Trump’s New Executive Order Revives Failed Policies of Institutionalization, Ignoring the Proven Solution: Housing First
Service providers and advocates warn that the Trump administration has created a dangerous new way for America to respond to homelessness.
In late July, President Donald Trump signed an executive order titled “Ending Crime and Disorder on America’s Streets.” The order requires state and city governments to commit people living unsheltered with mental health or substance abuse challenges to “appropriate facilities for appropriate periods of time.” It also asks the Attorney General to find ways to reverse federal or state law that prohibits the federal government from committing these individuals.
“Shifting homeless individuals into long-term institutional settings for humane treatment through the appropriate use of civil commitment will restore public order,” the order reads in part. “Surrendering our cities and citizens to disorder and fear is neither compassionate to the homeless nor other citizens.”
Said another way, the executive order seeks to institutionalize people living unsheltered without consideration for the reasons they are experiencing homelessness in the first place. It singles out people with mental health and substance abuse challenges. However, the wording of the order is so broad that advocates worry it can be used to target anyone experiencing homelessness.
“Mental illness is not a crime, and people with mental illness deserve to be treated as human beings, with dignity and respect,” National Alliance on Mental Illness CEO Daniel Gillison said in a statement.
“While we agree that homelessness is an urgent crisis in our country, to truly address the systemic causes of this crisis, we should be pouring resources into treatment to improve early access to care and investing in supportive housing and other wrap-around services,” he added.
Institutionalization and Homelessness
America institutionalized people experiencing homelessness beginning in 1833 when the first publicly funded psychiatric hospital opened in Worcester, Massachusetts. At the time, proponents believed that people with mental health challenges could recover if they were put in a facility that met their basic needs.
That assumption turned out to be false. The number of people living in institutions, otherwise known as asylums, swelled to more than half a million by the 1950s. Abuse and neglect were rampant at these institutions as the number of patients grew.
In the 1960s, the Community Mental Health Act shifted oversight responsibilities from states to the federal government. At the same time, thousands of former patients were sent back to their families, many of whom could not care for their loved ones.
Former President Ronald Reagan shuttered many of the institutions under the federal government’s purview, which experts say was the genesis of America’s street homelessness epidemic. Returning to this model would make homelessness much worse across America, experts warn.
“It is the stabilizing effect of permanent housing (not merely shelter) that provides a platform for wellness and engaging in care,” the National Health Care for the Homeless Council said in a statement. “This EO does nothing to create housing opportunities and instead distracts from the core issue: the severe shortage of affordable housing with appropriate health care and support services.”
Why Institutionalization Failed
Experts point to several reasons why institutionalizing unhoused people failed as a policy for addressing homelessness. Chief among them is that the policy does not address the root causes of homelessness, namely, the lack of affordable housing.
“Offering safe, stable, and affordable permanent housing, along with voluntary supportive services, has been demonstrated to help individuals stabilize and avoid hospitalization and incarceration,” said Renee Willis, CEO of the National Low Income Housing Coalition. “We must not allow disinformation to distract us from the evidence and programs that work.”
Institutionalization has also created other problems that make it more difficult for people who are homeless to access the services they need. According to Community of Hope, a homeless services provider in Washington, D.C., institutionalization further traumatizes people and can exacerbate mental health and substance abuse challenges.
The policy can also violate people’s civil rights by expanding involuntary detention, Community of Hope says. This can make it more likely that people who are homeless will not trust the help they are offered, which could make it harder to identify and serve people experiencing homelessness going forward.
“We know what the main challenges to reducing homelessness are: increasing access to affordable housing; more access to quality health care; and the availability of well-paying jobs,” the organization wrote in a blog. “The President’s Order offers no new resources to address these root causes of homelessness. Instead, it aims to criminalize the very people who we need to help.”
Housing Is the Only Way to Solve Homelessness
Decades of research has shown that the only way to effectively solve homelessness in America is by providing more affordable and subsidized housing options paired with healthcare and other services. This system is more commonly known as Housing First, and it has created meaningful reductions in homelessness across the country.
For instance, Denver used a Housing First approach to reduce unsheltered homelessness by 45% in two years. Houston used Housing First to reduce its overall homeless population by 60%. These cities, and others, have also seen declining numbers of police contacts and emergency room visits among unhoused people as well.
However, the Trump administration seeks to turn America away from Housing First toward a treatment-first or stair-step model that failed in the past. Experts say this will increase the number of people experiencing homelessness in the future as funding for proven solutions dries up.
“Sadly, but not surprisingly, Trump continues to focus on deeply unpopular policies like handcuffs and jail, which hurt Black and Brown people most,” Jesse Rabinowitz, spokesperson for the National Homelessness Law Center, said in a statement. “Laws and budgets that make homelessness and poverty worse negatively impact us all. To build truly safe, healthy, and just communities, we need housing and healthcare, not handcuffs and budget cuts.”
How You Can Help
The pandemic proved that we need to rethink housing in the U.S. It also showed that aid programs work when agencies and service organizations are provided with sufficient funds and clear guidance on spending aid dollars.
Contact your officials and representatives. Tell them you support keeping many of the pandemic-related aid programs in place for future use. They have proven effective at keeping people housed, which is the first step to ending homelessness.