A July 24 executive order to reduce homelessness in the U.S. instructs federal agencies to end “housing first” policies in favor of involuntary commitments, or force admissions, at hospitals.
President Donald Trump’s order, “Ending Crime and Disorder on America’s Streets,” aims to address the mental health conditions and addictions of the nation’s unhoused individuals.
HHS has been directed to help federally qualified health centers and community behavioral health clinics provide “comprehensive services for individuals with serious mental illness and substance use disorder, including crisis intervention services,” the order said.
The order also aims to direct federal resources toward ensuring “detainees with serious mental illness are not released into the public because of a lack of forensic bed capacity at appropriate local, state, and federal jails or hospitals.”
The executive order could lead to increased and extended hospitalizations of homeless people with mental health conditions and addictions, The Washington Post reported July 24. In the last 10 years, dozens of states have expanded involuntary commitment laws, according to the report.
Involuntary commitments have increased since 2011, according to studies examining psychiatric hospital holds and homeless people entering emergency departments.
Research has long linked homelessness to poor health outcomes. However, higher utilization at emergency departments can strain hospital operations — and result in inadequate care — as many people experiencing homelessness “often have a multitude of diagnosed and undiagnosed health conditions, in addition to poor social circumstances,” according to a study published in the International Journal of Emergency Medicine.
