ICE and DHS agents roam our streets under the pretext of ridding the country of “the worst of the worst.” In describing their mission to the public, the administration has adopted the metaphor of a diseased body politic infiltrated by dirt or infection that must be purged in order to restore our nation to health.
Meanwhile, alarm is increasing as awareness grows of the DHS plan vastly to expand its network of detention centers, places where, according to the few audits permitted, people are abused, disappeared and even murdered. These sites are being prepared as warehouses for these supposed foreign bodies, i.e., our family members, friends, co-workers and neighbors.
Our current administration has been startlingly vocal in its efforts to define who these so-called foreign bodies are, such that large sectors of the population are now portrayed as “other:” Immigrants are singled out, as are people of color more generally, trans persons, Muslims, those who speak languages other than English, and those who simply voice opinions counter to a narrow set of talking points, all of whom live under the threat of discrimination, disenfranchisement, deportation or worse.
Yet there is another identified group, with even less collective voice, in danger of mass detention without due process: Those diagnosed with mental illness.
Quietly, our country is moving, state by state and executive order by executive order, towards policies that all but dismantle the rights of those deemed mentally ill. In the US, both Republican and Democratic legislators have applauded the trend toward seemingly humane policies that lower the threshold for involuntary psychiatric commitment and assertive, non-consensual treatment in the community. What could be better for afflicted individuals and the country as a whole than making sure people are getting the treatment they need?
Of course those who carry a diagnosis of serious mental illness are often precisely the ones with the least opportunity to respond to that question, especially those who consider themselves survivors not of their diagnoses themselves but of the loss of autonomy and personhood they have experienced in their often traumatic interactions with a mental health system that has never successfully served them.
Now, fast forward to July of 2025, when Trump signed an Executive Order titled “Ending Crime and Disorder on America’s Streets.” This Order, which appeared roughly contemporaneously with the deployment of troops to American cities, explicitly blurs the lines between mental illness, addiction, homelessness and criminality. It proposes to lift the restrictions on civil commitment for those with mental health problems, essentially authorizing the removal of any person deemed as such, and providing the funds and the force to do so.
Will this Order help to restore those with serious psychological issues to health?
Those who have studied the issue know that forced treatment doesn’t help. There is an abundance of research to indicate that its most common results are an obliteration of trust in the mental health system and the intensification of post-traumatic symptoms due to retraumatization, including an increased incidence of death by suicide.
Meanwhile, such a policy would remove funding from programs that work, as explicitly mandated in the Executive Order. Housing first options for unhoused persons, harm-reduction programs for those who are addicted, and voluntary mental health treatment for those whose psychological issues are severe all have solid research behind them demonstrating that these are initiatives that help. These are precisely the programs that the EO targets.
Further, the terms of the EO are elastic and potentially expansive; for instance, just this week, the administration announced its intentions to claim guardianship for homeless veterans and even those who are merely “at risk of homelessness,” stripping them of the right to self-determination, including access to their own finances and their choice to refuse treatment, and to do so not in response to a specific episode of homelessness or emotional distress, but permanently, since guardianship, once it is established, is often difficult to overturn.
Mental health and civil rights organizations should be sounding the alarm. There are urgent reasons to be concerned that the current administration is readying itself for a program of mass-incarceration and forced “treatment” of those diagnosed as mentally ill. The Make America Healthy Again Commission, chaired by RFK Jr., calls for the removal of those who are troubled to isolated spaces where, it is claimed, they can be cured at “wellness farms” through a diet of organic food (unlikely given the putrid fare provided in existing encampments) and an embrace of “accountability,” ironic given the lack of accountability for insuring basic human rights standards within current detention programs. For instance, a facility under construction in the remote Utah desert is slated to house 1,300 mentally ill inmates who have fallen victim to the “culture of permissiveness” that the current administration sees as a cause of mental illness and addiction.
Such forced treatment is a lucrative business. Companies such as CoreCivic and GEO Group stand to reap huge profits from the creation of thousands of additional mental health beds, hastily erected in repurposed warehouses and encampments, just as venture capital firms such as 8VC will benefit their stakeholders greatly from the sale of long-acting injectables as well as surveillance tools that track compliance with medication regimens, such as medications that contain embedded sensors that notify prescribers when they are ingested.
Popular myths about mental illness have made it easier to turn a blind eye to this threat to a vulnerable population. For instance, many still embrace the idea that psychosis is the manifestation of a chemical imbalance in the brain that permanently marks affected individuals as “other,” although this theory has long been debunked by reputable researchers. The general public embraces the idea that people diagnosed with mental illness are a threat to civil society, when in fact most research indicates that those diagnosed are more likely to be victims of violent crime than the average citizen while they commit only a small fraction of the violent crime that occurs. And people believe that mental illness causes homelessness when studies suggest that people most often become homelessness due to systemic issues such as economic inequality, debt including medical debt, and the lack of affordable housing.
All these myths contribute towards seeing the homeless as mentally ill and the mentally ill as irredeemable and “other,” and impede the provision of effective care. We should already know the consequences of such beliefs, as there is a long history of persecution of those deemed mentally ill towards eugenic ends, including through sterilization, confinement and even death. For instance, how easily we forget that the violation and extermination of the Jews from Europe was preceded by the violation and extermination of those the Reich deemed mentally ill, and in fact was modelled on those efforts.
Some say that drawing parallels between current US policies and those of Nazi Germany is exaggerated, that calling detention centers concentration camps is provocative and overblown, despite the explicit embrace of Nazi ideology by many key administration figures.
But history suggests that this rhetoric will prove misguided only if we don’t act now to quash efforts to create the building blocks from which extermination and work camps can be assembled and brought online. For instance, Indiana House Bill 1119, expanding the methods that can legally be used to execute criminals, was defeated not because it failed to garner the majority of yeas from those who voted, but because that majority did not constitute a constitutional majority according to Indiana legislative definition.
People who believe that the mentally ill should not be afforded the same rights as the rest of us find comfort in the idea of a clear distinction between so-called insanity and the forms of reality prescribed by consensus, just as many immigrants who are naturalized citizens voted for the current administration because they felt insulated from deportation threats on the basis of the distinction between “criminals” and themselves.
But fascist regimes are proficient at manipulating the definition of mental illness to fit their needs, and of blurring the boundary between treatment and punishment. There is a well-documented practice of diagnosing mental illness in social justice activists in the former Soviet Union, Post-Soviet Russia, China, Belarus, Romania, Hungary, Cuba, India, Japan, Suriname, and Thailand, for starters, despite the belief by most people that such a practice can’t happen here.
This idea, that “it can’t happen here,” in essence creates its own form of “othering” in its implication of our exceptionalism, its suggestion that “we are not like you and would not do the terrible things that you do.” Yet even at this moment, across the US, the plans are being drawn up and the warehouses are being retrofitted. The time is now to look towards the future with caution and a commitment to act, for the sake of the sanity of America.
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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.