Opinion: You Can’t Commit Your Way Out of a Crisis of Neglect

Key points:

• Trump administration’s executive order targets homelessness and mental illness with a controversial approach.
• Plan expands civil commitments to hospitalize unhoused people with mental illness against their will.
• Experts warn that civil commitment is an expensive and ineffective intervention.

The Trump administration’s latest executive order on homelessness and mental illness is a jarring throwback to a discredited past. The plan calls for expanding civil commitments to force unhoused people into psychiatric hospitals, slashing support for evidence-based programs like Housing First, and empowering cities to crack down on encampments in the name of “public order.” But this is not a plan to help people. It is a strategy to disappear them.

As The Marshall Project reported, the administration’s July executive order envisions a sweeping federal push to use civil commitment laws to hospitalize more people with mental illness, framing the issue not as a public health challenge but as a crisis of public visibility. It is an effort to remove people from the streets—not to meet their needs.

Legal experts and mental health advocates are sounding the alarm. Jennifer Mathis, Deputy Director of the Bazelon Center for Mental Health Law, called the move “entirely misguided”

in a recent interview with The Marshall Project.

She warns: “You can’t commit your way out of a problem of not having sufficient community services.” That simple truth lies at the heart of this debate.

Civil commitment—forcing someone into psychiatric care against their will—is a legally and ethically fraught process. Under Supreme Court precedent, a person cannot be involuntarily committed unless they are diagnosed with a mental illness and deemed a danger to themselves or others.

The Trump order, by contrast, encourages a far broader use of commitment, with vague references to restoring “public order” rather than protecting individual rights or health.

As Mathis notes, “There is no legal support for what they are advocating. If there were, they would not need to try to overturn judicial precedents.”

The order frames civil commitment as a humane alternative to homelessness. But what happens after someone is locked in a hospital against their will? What services are available when they are released? What housing, if any, is waiting for them? The administration offers no answers—only the illusion of action.

What makes this policy especially misguided is that it confuses public discomfort with public safety. The executive order treats homelessness as a visual nuisance rather than a human crisis. By targeting those with visible signs of mental illness for institutionalization, it substitutes optics for outcomes. There is no attempt to evaluate need, assess individual capacity, or provide long-term support.

The goal is removal not treatment.

Moreover, the policy fails to address the underlying causes of homelessness, which include soaring housing costs, stagnant wages, systemic racism, and disinvestment in mental health infrastructure.

Civil commitment is a blunt instrument being used in place of the comprehensive investment that is truly needed. It does not expand the housing stock. It does not train or pay mental health workers. It does not fund community clinics. It simply cycles people in and out of high-cost institutions without any plan for stability.

As Mathis points out, “You can’t create hospitals ad nauseam.”

In reality, this strategy simply recycles the failures of the past.

Mass institutionalization—once a hallmark of mental health systems in the U.S.—was discredited decades ago for a reason. It was inhumane, expensive, and ineffective. Facilities were often overcrowded and under-resourced, and people were held indefinitely with little oversight.

The movement toward deinstitutionalization in the 1960s and ’70s was driven by a consensus that people with mental health conditions deserve to live in communities, not behind locked doors. But that transition was never completed.

Community-based services were promised but never fully funded. Today’s homelessness crisis is, in part, the result of that broken promise.

Instead of fulfilling that obligation, the Trump administration wants to revive the worst aspects of the old system.

“It seems like a very backward vision of a system that resembles the one we came from many years ago, and that we got away from because it was not only destroying lives — it was destroying budgets as well,” Mathis explains.

Civil commitment is not only a violation of personal liberty; it is also one of the most expensive interventions available.

At a time when Congress has enacted historic cuts to Medicaid and other social programs, the idea of channeling scarce resources into forced hospitalizations is both fiscally and morally indefensible.

Just as troubling is the administration’s move to defund Housing First programs, which prioritize stable housing without preconditions like sobriety or treatment compliance. These programs have been studied extensively and consistently shown to be more effective than coercive approaches.

“There is a mountain of evidence supporting housing-first, that it works,” Mathis said. In fact, Housing First gained bipartisan support under George W. Bush and was scaled nationally during the Obama years.

Defunding Housing First is not just shortsighted—it is dangerous. Without housing, no amount of treatment can produce stability. The administration’s order implies that people who are unable to comply with program requirements should be left on the streets—or committed.

The data is clear: housing people unconditionally is often the first and most crucial step to improving their mental and physical health, increasing safety, and reducing emergency service costs.

The executive order also promotes expanded use of assisted outpatient treatment (AOT)—a form of court-ordered treatment for individuals living in the community.

While AOT is less restrictive than inpatient commitment, its effectiveness is disputed. A recent Government Accountability Office report found the evidence for AOT to be inconclusive. Forcing people into treatment without addressing the structural factors driving their instability—lack of housing, income, support—may only worsen their distrust and disengagement from care systems.

This policy is also rooted in a dangerous and deeply misleading narrative: that people with mental illness are inherently violent or threatening.

“There have been efforts to demonize people with mental health disabilities and portray them as violent, even despite a lack of evidence,” Mathis said. In reality, people with mental illness are more likely to be victims of violence than perpetrators. They account for only 3 to 5 percent of violent acts. But by exploiting public fears, politicians shift blame away from systemic failures—like unaffordable housing, lack of treatment access, and structural poverty—and onto vulnerable individuals.

The timing of this executive order adds insult to injury. As states face mounting shortfalls in mental health budgets due to federal cuts, the administration is urging them to pour money into the most expensive and least effective forms of intervention.

“They would be able to serve far fewer people,” Mathis warned. “It makes no sense.”

Jesse Rabinowitz of the National Homelessness Law Center put it bluntly: “Some people experiencing homelessness have mental illness. That’s not the cause of homelessness. The cause of homelessness is that housing is too expensive” source.

Trying to solve a housing crisis with psychiatric beds is like trying to fix a leaky roof with duct tape—it’s a distraction at best, and a disaster at worst.

You cannot punish your way out of poverty. You cannot medicate away systemic failure. And you cannot commit your way out of a national housing crisis. What you can do is invest in what works: supportive housing, peer-led outreach, voluntary mental health care, trauma-informed services, and a livable safety net.

This executive order will not solve homelessness. It will not help people with serious mental illness. But it may succeed in hiding them—at least for a while. That may be politically convenient, but it is morally bankrupt. Americans deserve real solutions, not scapegoats.

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