The hard truth that advocates of forced treatment ought to concede is that coercion often backfires. Each year in California,
tens of thousands of people are already transported involuntarily to ERs and admitted to hospitals against their will. These involuntary hospitalizations may save a person’s life in the moment, which is no small thing, but research shows that many who undergo this process are
traumatized and humiliated, leading to increased
suicide risk and
long-term distrust of treatment providers. When delivered in a heavy-handed way, court-ordered treatment is not only ineffective but can also drive people decisively away from essential services.
Anti-coercion advocates, on the other hand, are right that most homeless people are clamoring for voluntary resources and housing. (Newsom’s last two budgets
included $14 billion in new funds to combat homelessness, through housing and services, to be distributed over several years; it is unclear what the tab for Care Courts would be, though they may draw on those funds.) But the reality is that some people who might have accepted assistance earlier in their lives, had it been available, have deteriorated psychologically or become so skeptical of providers that they won’t accept help they need. One county official we interviewed (granted anonymity by university protocols) described an elderly homeless person with psychosis who had refused more than 100 offers of supported housing.
We’ve observed such refusals ourselves, and we’ve watched people drink themselves to death or die from untreated medical conditions when left with purely voluntary supports in independent apartments. Our society should not sacrifice these vulnerable people on the altar of a one-size-fits-all ideal of voluntary care.