by: O. Rose Broderick
President Trump wants to make it easier to involuntarily treat people with serious mental illnesses as part of a bid to end homelessness across the United States, according to a new order signed Thursday.
The administration wants to expand involuntary commitments by reversing judicial policies that restrict the use of the controversial approach and by providing grants, legal advice, and other assistance to local and state governments. The order also directs several agencies, including the Department of Health and Human Services, to audit grant recipients to ensure no money flows to organizations that promote policies that clash with the administration’s stated values.
While some studies have found that involuntary commitments are already increasing, the practice would grow dramatically if the changes laid out in the order come to pass. The effort is the latest push by the administration to move unhoused people off the street and into private psychiatric hospitals and facilities. Critics say the campaign is aimed at moving unhouse people outside of the public eye.
“By removing vagrant criminals from our streets and redirecting resources toward substance abuse programs, the Trump Administration will ensure that Americans feel safe in their own communities and that individuals suffering from addiction or mental health struggles are able to get the help they need,” said White House Press Secretary Karoline Leavitt.
Many public health professionals believe that involuntary commitment should be used as a last resort, if it is used at all. They suggested that involuntary treatment lacks sufficient evidence for its expansion and would only dissuade individuals from seeking care.
“Simply locking people up is not a solution,” said Jennifer Mathis, deputy director for the Bazelon Center for Mental Health Law. “The order’s directive to agencies to seek opportunities to overturn basic protections against arbitrary commitment is shocking. At a time when the federal government is making historic cuts to Medicaid and housing, it is particularly absurd to invest resources warehousing people in institutions.”
While it is unclear precisely how the White House plans to enact these actions, it instructs federal agencies to crack down on public drug use, urban camping, and loitering. It also directs Attorney General Pam Bondi to potentially pursue legal action against organizations that run supervised drug consumption sites. Harm reduction programs will also be deprioritized.
One of the biggest changes would be a shift away from a “housing first” approach to homelessness pursued by the Biden administration. These policies have shown remarkable success over treatment-first models in helping unhoused populations stay off the street and reduce the level of care they require. The Department of Housing and Urban Development would also be required to force organizations to collect federal health information from unhoused people who receive services and share such data with law enforcement officials.
Some experts suggest these initiatives were not developed in consultation with other federal officials, including public health professionals at the Substance Abuse and Mental Health Services Administration, the agency that has traditionally overseen relevant policy recommendations and grantmaking.
Under the order, to get people off the street, local and state officials are supposed to prioritize involuntary outpatient treatments, even though a recent Government Accountability Office report found that involuntary outpatient treatments were not necessarily as effective as proponents claimed.
“Trump’s actions to expand involuntary treatment and long-term institutionalization set us back decades to the days of warehousing people in back hospital wards instead of providing care back home,” said Paolo del Vecchio, a former SAMHSA executive officer.
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President Trump wants to make it easier to involuntarily treat people with serious mental illnesses as part of a bid to end homelessness across the United States, according to a new order signed Thursday.
The administration wants to expand involuntary commitments by reversing judicial policies that restrict the use of the controversial approach and by providing grants, legal advice, and other assistance to local and state governments. The order also directs several agencies, including the Department of Health and Human Services, to audit grant recipients to ensure no money flows to organizations that promote policies that clash with the administration’s stated values.
While some studies have found that involuntary commitments are already increasing, the practice would grow dramatically if the changes laid out in the order come to pass. The effort is the latest push by the administration to move unhoused people off the street and into private psychiatric hospitals and facilities. Critics say the campaign is aimed at moving unhouse people outside of the public eye.
“By removing vagrant criminals from our streets and redirecting resources toward substance abuse programs, the Trump Administration will ensure that Americans feel safe in their own communities and that individuals suffering from addiction or mental health struggles are able to get the help they need,” said White House Press Secretary Karoline Leavitt.
Many public health professionals believe that involuntary commitment should be used as a last resort, if it is used at all. They suggested that involuntary treatment lacks sufficient evidence for its expansion and would only dissuade individuals from seeking care.
“Simply locking people up is not a solution,” said Jennifer Mathis, deputy director for the Bazelon Center for Mental Health Law. “The order’s directive to agencies to seek opportunities to overturn basic protections against arbitrary commitment is shocking. At a time when the federal government is making historic cuts to Medicaid and housing, it is particularly absurd to invest resources warehousing people in institutions.”
While it is unclear precisely how the White House plans to enact these actions, it instructs federal agencies to crack down on public drug use, urban camping, and loitering. It also directs Attorney General Pam Bondi to potentially pursue legal action against organizations that run supervised drug consumption sites. Harm reduction programs will also be deprioritized.
One of the biggest changes would be a shift away from a “housing first” approach to homelessness pursued by the Biden administration. These policies have shown remarkable success over treatment-first models in helping unhoused populations stay off the street and reduce the level of care they require. The Department of Housing and Urban Development would also be required to force organizations to collect federal health information from unhoused people who receive services and share such data with law enforcement officials.
Some experts suggest these initiatives were not developed in consultation with other federal officials, including public health professionals at the Substance Abuse and Mental Health Services Administration, the agency that has traditionally overseen relevant policy recommendations and grantmaking.
Under the order, to get people off the street, local and state officials are supposed to prioritize involuntary outpatient treatments, even though a recent Government Accountability Office report found that involuntary outpatient treatments were not necessarily as effective as proponents claimed.
“Trump’s actions to expand involuntary treatment and long-term institutionalization set us back decades to the days of warehousing people in back hospital wards instead of providing care back home,” said Paolo del Vecchio, a former SAMHSA executive officer.
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