Trump order pushes forcible hospitalization of homeless people

President Donald Trump directed federal agencies to find ways to make it easier to forcibly hospitalize homeless people with mental illness and addiction for longer periods - an effort to fight what the administration calls “vagrancy” threatening the streets of U.S. cities.

An executive order signed Thursday pushes federal agencies to overturn state and federal legal precedent that limits how local and state governments can involuntarily commit people who pose a risk to themselves or others.

The order said shifting homeless people into long-term institutional settings will restore public order. “Surrendering our cities and citizens to disorder and fear is neither compassionate to the homeless nor other citizens,” Trump’s order said.

Critics immediately warned such policy threatens returning the nation to a darker era when people were often unjustly locked away in mental health institutions, and does nothing to help people afford housing.

“The safest communities are those with the most housing and resources, not those that make it a crime to be poor or sick,” Jesse Rabinowitz, communications director of the National Homelessness Law Center, said in a statement. “Forced treatment is unethical, ineffective, and illegal.”

Trump’s order instructs agencies to prioritize funding to mental health and drug courts - and to not fund “harm reduction” programs that the administrations said facilitate illegal drug use.

The executive order was issued as the Trump administration has slashed more than $1 billion in COVID-era grants administered by the Substance Abuse and Mental Health Services Administration and is proposing to slash hundreds of millions more in agency grants.

“There’s no question we need to do more to address both homelessness and untreated substance use disorder and mental health conditions in the U.S.,” said Regina LaBelle, director of the Addiction and Public Policy Initiative at the Georgetown University Law Center and a former drug policy official in the Biden White House. “But 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 impact of Trump’s executive order remains unclear because states set laws and handle the process of involuntarily commitments.

Homelessness - and perceptions of street crime run amok - has proved a potent issue for Trump and Republican leaders as the nation grapples with a mounting housing crisis.

The Supreme Court last year ruled that cities may ban homeless residents from sleeping outside, rejecting a constitutional challenge to a set of anti-camping laws.

Trump signed the executive order about three months after the Justice Department asked agency officials who oversee grant distributions to brainstorm ways to clear encampments and boost involuntary hospitalizations as part of an aggressive push to drive homeless people from public spaces.

Dozens of states have added to or expanded involuntary commitment laws during the past decade. That includes states controlled by Democrats, an illustration that political momentum has shifted toward a more aggressive approach to dealing with the inextricably intertwined crises of mental health and addiction - and perceptions pushed by the right that they lead to crime run amok.

Oregon state lawmakers, after years of contentious debate and failed attempts, are pushing forward with a bill that would make it easier to force someone who is a danger to themselves or others into treatment.

In California, a new law went into effect this year expanding the criteria for who is eligible for involuntary commitments to include those suffering from substance use disorders. Gov. Gavin Newsom (D), a potential presidential candidate in 2026 who is often criticized by Trump on the issue of public safety, said 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, state lawmakers this year cemented earlier state guidance that allowed first responders to involuntarily commit people with severe mental illnesses who cannot meet their own basic needs such as obtaining medical care, shelter or food. The law was pushed by New York Gov. Kathy Hochul (D), who has faced criticism regarding public safety against the backdrop of high-profile acts of violence involving mentally ill people in New York City and a push by Mayor Eric Adams for more forced commitments.

While there may be an uptick in police officers transporting people to hospital, it’s doubtful that significantly more people will actually be admitted for forced treatment, said Patrick Wildes, a former assistant secretary for human services and mental hygiene under Hochul.

“I don’t think that there’s all these people who are waiting around, looking unwell, who need to get picked up,” he said. “But I do think that it can make some members of the public feel better that, in theory, it’s easier for the authorities and for the government to try to bring people in.”

States beefing up involuntary commitment laws illustrates a growing recognition that officials had grown too reluctant to employ laws aimed at the most severely ill who are not able to seek treatment on their own, said Lisa Dailey, executive director of Treatment Advocacy Center. Those people often end up in jail or prison, or are harm themselves or others, while conditions such as schizophrenia and bipolar disorder go untreated, she said.

The nation has long grappled with forced hospitalizations.

In 1975, the Supreme Court in a landmark ruling cemented due process rights for people with mental illness, ruling they could not be involuntarily committed without a showing that they posed a danger. Four years later, the court imposed a higher legal threshold for committing someone for treatment against their will.

During the campaign, Trump claimed U.S. cities had been surrendered to the “drug addicted” and “dangerously deranged.” He vowed to put people “in mental institutions where the belong” and floated the idea of putting them in government-sponsored tent cities.

His rhetoric suggests “there is some interest in retrenchment and a movement back toward institutionalization,” said Jennifer Mathis, deputy director of the Judge David L. Bazelon Center for Mental Health Law.