Governor Newsom’s CARE Court, previously limited to schizophrenia, now covers bipolar I disorder with psychotic features under a law that took effect January 1, 2026.
A new California law has expanded the state’s controversial CARE Court program to include people diagnosed with bipolar I disorder. Senate Bill 27, signed by Governor Gavin Newsom in October 2025, took effect on January 1, 2026, and represents the most significant expansion of the program since its launch.
Under the original CARE Act, only individuals diagnosed with schizophrenia and other psychotic disorders were eligible for the program, which allows courts to order treatment plans for people with severe mental illness who are unable or unwilling to seek care on their own. With the expansion, people who experience psychosis as a result of bipolar I disorder now qualify as well.
The law was authored by Senator Thomas Umberg (D-Santa Ana) and is specifically limited to bipolar I disorder with psychotic features, excluding psychosis related to substance intoxication. That distinction is important because it narrows the eligible population to those whose psychotic symptoms are driven by the mood disorder itself, not by drugs or alcohol.
How CARE Court Works
The CARE Court program allows family members, first responders, clinicians, and others to petition the court on behalf of someone experiencing severe mental illness who is not receiving adequate care. If the court finds the person eligible, it orders a treatment plan that can include medication, housing assistance, and support services.
Participation is technically voluntary. A person can refuse the treatment plan, but courts can take that refusal into account in any subsequent conservatorship proceedings. Critics argue this creates a coercive dynamic that is involuntary in practice, even if not in name.
SB 27 also streamlined the court process by combining two early hearings into one, reducing the time participants must spend in court and lowering administrative costs.
A Divided Response
Governor Newsom’s office framed the expansion as a way to “connect more Californians living with severe mental illness to treatment, housing, and recovery services.” Supporters say the program fills a gap for people who cycle between psychiatric crises, homelessness, and incarceration without ever receiving sustained treatment.
Mental Health America of California opposed SB 27, arguing that court-ordered treatment undermines the principles of voluntary, recovery-oriented care. The Western Center on Law and Poverty has also raised concerns about the program’s effectiveness and its potential to disproportionately affect unhoused and marginalized populations.
The debate touches on one of the most difficult questions in mental health policy: when, if ever, should the state intervene in someone’s psychiatric care over their objections? For people with bipolar I disorder whose manic episodes include psychosis, that question just became directly relevant.
Sources:
CalMatters
Governor of California
Mental Health America of California
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