The Worst Part of Trump's Order to Boost Civil Commitment

The demolition of federal agreements and consent decrees will be a license to abuse

On July 24th, the White House issued an executive order to try to help increase rates of civil commitment across the nation. Titled, “ENDING CRIME AND DISORDER ON AMERICA’S STREETS,” President Trump promises to “take a new approach” to solving '[e]ndemic vagrancy, disorderly behavior, sudden confrontations, and violent attacks” that “have made our cities unsafe.” Trump, in fact, then takes the same old approach that has been going on (and failing) for many years already, doubling down on what many states have already been doubling down on: Trump advocates using civil commitment as a policing tool, as a way of “[s]hifting homeless individuals into long-term institutional settings.”

As Trump has been doing in so many other aspects of society, he then pledges to weaponize the full brunt of the federal government and its enormous financial granting systems (read: fascistically over-rule Congress’ powers of the purse) to help further this cause, and to simultaneously undermine and attack cities and states unless they boost their efforts at doing the following:

“(i) enforce prohibitions on open illicit drug use;

(ii) enforce prohibitions on urban camping and loitering;

(iii) enforce prohibitions on urban squatting;”

(iv) enforce, and where necessary, adopt, standards that address individuals who are a danger to themselves or others and suffer from serious mental illness or substance use disorder, or who are living on the streets and cannot care for themselves, through assisted outpatient treatment or by moving them into treatment centers or other appropriate facilities via civil commitment or other available means, to the maximum extent permitted by law”

So, whom and what Trump is targeting is clear. There is token accompanying language, without evidence because there isn’t any, suggesting that the vast majority of these homeless people, users of drugs, urban campers, loiterers, and squatters are seriously mentally ill — and there’s not even a passing nod to rising problems of housing affordability.

In his executive order, Trump also insists we should have “evidence-based” programs for helping unhoused people with “serious mental illness or substance use disorder.” He then pledges to kill both Housing First and safe consumption sites—two of the programs, when properly implemented, with the strongest evidence bases for successfully helping these very people.

To the extent it’s implemented, this executive order will be disastrous and enormously costly—psychiatric hospitalization is by far the priciest way to try to tackle loitering, urban camping, squatting, homelessness, drug use, or “mental illness.” And how all of this is going to be funded even as Trump is making massive cuts to Medicaid is anyone’s guess.

I don’t want to downplay that threat — BUT… the fact is, many states have been doing these things already. (And, sadly, many of those governments will probably be glad to get federal support in their efforts.) Therefore, in my opinion, the worst part, the scariest part, the truly NEW part of this executive order is here:

“Sec. 2. Restoring Civil Commitment. (a) The Attorney General, in consultation with the Secretary of Health and Human Services, shall take appropriate action to:

(i) seek, in appropriate cases, the reversal of Federal or State judicial precedents and the termination of consent decrees that impede the United States’ policy of encouraging civil commitment of individuals with mental illness”

The National Disability Rights Network discusses some of the significance of this in a statement. I’m going to use slightly plainer language. Notwithstanding the token use of the word “appropriate”, this is Trump promising, as he’s been doing in other aspects of society, to subvert the Constitution, ignore court precedents, rescind legal agreements, and break laws to achieve what he wants.

Specifically, Trump is promising to reverse “judicial precedents” and “consent decrees” related to civil commitment. What do these refer to?

Basically, wherever you stand on forced treatment, I think most of us could agree that, at the very least, if doctors don’t believe certain people NEED to be psychiatrically hospitalized long term, and if those people don’t meet the LEGAL CRITERIA to be incarcerated long term, then such people definitely should not be psychiatrically incarcerated long term. Seems obvious, right? And yet, these improper situations happen a lot — affecting tens of thousands of people in hundreds of institutions around the country.

Consequently, the U.S. Department of Justice Civil Rights, Special Litigation, and Health Care Fraud divisions, along with state attorneys general have, for many years, prosecuted countless cases where children, youth, adults, and older adults are being held indefinitely, abusively, and illegally in institutions, jails, and psychiatric facilities. In the end, agreements and consent decrees are then established among the parties to create procedures for these guilty states and institutions to come into compliance with the law, release these incarcerated people, and help transfer these people back into homes or other community settings. U.S. Supreme Court and constitutional precedents support, whenever possible, integration of people with disabilities into communities rather than segregation and isolation in institutions.

For example, this case in December of 2024, where the State of Rhode Island was found to be illegally incarcerating children in psychiatric hospitals instead of allowing these children to get treatments at home.

Or here’s a slew of past cases. A few samples:

In Alaska: “many children with behavioral health disabilities, including a substantial number of Alaska Native children, are forced to endure unnecessary and unduly long admissions to psychiatric hospitals and psychiatric residential treatment facilities both within Alaska and in states across the country.”

In Florida: “individuals on a wait list for a home and community-based services… [where government policy] places them at risk of nursing facility placement.”

In Delaware: “The goals of the Agreement were to ensure that people who are unnecessarily institutionalized can receive the treatment they need in the community; to ensure that individuals in health crisis have sufficient community resources available to avoid unnecessarily being hospitalized or arrested or jailed; and to ensure that people with mental illness in the community are not forced to enter institutions because of the lack of stable housing and intensive treatment options.”

In Georgia: ‘The 2009 settlement agreement resolved the United States' claims that persons with mental illness or developmental disabilities were harmed by unnecessary confinement in State Hospitals… In the 2010 settlement agreement, the State agreed to expand its community services system, including crisis services, case management, housing supports, and other services supporting full integration in daily life for thousands of people with mental illness or developmental disabilities receiving State services.”

…the list goes on…

If these kinds of agreements with states get reversed by Trump, what then? In effect, he gives these states and institutions a license to break the law and incarcerate, using civil commitment laws, as many people as they want for as long as they want—even when those people don’t meet the criteria for commitment.

There’s a lot more to talk about with respect to what’s going to be happening as a result of this ugly executive order. But to me, this is the most glaring and worrisome element that will have immediate impacts.

We don’t know right now which agreements the Trump Administration might target for demolition—but does it even ultimately matter? Because this executive order, if nothing else, already makes it abundantly clear that the U.S. Department of Justice, under Trump, is not going to be trying to stop unconstitutional long-term civil commitments anymore. Everyone has heard this message. Trump has already issued a universal license to abuse.

Please share this post with others to help increase awareness of PsychForce Report.