Yesterday, President Trump issued an Executive Order that threatens the safety and civil rights of millions of people with mental health or substance use disorders and directly calls on states to arrest and institutionalize people experiencing homelessness. We agree that homelessness should not exist in the United States and we assert that everyone has a right to housing and health care as human beings.
For 40 years, the Health Care for the Homeless (HCH) Community has been on the front lines of addressing the health care needs of people experiencing homelessness. HCH clinics integrate behavioral health and primary care and we know what works to end homelessness – and what doesn’t. We are strongly opposed to this directive which threatens, demonizes, and calls for the incarceration and institutionalization of unhoused people. Mass homelessness in the wealthiest country on earth is a result of policymakers’ decades-long failure to provide housing and appropriate health care. This EO ignores human rights and criminalizes poverty instead of addressing its root causes.
The root cause of homelessness is the inability to afford housing, not mental health and substance use. Behavioral health conditions often emerge (or worsen) after the loss of housing, and it is difficult to treat people living in crisis. However, it is the stabilizing effect of permanent housing (not merely shelter) that provides a platform for wellness and engaging in care. 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.
Long-term institutional settings and forced treatment do not solve homelessness. Many Americans are struggling to access high-quality, community-based mental health and substance use treatment, yet this Administration just signed into law historic cuts to Medicaid – gutting the very funding streams that support mental health and substance use treatment in community settings. Institutionalizing people who could be treated in a less restrictive setting is not only expensive, unethical, and illegal, but it can also drive people away from care and contribute to overdose deaths and premature mortality. This EO fails to engage people in care, increase the quality and capacity of community behavioral health care, or advance evidence-based practices like harm reduction.
Withholding basic human needs like shelter and housing and calling on states to conduct mass arrests because of mental health and substance use is inhumane and does not solve homelessness. Forcing states to adopt ineffective and harmful practices like this will increase street homelessness and divert law enforcement resources away from actual crime and violence. Rather than improve the criminal justice system or promote public safety in a meaningful or sustainable way, this EO perpetuates cycles of incarceration, stigma, and trauma that make it harder for people to stabilize and access the help they need.
Demonizing and terrifying the most vulnerable people in our communities is shockingly wrong and does not solve homelessness. False assertions about the prevalence of behavioral health disorders and conflating homelessness with violence misleads the general public about the causes of homelessness and distracts from proven solutions like stable housing and community-based care. It prioritizes coercion over compassion and political optics over proven public health approaches. This EO does nothing to treat our fellow neighbors with the dignity and respect they deserve.
Real solutions will only come from listening to those who understand the realities of life on the street, in shelter, and in underfunded health care systems – not from top-down mandates rooted in stigma and fear.
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