A new law extends California’s controversial court-ordered treatment program to people with bipolar I disorder — but only those experiencing psychotic features. Here’s what it means, who qualifies, and why advocates are divided.

California’s CARE Court — the Community Assistance, Recovery, and Empowerment Act — has expanded. Governor Gavin Newsom signed SB 27 on October 10, 2025, and as of January 1, 2026, the program now includes people diagnosed with bipolar I disorder with psychotic features. Previously, the program applied only to individuals with schizophrenia spectrum disorders.

CARE Court allows family members, first responders, or behavioral health providers to petition a civil court to create an individualized treatment plan for someone with a severe mental illness who is unable or unwilling to engage in voluntary care.

If the court agrees the person qualifies, a judge can order up to 24 months of community-based treatment — including housing support, medication, and therapy.

The expansion is significant for the bipolar community, but it comes with a limitation: the law applies only to bipolar I disorder with psychotic features.

That means someone experiencing severe mania — grandiosity, reckless behavior, no sleep for days — would not qualify unless their episodes also include hallucinations, delusions, or other psychotic symptoms. This is an important distinction that could leave many people in crisis without access to the program.

The numbers so far suggest the program is reaching fewer people than hoped. According to state data from the first year of CARE Court operations, only 893 treatment agreements have resulted from 3,817 petitions filed statewide. That’s a roughly 23% conversion rate — meaning more than three out of four petitions do not lead to a treatment plan.

Not everyone sees the expansion as progress. Disability Rights California has raised concerns that CARE Court amounts to forced treatment dressed in therapeutic language.

Civil liberties advocates argue that court-ordered care — even when framed as voluntary — carries inherent coercion, especially for people experiencing psychosis who may not fully understand the proceedings. Others counter that for individuals in severe crisis, particularly those cycling through emergency rooms and jails, the program offers a path to sustained care that the current system fails to provide.

For people living with bipolar I disorder, the expansion raises practical questions. A manic episode with psychotic features might last days or weeks — but the petition process, court hearings, and treatment plan development take time. By the time the system moves, the acute episode may have passed. Whether CARE Court can be responsive enough to help people during their most vulnerable moments remains an open question.

What the law does establish is a legal framework acknowledging that bipolar I with psychotic features can be as debilitating and dangerous as schizophrenia spectrum conditions.

For years, bipolar disorder has been treated as a less severe category in involuntary treatment statutes, even though manic episodes with psychosis can lead to devastating consequences — financial ruin, broken relationships, incarceration, and in some cases, death.

A note from Alex Rowan: I’ve been on both sides of the question this law tries to answer. During my lengthy manic episode I was certain I didn’t need help. I thought I was fine. I was not fine. If someone had petitioned a court to get me into treatment during those weeks, I would have fought it with everything I had. Though it might have saved me years of damage and criminal charges. I don’t know if CARE Court is the right answer. But I know the current system of waiting until someone is arrested or hospitalized isn’t working either. And I did meet many homeless people on the streets who would certainly benefit from the program if they had an advocate to pursue it.

Sources: California Legislature — SB 27 | California Courts — CARE Act | Disability Rights California

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