Mental Health Advocates in the Bay Area express anxieties over Trump's executive order aimed at resolving the homelessness dilemma
In a move that has sparked controversy and fear, President Trump signed an executive order last month, targeting homelessness and identifying mental illness as one of the root causes. The order, critics argue, promotes forced involuntary civil commitment and institutionalization, effectively criminalizing mental illness and homelessness.
Mental health advocates, led by a group called Families Advocating for the Seriously Mentally Ill (FASMI), are deeply concerned about the order's implications. The founders of FASMI all share the struggle of having a loved one with a serious mental illness. Members like Alison Monroe, Margot Dashiell, and Katie Polony express fear that the executive order could indefinitely imprison their loved ones, criminalize mental illness, and trap individuals in facilities for prolonged periods without adequate exit strategies.
The history of government involvement with mental illness is a complex one. From the use of asylums, some of which became known as "snake pits," to the closure of asylums in the 1960s, which was supposed to lead to robust treatment within the community, many individuals wound up on the streets instead. FASMI members are concerned that the administration may force the mentally ill into places not designed to treat or support them.
The order encourages states to use involuntary psychiatric commitments more broadly for unhoused individuals with serious mental illness (SMI), expanding the use of psychiatric hospitals that function similarly to prisons and often result in long-term or indefinite confinement. It also ends funding for “Housing First” programs, which provide immediate housing without requiring treatment or sobriety, in favor of programs that demand participation in mental health or substance use treatment before housing aid, potentially making access to housing conditional and more difficult.
Moreover, the order prioritizes law enforcement actions such as ticketing, fining, arresting, and clearing homeless encampments, often displacing individuals without assuring adequate, stable housing or services. It also redirects federal resources toward enforcement of prohibitions on public drug use and urban camping, while denying funding to harm reduction programs and safe injection sites, which advocates say are evidence-based approaches to managing substance use disorders.
The order's focus on law enforcement as a solution for homelessness and mental illness is causing apprehension among many. Advocates criticize the order as ethically problematic, legally dubious, and ineffective because forced institutionalization does not ensure proper care. They warn it will increase homelessness, worsen public health, and strain community resources, while violating the rights and dignity of vulnerable populations.
San Francisco has reached out to the White House seeking comment on the concerns regarding the executive order. The concerns about the executive order are shared by individuals with a personal connection to mental illness and homelessness, like Patricia Fontana, a community member, who voices concern that the order may lead to a return to the neglect of the past, rather than improving the current system.
Mental health and homelessness advocates see the executive order as a regression to punitive, coercive policies that neglect the importance of stable housing and voluntary, supportive mental health services to effectively address homelessness associated with mental illness. They urge for a more humane approach that addresses the root causes of homelessness and mental illness, such as housing affordability and mental health service accessibility.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350203/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345737/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436071/ [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6321814/ [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300872/
- The controversy surrounding President Trump's executive order on homelessness and mental illness has raised concerns about the potential criminalization of mental illness within the general news and health-and-wellness sectors.
- Mental health news reports highlight the fears of families, such as those in FASMI, who may see their loved ones indefinitely institutionalized due to the order's broad use of involuntary civil commitment.
- The history of government involvement in mental health, as shown by the rise and fall of asylums and the closure of these institutions in the 1960s, adds to concerns that this order will lead to individuals being placed in facilities ill-equipped to treat or support them.
- The executive order's focus on law enforcement actions, such as clearing homeless encampments, and the denial of funding for harm reduction programs, is causing apprehension across various sectors, including politics and science, as it is seen as a regression, potentially worsening public health and straining community resources.
