mandates do not build affordable homes and forced appearances do not cure addiction.
This creates what we might call an access paradox. A person may have difficulty obtaining the help they ask for voluntarily, yet once their unmet needs become visible as crisis, California can mobilize police, courts, attorneys, evaluators, hospitals, involuntary treatment, and supervision. Understanding these patterns makes the access paradox actionable. It helps identify where systems are failing before crisis occurs and where public resources and authority are being directed toward coercion rather than support.
One part of this paradox resembles the “inverse care law” whereby as people’s need for care increases, meaningful access to that care can actually decrease. This problem can be compounded by “inequitable enforcement”, in which laws and systems meant to protect disabled people are underenforced while punitive ones are more readily enforced against them. For people experiencing homelessness, that imbalance can become “pervasive penalty”: repeated move-along orders, citations, property loss, displacement, and other punitive encounters that make it even harder to obtain housing, services, employment, and stability. Further, when intervention is framed as treatment, the line between support and control can blur into “coercive care”, where access to services is intertwined with compulsion, court supervision, confinement, or the threat of losing liberty.
Taken together, these concepts help explain the access paradox at the center of California’s current approach: the state can be absent when people seek support and highly present when it seeks compliance. People can struggle for months or years to obtain housing, healthcare, peer support, or voluntary treatment, only to encounter a well-resourced network of police, courts, evaluators, hospitals, and supervision once their unmet needs become visible as crisis.
We already know important parts of what community-based support looks like because communities have been doing this work for years through clinicians and social workers, peer specialists, disability-led organizations, culturally and linguistically responsive providers, harm reduction programs, and community groups that help people navigate systems before an emergency. However, there are simply not enough of them, and many are operating with unstable funding, low wages, and chronic workforce shortages. We cannot expect good intentions alone to hold up an underfunded system. California must strengthen its foundation and reverse this imbalance.
What the Next Governor Can Do Differently
As California looks toward its next Governor, we hope to see an inclusive, goal-oriented approach that brings impacted communities, service providers, and disabled leaders to the table rather than further advancing carceral policies. The state cannot break a cycle that it refuses to understand. While it is true that the next administration will inherit the systems described above, it will also inherit alternatives. The goal should not simply be to respond differently once crisis occurs. It should be to ask how to make housing, healthcare, economic security, disability supports, and voluntary care available early enough that fewer people are pushed into crisis in the first place.
That begins with a simple principle: voluntary support should be meaningfully available before coercive intervention becomes an option. People should not have to become court-involved, institutionalized, arrested, or subject to an involuntary hold before they can obtain intensive services, peer support, substance use care, case management, or help securing housing. The same services offered through court-ordered programs should be meaningfully available voluntarily, in the least restrictive setting and consistent with individual choice. That approach is consistent with longstanding disability-rights principles on involuntary mental health treatment.
That also means treating the supports that allow people to remain in their communities as part of its crisis-prevention infrastructure. Affordable and accessible housing, Medi-Cal, IHSS and other home- and community-based services (HCBS), income supports, transportation, benefits assistance, harm reduction, and culturally responsive care all shape whether unmet need becomes crisis. Protecting access to healthcare is especially important at a moment when an estimated 2.2 million Californians could lose health insurance by 2030, with some of the sharpest losses expected among low-income and racialized communities. California cannot credibly invest in crisis intervention while allowing the systems that help prevent crisis to become harder to access. Investing in these systems is not separate from public safety or behavioral health policy. It is critical in preventing people from reaching the point where police, courts, hospitals, or jails become the state’s primary response.
When crisis does occur, California can build a response system centered on self-determination rather than force. A collaborative report between Human Rights Watch, NYLPI, and CRDJ on rights-based alternatives to police mental health crisis response identified more than 150 non-police programs nationwide, including models already operating in California. The strongest approaches share several features:
Police should not be the primary or default responders
Peers with lived experience are part of response, leadership, and oversight
Services are consent-centered, accessible, confidential, and available around the clock
Responders know the communities they serve
Crisis support is connected to housing, food, healthcare, and other resources afterward
The next administration must go beyond performatively pairing clinicians with law enforcement. A clinician arriving with an armed officer is not the same as a civilian crisis system. The state can strengthen 988 and mobile crisis, expand peer-led and community-based response, create non-police transportation and crisis respite options, and ensure that appropriate 911 and 988 calls can be routed directly to civilian responders. Communities should not have to choose between calling the police and handling a crisis alone.
California should stop treating each coercive system as a separate problem and instead examine how systemic ableism—often compounded by racism, poverty, and housing exclusion—can turn disability-related needs into pathways toward deeper state control. That means expanding voluntary diversion, community-based competency supports, housing, peer services, and other alternatives at the earliest possible point; strengthening civil-rights protections where coercive systems remain; and tracking what happens across involuntary holds, conservatorships, CARE Court, assisted outpatient treatment (AOT), competency proceedings, jail-based treatment, homelessness enforcement, and police encounters. The state should publicly track who enters these systems, what less restrictive supports were actually available beforehand, what happens afterward, and who cycles back through them. That data must be reported across race, disability, housing status, gender, age, and geography so multiply marginalized people do not disappear inside aggregate statistics and siloed datasets. When disparities emerge, agencies should be required not only to report them, but to explain what is driving them and what they will change as a result.
The people most impacted by these policies must be centered in these conversations and in designing solutions to respond to the problems presented here. Racialized disabled people and those with lived experience of homelessness and psychiatric systems should have paid, meaningful roles in designing services, allocating resources, defining what safety and success looks like, and evaluating whether programs are actually helping. Moreover, community organizations already doing this work need sustained funding and decision-making power, not simply invitations to comment after major choices have been made.
The measure of California’s leadership should not be how many people move through courts, hospitals, jails, or disappear from public view. It should be whether people can get help before crisis, remain housed and connected to their communities, receive care without police involvement, retain autonomy over their lives, are given real economic opportunities, and experience fewer racial and disability disparities in the systems meant to support them. True safety is not forced compliance. It is having what people need to live with dignity in their communities.
The next Governor will have a clear choice on day one. We are prepared to work collaboratively with the administration to build a human-centered support framework, but we will remain uncompromisingly honest about what has failed, who has been harmed, and what is needed for real change.