“Ending Crime and Disorder on America’s Streets”: Executive Order Targets Homeless Individuals with Psychiatric Illness

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Every night in the United States, more than a quarter million people have nowhere to sleep¾they are both homeless and unsheltered. Many struggle with mental illness and substance use, others are impoverished with no place to go. Rates of homelessness are increasing and there is not enough supported housing or shelter beds to meet the needs of people with nowhere to stay; these are the people who end up sleeping on the streets.¹

In late July, President Donald Trump issued an executive order entitled “Ending Crime and Disorder on America’s Streets.”² Although this might sound like an order related to criminal activity and policing, it is not. The agenda of this executive order is to institutionalize unhoused people with the proposed intention of making cities safer. There is no attempt to address violent crime that is not perpetrated by people who are homeless, yet the order targets every person living on the street with a history of substance use or psychiatric disorder, regardless of whether history of criminal behavior. In addition, the order does not include a mechanism for addressing the problem of homelessness for people who do not have either condition.

With no statistics or references, the order states that the overwhelming majority of people who are homeless have a history of drug addiction, many of whom are also mentally ill. Section 1 of the order reads, “Shifting homeless individuals into long-term institutional settings for humane treatment through the appropriate use of civil commitment will restore public order.”

The executive order continues with an action plan, which includes terminating policies that stand in the way of civil commitment for those who are mentally ill and dangerous orliving on the streets. It goes on to assert that several cabinet members will direct the assessment of grant funding and give priority for funding to states that: enforce prohibitions on open illegal drug use, prohibit urban camping and loitering, maximize the use of both inpatient and outpatient civil commitment, and track homeless sex offenders. Individuals with serious mental illness are not to be released because of a lack of space in forensic facilities or hospitals.

Although the order does not explicitly provide for housing or funding for more hospital beds, it calls to abolish current housing options: “These actions shall include, to the extent permitted by law, ending support for ‘housing first’ policies that deprioritize accountability and fail to promote treatment, recovery, and self-sufficiency.” It further targets facilities with safe consumption sites or needle exchanges. Finally, the president’s order requires the collection of health-related information from those individuals who receive federal funding for homelessness assistance and requires that information is shared with law enforcement.

From a psychiatric perspective, there are many concerns with this executive order. There is the assumption that people with mental illness are dangerous, perpetrating a stigma that we have fought for so long to dispel. It calls for civil commitment based on homelessness and not on individual actions¾ as it calls for unhoused people to be rounded up and involuntarily confined before they have committed any crime.

Our current laws provide for hospitalization only for the duration of an acute episode, and the average length of a hospital stay is approximately 2 to 3 weeks. Our current system does not provide for long-term institutionalization, and if anything, our emergency departments may often turn away people who are homeless and request admission. Hospitals, jails, and shelters are often filled to capacity and struggle to meet current demand. Presumably, President Trump would intend to house those with chronic mental illness and homelessness in state hospitals, but there is no mention in this order of funding new facilities or increasing bed capacity. Instead, the order seeks to defund Housing First facilities that have been found to improve housing stability in vulnerable populations.³

In a wealthy country such as ours, it is shameful that people are left to sleep on the streets, whether they are there because they are ill, addicted, or impoverished. A radical plan to provide housing is very much needed, but it should be addressed with sensitivity. Instead, this executive order invokes fear of people with psychiatric illnesses, talks of indiscriminate incarceration of people who have not committed a crime, as well as collection and sharing of sensitive health information with law enforcement, and yet proposes no actual solutions.

Dr Miller is a clinical psychiatrist and writer in Baltimore. She is on the faculty at the Johns Hopkins School of Medicine.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions of Psychiatric Times or its parent company, MJH Life Sciences.

References

1. Soucy D, Janes M, Hall A. State of homelessness: 2024 edition. National Alliance to End Homelessness. August 5, 2024. Accessed August 7, 2025. https://endhomelessness.org/state-of-homelessness/

2. Ending crime and disorder on America’s streets. The White House. July 24, 2025. Accessed August 7, 2025. https://www.whitehouse.gov/presidential-actions/2025/07/ending-crime-and-disorder-on-americas-streets/

3. Housing first: a review of the evidence. US Department of Housing and Urban Development. 2023. Accessed August 7, 2025. https://archives.huduser.gov/portal/periodicals/em/spring-summer-23/highlight2.html