In a significant shift in policy, President Donald Trump has directed federal agencies to explore ways to facilitate the involuntary hospitalization of homeless individuals suffering from mental illness and addiction. This initiative aims to combat what the administration describes as a rising threat of “vagrancy” in U.S. cities. An executive order signed on Thursday mandates federal agencies to revisit state and federal legal frameworks that currently restrict local and state governments from committing individuals who may pose a risk to themselves or others.
The executive order emphasizes that transferring homeless individuals into long-term institutional settings is essential for restoring public order. “Surrendering our cities and citizens to disorder and fear is neither compassionate to the homeless nor other citizens,” the order states. This perspective has drawn immediate criticism, as opponents argue that such policies could revert the nation to a troubling era when individuals were often unjustly confined in mental health facilities, failing to address the underlying issue of affordable housing.
Jesse Rabinowitz, communications director of the National Homelessness Law Center, expressed concerns regarding the executive order, stating, “The safest communities are those with the most housing and resources, not those that make it a crime to be poor or sick. Forced treatment is unethical, ineffective, and illegal.” The order further instructs agencies to prioritize funding for mental health and drug courts, while cutting support for “harm reduction” programs that the administration claims encourage illegal drug use.
The backdrop to this executive order is the Trump administration's recent decision to slash over $1 billion in COVID-era grants distributed by the Substance Abuse and Mental Health Services Administration. There are proposals to cut hundreds of millions more in agency funding. Regina LaBelle, director of the Addiction and Public Policy Initiative at Georgetown University Law Center, criticized the approach, noting, “Issuing an executive order, while disinvesting in treatment and other funding that will help prevent homelessness and untreated health conditions, will do nothing to address the fundamental issues facing the country.”
The implications of Trump’s executive order remain unclear, as states are responsible for setting laws and managing the involuntary commitment process. The growing crisis of homelessness and the perception of rampant street crime have become potent issues for Trump and Republican leaders amidst an escalating housing crisis. Last year, the Supreme Court ruled that cities could prohibit homeless individuals from sleeping outdoors, denying a constitutional challenge to anti-camping laws.
About three months prior to the executive order, the Justice Department sought input from agency officials on strategies to clear homeless encampments and enhance involuntary hospitalizations. In recent years, many states have enacted or expanded involuntary commitment laws, including those controlled by Democrats, reflecting a political shift toward a more aggressive approach to the interlinked crises of mental health and addiction.
For instance, Oregon legislators are advancing a bill aimed at simplifying the process for forcing individuals who pose a danger to themselves or others into treatment. Similarly, a new law in California has broadened the criteria for involuntary commitments, now including those with substance use disorders. Governor Gavin Newsom (D) stated that the law would “ensure no one falls through the cracks and that people get the help they need and the respect they deserve.” In New York, legislation has been solidified to allow first responders to involuntarily commit individuals with severe mental illnesses who are unable to secure basic necessities.
Despite potential increases in police officers transporting individuals to hospitals, experts like Patrick Wildes, a former assistant secretary for human services and mental hygiene under Governor Hochul, question whether more people will actually be admitted for forced treatment. “I don’t think that there’s all these people who are waiting around, looking unwell, who need to get picked up,” he noted. However, he acknowledged that the new measures may provide some comfort to the public, suggesting that it is easier for authorities to intervene.
The issue of forced hospitalizations has long been contentious in the U.S. In 1975, the Supreme Court established due process rights for people with mental illnesses, ruling that individuals could not be committed against their will without demonstrating that they posed a danger. A subsequent ruling in 1979 set even higher legal standards for such involuntary commitments. During his campaign, Trump claimed that U.S. cities had succumbed to the “drug addicted” and “dangerously deranged,” vowing to place individuals “in mental institutions where they belong” and even suggesting government-sponsored tent cities.
Jennifer Mathis, deputy director of the Judge David L. Bazelon Center for Mental Health Law, commented on the implications of Trump’s rhetoric, indicating a potential shift back toward institutionalization. As the nation faces these ongoing challenges, the balance between addressing homelessness, mental health, and public safety remains a complex and evolving issue.
