Trump Order to Criminalize Homelessness Sparks Alarm

Key Takeaways

Executive Order 14321 moves away from decades of “Housing First” policy by focusing on criminalizing unsheltered homelessness and emphasizing treatment first for mental illness and substance use.

This approach misunderstands the root cause of homelessness, experts say. The main driver is lack of affordable housing—not behavioral health issues—research shows.

The new policy could worsen homelessness, while proven solutions like expanding rental assistance and strengthening housing programs remain underused.

In July 2025, in a sharp turn from two decades of housing policy, the White House released Executive Order 14321, which intends to deal with the homeless crisis by promoting involuntary treatment of mental illness and substance use disorder, and criminalizing unsheltered people who live in places like homeless encampments.

The decree ignores the fact that the most visible homeless people in the U.S. are also among the least typical. In Philadelphia, from 4% to 10% of the unhoused are without temporary shelter and sleep on the street and similar places depending on the season, according to LDI Senior Fellow Dennis Culhane, Professor at the School of Social Policy and Practice at the University of Pennsylvania. Most people who experience homelessness do not have mental health or substance use issues.

“This policy conflates homelessness with a behavioral health problem,” said Culhane. “It’s as if the federal government were focusing on the 300 to 400 unhoused people in Kensington, thinking that moving them is going to somehow address the 15,000 people who come into Philadelphia’s homeless system a year.”

Here, LDI experts weigh in on the potential effects of this paradigm shift.

Lack of Affordable Housing is the Leading Cause of Homelessness

“The main driver of homelessness in the United States is a dearth of affordable housing that’s placing millions of people at risk of losing their homes,” Culhane said. “A lot of research modeling rates of homelessness by city or county shows that, overwhelmingly, housing affordability is the primary explanatory variable, usually followed by unemployment rates.” For that reason, since 2000, federal housing policy has moved in the direction of subsidizing housing for homeless people.

In 2003, under President George W. Bush, the U.S. Department of Housing and Urban Development (HUD) endorsed a Housing First approach to reducing chronic homelessness. In 2009, Congress and President Barack Obama made this official federal policy with the passage of the Homeless Emergency Assistance and Rapid Transition (HEARTH) Act, expanding the policy to include temporary rental assistance (“Rapid Rehousing”) for people facing an acute episode of homelessness. “Potential tenants are helped to find housing, usually in scattered-site, community settings,” Culhane said. “There’s no requirement that they be sober, and they are not drug-tested. But Housing First is not housing only. The participants have a case management team that works to sustain them in that unit over time. About 85% of people are still in this housing two years after they’ve been placed.”

However, Housing First and other programs to address homelessness have had limited reach. In 2023, only about 16% of households in shelters were placed in permanent housing, according to research by Culhane and colleagues. The U.S. Department of Veterans Affairs (VA)’s Housing First policies, which include prevention, rapid rehousing for acute homelessness, and supported housing for people experiencing chronic homelessness, have had a much higher success rate. Established in 2009 and designed by Culhane, the policy framework has reduced veteran homelessness by 55%. “The VA is the best example in the U.S. of a health organization that has integrated supportive housing,” said LDI Senior Fellow Margaret Lowenstein, Assistant Professor of Medicine at the Perelman School of Medicine.

The Backlash to Housing First

Unhoused people have become more visible in recent years, especially on the West Coast. “Homelessness has increased, and the share of homeless individuals who are unsheltered has also grown,” said LDI Senior Fellow Vincent Reina, Professor in the Department of City and Regional Planning and Founder and Faculty Director of the Housing Initiative at Penn.

Many people find walking past homeless people disturbing. “The public is weary of seeing so many unhoused people neglected,” noted LDI Senior Fellow Dominic Sisti, Associate Professor of Medical Ethics and Health Policy and Director of the Scattergood Program for the Applied Ethics of Behavioral Healthcare.

And so are many politicians.

Critics argue that if Housing First worked, then we would not encounter so many homelessness on the streets. In a counterargument, Culhane stated: “The fundamental problem is not the policy, but the lack of scale—after all, 84% of households in shelters don’t receive Housing First or any rental assistance to exit homelessness. They receive temporary shelter and only temporary shelter.”

A Federal Appeals Court Defends Housing First

Late last year, HUD tried to align grants for local homeless housing assistance with the policies expressed in EO 14321. HUD’s notice of funding opportunity (NOFO) would cap spending on permanent housing at 30% of grants. “Implementation would mean that 50% of HUD funds currently spent on housing would be transferred to treatment, leaving nearly 200,000 formerly homeless tenants and their housing providers in the lurch,” Culhane explained.

On March 31, a federal appeals court ordered the government to scrap the new policy, calling it “a slapdash imposition of political whims,” according to the Associated Press. In a statement, HUD said it “remains committed to reforming the misguided ‘Housing First’ approach that for years funded the self-serving homeless industrial complex, rewarded activists, and ignored solutions.” To change HUD’s 30% cap on grant spending for permanent housing, the administration must go to Congress next year.

