Trump pushes for forced psychiatric care for homeless people while slashing Medicaid and housing aid. Can his plan work? Read the full story.
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Trump’s Mental Health Push: Forced Treatment, Fewer Resources
President Donald Trump has unveiled a controversial plan to address the nation’s homelessness and mental health crisis. His approach centers on involuntary psychiatric commitment, where homeless people with severe mental illness could be placed in hospitals or treatment programs against their will.
But while Trump calls this a public safety solution, critics argue his deep funding cuts to Medicaid, housing programs, and mental health services will make his plan nearly impossible to implement.
Rising Homelessness and Mental Health Crisis
Homelessness in the U.S. has surged to over 770,000 people in 2024, an 18% increase from the previous year. Roughly a quarter of them struggle with schizophrenia, bipolar disorder, or other severe mental illnesses.
Research shows only 3% to 5% of violent acts are linked to people with serious mental illness. Yet Trump frames the issue as a public safety threat, arguing that stronger involuntary commitment laws will “restore public order.”
Trump’s Executive Order on Involuntary Commitment
In July, Trump issued an executive order urging states to expand civil commitment laws. This would allow judges and doctors to force people into psychiatric care if deemed a danger to themselves or others.
He even floated the idea of reopening old “insane asylums.”
At the same time, his administration is pushing states to expand Assisted Outpatient Treatment (AOT) — a court-supervised program that provides therapy, medication, and services without hospitalization.
Cuts That Undermine His Goal
The challenge: Trump has simultaneously proposed major cuts to the very programs needed to support his plan.
- $900 billion in Medicaid cuts projected over the next decade
- $1 billion slashed from the Substance Abuse and Mental Health Services Administration (SAMHSA)
- Reductions in Housing First programs, which provide stable housing for the chronically homeless
Experts warn this creates a paradox: forcing people into care that doesn’t exist.
Jeffrey Swanson, psychiatry professor at Duke University, said:
“The administration wants to force people into treatment that may not exist. It’s a bridge to nowhere.”
Historical Context: From Asylums to Today
America has been moving away from psychiatric institutions since the 1950s. At the peak in 1955, there were 550,000 psychiatric beds in state hospitals. Today, that number has dwindled to around 36,000.
The shift, known as deinstitutionalization, was meant to replace hospitals with community-based care. But funding never kept up, leaving millions without adequate treatment.
Now, prisons and jails have become the nation’s largest mental health facilities — a costly and ineffective substitute.
Supporters vs Critics
Supporters of Trump’s plan argue:
- Involuntary treatment can save lives in extreme cases
- Expanding psychiatric beds is critical to reducing street homelessness
- Public safety requires stronger intervention
Critics counter:
- Cuts to Medicaid and housing programs make the plan unsustainable
- Forced treatment can be traumatizing and more expensive
- Voluntary treatment, paired with housing, produces better long-term outcomes
FAQs
Q1: What is involuntary commitment?
It’s a legal process where someone is admitted to psychiatric care against their will if they’re deemed a danger to themselves or others.
Q2: How many psychiatric beds does the U.S. currently have?
As of 2022, only 18 beds per 100,000 people — far below the 60 experts recommend.
Q3: How does Trump’s plan conflict with his budget cuts?
While promoting forced treatment, his administration has cut Medicaid, housing aid, and mental health funding — reducing the very resources needed.
Q4: What alternatives do experts suggest?
Experts advocate for Housing First, voluntary treatment programs, and investments in the mental health workforce.
Conclusion
Trump’s push to force homeless people with mental illness into hospitals marks a major policy shift. But without new funding for psychiatric beds, housing, and mental health services, experts warn his plan may be unworkable.
Instead, many argue the U.S. needs a comprehensive mental health care system — one that prioritizes voluntary treatment, housing stability, and community support, rather than forced hospitalizations alone.