Executive Order Regarding Homelessness Does Not Address Root Causes

On July 24, 2025,¹ the Trump administration passed an executive order, “Ending Crime and Disorder on America’s Streets,” which was aimed at addressing the homelessness epidemic in the US. Although some conservative outlets have praised the move, critics of the executive order are calling attention to the fact that the root cause of homelessness is not addressed in the long document.

What Does the Executive Order Include?

The executive order stated that “endemic vagrancy, disorderly behavior, sudden confrontations, and violent attacks have made [US] cities unsafe,” linking the record 274,224 people living on the street in a single night to at least part of this danger. The executive order claimed that the majority of those living on the streets are addicted to drugs, have a mental health condition, or both.

According to a survey conducted by the United States Conference of Mayors with the Substance Abuse and Mental Health Services Administration (SAMHSA),² about 26% of those who are homeless abuse drugs, and about 38% of homeless people abuse alcohol. The order states that the goal is to shift these homeless people into long-term institutional settings for potential rehabilitation.

The new executive order may only address the surface issue of homelessness, according to some experts. | Image credit: Inam - stock.adobe.com

"It focuses on involuntary civil commitment and it ends federal support for housing first programs...Housing first says get people into housing and then deal with their chemical dependency and substance use disorder vs requiring them to get clean before they're housed," said Thomas Kottke, MD, MSPH, senior research investigator at the Health Partners Institute.*

“The administrative executive order really demonstrates a shift in how the federal government is going to approach homelessness,” said Shannon Scully, director of justice policy and initiatives at the National Alliance on Mental Illness (NAMI), based in Washington, DC. “Prior to this order, there’d been kind of a consistent commitment to the housing-first model, which really made housing the priority when addressing some of the underlying reasons why someone becomes homeless.”

This shift, according to the executive order,¹ is to seek the reversal of judicial precedents and the termination of consent decrees to allow for the civil commitment of individuals with mental illness. This would also extend to providing assistance to state governments to adopt and implement civil commitment, institutional treatment, and “step-down” treatment standards. These funds would be appropriated by the Attorney General, the Secretary of HHS, the secretary of Housing and Urban Development, and the Secretary of Transportation to give priority to areas that prohibit open drug use, prohibit urban camping, and prohibit urban squatting.

Response to the Executive Order Remains Mixed

The executive order was met with mixed responses from experts in the space, with those working in substance abuse and mental health expressing trepidation on whether these methods would be successful in addressing homelessness across the country.

“It also puts a significant focus on leveraging civil commitment and institutionalization, and those aren’t anything that we see as real solutions to preventing homelessness among people with behavioral health needs,” said Scully.

Programs that encourage harm reduction or safe consumption of substances have also been put on notice, with the administration calling on SAMHSA to make sure that grants are not being used for such programs, potentially walking back progress in these areas.^1,3

The immediate effects, however, are not likely to be noticed for a time. Scully said that the executive order has caused confusion in the immediate aftermath, primarily in people with mental illness in their families. On top of that, civil commitment is defined by states, she said, which will make it up to the states whether or not they follow the lead of the executive order. The definition of civil commitment had been expanded in the past in several states, including California, which might make it easier for some parts of the country to follow through.

The biggest barrier to any of this occurring, though, is funding. Trying to treat all of these individuals would take a massive budget. However, the Trump administration has previously pulled back on $11 billion worth of funding for mental health and substance use,⁴ leaving many areas to address the problem with fewer funds.

On top of that, SAMHSA has lost approximately $1 billion from its budget, potentially making it harder to address any substance use or mental health issues in the country.⁵ Kottke noted that, although each individual action by the administration may not appear to be a problem, these decisions can lead to bigger issues down the road.

"On the 1 hand, they're going to flood the mental health care system with, by my calculations, they say there's 240,000 homeless, two-thirds of which have mental health problems," said Kottke. "Well there's only 112,000 psychiatric beds in the United States which, according to some calculations, is half of what's needed...adding 180,000 people to a service that has 112,000 [beds] while cutting a billion dollars right out of the support, the math doesn't add up."

“If we don’t have any level of commitment of resources, even implementing the order as written or states trying to respond to this order, they’re going to face challenges because there is a lack of resources in order to even provide mental health care to folks that really need it most,” said Scully.

Although on the surface this executive order seems to tease at a potential increase in the use of hospital beds in places such as emergency departments, Scully says that the loss in resources is truly going to be the culprit should that increase happen.

Kottke noted that this executive order could end up leading to mass incarceration if homeless people do not meet the criteria for involuntary commitment and are instead put in jail due to camping, costing the state lots of money.

If Not the Executive Order, What Is the Solution?

Advocates for the homeless have long promoted the idea of addressing the affordable housing crisis in order to address homelessness across the nation.

"There's that old adage that for every problem there's a simple solution, but it's usually wrong and there's no simple solution here," said Kottke. "It's much cheaper to educate [homeless people and] to give them a job. What we need to do is look beyond the simple solution of, say, 'Oh, we'll just get them off the street," to say, 'What are the root causes?' And the root causes are low income [and] lack of affordable housing."

The National Alliance to End Homelessness calls for expanding funding for federal rental assistance and universal access to rental assistance to help those with low incomes have safe places to live.⁶

Scully emphasized that this housing should also bring wraparound care, including access to care, which is often referred to as supportive housing. “You’re receiving these wraparound services and those supports while you are in a housing program and really looking at how we get people engaged in their own care and on track to wellness and being able to sustain stable housing,” she said.

Kottke noted that, although states can technically do what they want because the executive order is not law, there is the potential that the administration could exert force through withholding funds. "I think the attorneys general will have a role to play basically suing the federal government about this," he said.

Although it is unknown what the individual states will do as a response to this executive order, Scully said that advocates, including NAMI, are ready to talk to state governments in all 50 states to discuss “real solutions” to both untreated serious mental illness and homelessness. “We’re prepared to have those conversations.”

*All opinions expressed by Thomas Kottke, MD, MSPH, are his own and do not reflect those of his employer.

References

1. Ending crime and disorder on America’s streets. The White House. July 24, 2025. Accessed August 12, 2025. https://www.whitehouse.gov/presidential-actions/2025/07/ending-crime-and-disorder-on-americas-streets/

2. Miller J. Addiction and homelessness. AddictionHelp.com. Updated June 22, 2025. Accessed August 12, 2025. https://www.addictionhelp.com/addiction/homelessness/

3. Ludden J. Trump signs an executive order to make it easier to remove homeless people from streets. NPR. Updated July 24, 2025. Accessed August 12, 2025. https://www.npr.org/2025/07/24/nx-s1-5479139/trump-homelessness-executive-order-civil-commitment-camping

4. Mann B. Trump team revokes $11 billion in funding for addiction, mental health care. NPR. March 27, 2025. Accessed August 12, 2025. https://www.npr.org/2025/03/27/nx-s1-5342368/addiction-trump-mental-health-funding

5. Chatterjee R. RFK Jr. is shrinking the agency that works on mental illness and addiction. NPR. June 6, 2025. Accessed August 27, 2025. https://www.npr.org/sections/shots-health-news/2025/06/06/nx-s1-5424670/rfk-jr-samhsa-mental-health-addiction-overdose-trump-budget-cuts

6. Improving access to affordable housing. National Alliance to End Homelessness. Accessed August 12, 2025. https://endhomelessness.org/improve-access-to-affordable-housing/