Interestingly, there has been no attempt by the government to change the policies for homeless veterans. “They are not messing with the successful VA program architecture,” Culhane said.

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Trump’s Order Marks the Return to Treatment-First Policies

One charge against Housing First programs is that they allow people who are not sober to receive rental assistance. The criticism is in line with a recent retreat from harm reduction programs such as needle exchanges and medical outreach in cities like Philadelphia, San Francisco, and Santa Ana, California. “There’s a belief held by some people that having an addiction is a moral failure. They believe that people who use substances should work hard or suffer in some way to earn services,” said LDI Senior Fellow Shoshana Aronowitz, Assistant Professor of Family and Community Health at Penn Nursing. In this thinking, anything short of total abstinence would disqualify people from housing or other help.

This treatment-first approach contains a basic flaw. “We have a really broken behavioral health treatment system that does not have sufficient capacity for the people who need it, especially residential treatment for people who do not have a place to stay,” Culhane said. “It’s not practical to expect people to get clean and sober through an outpatient program if they’re sleeping on the streets.”

Lowenstein concurred, “If you are experiencing homelessness, it is challenging to receive treatment for your substance use disorder, particularly in some of the more traditional models where there’s an expectation that you show up on time, keep track of your meds, and so on.”

The prospect of involuntary substance use treatment posed by EO 14321 does not make much sense to many experts. “The people who want treatment don’t have places to go,” said Culhane. In addition, “Forced treatment is not well supported by research. Treatment usually requires buy-in,” Lowenstein said.

Should the Mentally Ill Be Institutionalized?

EO 14321 intends to make institutionalizing mentally ill people easier. But the availability of mental health treatment is limited. “There’s a shortage of psychiatrists, psychologists, and social workers,” said Sisti. “The entire continuum from outpatient care to long-term psychiatric beds needs to be built up. We need an all-in investment on mental healthcare.”

Assuming a bed is available, is it ethical to put someone into a psychiatric hospital against their will? “In cases where a patient is a clear and imminent threat to themselves or another individual, there’s often a legal obligation to hospitalize a patient,” Sisti said. “But setting aside those instances, I’m not categorically opposed to it. For some people, it’s the least bad option that could maybe stabilize them and get them back onto a journey of recovery. But it can also be traumatic and harmful. It depends on the case and the gravity of the person’s illness.”

He continued, “Involuntary treatment has to be done very carefully, with respect to a person’s civil liberties. And I don’t necessarily trust this administration to do that. You see how they treat immigrants and other vulnerable people.”

An Alternative Approach to Homelessness

What’s the verdict on EO 14321? “If vigorously implemented, EO 14321 will likely exacerbate the very problems it claims to address and create new ones,” wrote Sisti, Arthur Caplan, Emeritus Professor of Medical Ethics and Health Policy at the NYU Grossman School of Medicine, and Benjamin A. Barsky, Associate Professor of Law at the University of California, San Francisco, in a recent issue of Psychiatric Services.

Culhane, who served as a consultant to the Bush administration’s Chronic Homelessness Initiative and was also Director of Research at the National Center on Homelessness Among Veterans, presents an alternative strategy.

Expand rental assistance: “The primary rental assistance program is the Housing Choice Voucher Program administered by HUD. With its funding capped by Congress, only 25% of eligible households receive vouchers.

Increase child tax credits: “During the pandemic, the government extended child tax credits to families who were previously not eligible because they didn’t pay enough taxes. Child poverty fell more than 50%, to 5.2%, in 2021, the lowest number on record. If we return to the pandemic child tax credits, it would substantially reduce the risk of homelessness,” Culhane said.

Elevate Supplemental Security Income (SSI) payments: “Sixty percent of the single, adult homeless are either elderly or have a disability, and most don’t qualify for Social Security. Instead, they rely on a public assistance program called Supplemental Security Income (SSI), which in 2026 provides maximum monthly payments of $994 for an individual—not enough to afford the fair market rent for an efficiency apartment anywhere in the country. So a state or Congress could either raise the SSI amount or provide a rent supplement to SSI,” said Culhane.

Each of these proposals, he said, would reach a far broader population than the administration’s focus on encampments.

For Further Reading

“How Much Would It Cost to Provide Housing First to All Households Staying in Homeless Shelters?” was published by the National Alliance to End Homelessness. Authors include Dennis Culhane, Matthew Fowle, and Joy Moses.

“What’s Happening to Homeless Policy in the U.S., and What Might Europeans Learn From It?” was published by FEANSTA. The author is Dennis Culhane.

“The Executive Order on Crime and Disorder: An Affront to Policy, Law, and Ethics” was published in Psychiatric Services. Authors include Dominic Sisti, Arthur Caplan, and Benjamin Barksy.

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