When President Donald Trump laid out his vision for a second term, one of his goals was to sweep millions of migrants from U.S. communities, describing them as dangerous criminals. Another part of his plan to restore public order called for pushing more than 270,000 homeless Americans off the streets
"Our once great cities have become unlivable, unsanitary nightmares, surrendered to the homeless, the drug-addicted and the violent and dangerously deranged," Trump said in a campaign video posted in April 2023. "We're making many suffer for the whims of a deeply unwell few."
It's one thing to round up and deport non-citizens, as Trump's administration has done, using increasingly aggressive and controversial tactics. Experts on homelessness say it's far more difficult to purge homeless people at a time when housing costs are are skyrocketing and federal funds to help people escape life on the streets are being slashed.
"There's literally no place for people to go," said Ann Oliva, head of the National Alliance to End Homelessness, a national advocacy group. "There's not even enough shelter in most communities to serve everybody who's experiencing homelessness."
Trump's controversial answer to this question - where should the homeless go? - was laid out in that 2023 campaign video and detailed further in an executive order signed in July. He wants state and local governments to force people off the streets into "tent camps" or into "long-term institutional settings."
"We will use every tool, lever and authority to get the homeless off our streets," Trump said during the campaign, describing his policy as tough but compassionate.
A centerpiece of Trump's plan is his push to dramatically expand use of a legal process known as civil commitment, where judges can mandate medical care for people facing severe addiction or mental illness.
Many states already have civil commitment laws on the books, but the power is used rarely and typically involves only brief institutionalization.
Trump's executive order, by contrast, urges state and local governments to use civil commitment far more often. It also calls for "shifting homeless individuals into long-term institutional settings" as part of a wider effort to "restore public order."
But even some advocates for expanded civil commitment laws say Trump's concept makes them nervous. They point to the fact that long-term institutionalization of people with mental illness in the U.S. has a troubled history of abuse, neglect and underfunding.
"It can be used for good or bad, it can be used to help or to harm," said Judy Thompson, an activist in St. Helens, Oregon, who lobbied in favor of Oregon's new civil commitment law, which was enacted in August.
Thompson came to believe judges should have broader authority to force people into medical care after an episode in 2019 when her son's mental illness spiraled out of control. She says he stopped taking his medication and began behaving erratically and suffering delusions.
According to Thompson, the crisis led to a high-speed car chase that almost turned deadly. No one was killed, but she said her son put other people in grave danger and wound up with a criminal record before a state judge finally agreed to send him to a mental hospital.
"This thing where you have to wait until they've hurt themselves or they've hurt somebody else" is inadequate, Thompson told NPR. "We need some wiggle room before things collapse and end up in this horrific, horrible nightmare."
A growing number of elected officials across the political spectrum agree. California, Oregon and New York — all led by Democratic officials — have moved to expand the power of judges to mandate care sooner, before problems with addiction or mental illness spiral into full-blown crisis.
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Thompson's son, Alton Aanderud, agrees. He was diagnosed with
In recent years, California, Oregon and New York have made it easier for judges and other officials to use civil commitment
In that video, Trump suggested many homeless people would be forced into "tent cities" or sent to "mental institutions where they belong."
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President Trump is promising to sweep homeless people off America's streets. One controversial part of his plan could FORCE thousands of people into institutions where they would be treated "long-term" for for addiction and mental illness. Critics say the policy raises big concerns about civil liberties and cost. But parts of this idea - known as "civil commitment" — are gaining traction with some Democratic leaders. Brian Mann reports.
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I meet David on a busy corner in downtown Portland Oregon. He's 35, living on the streets, carrying his belongings in garbage bags. He seems disoriented and when I ask about his situation he says he's afraid of the government.
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They put me in a concentration camp, he says. David gives NPR permission to use his full name and says he doesn't use drugs or experience mental illness.
But because David seems to be struggling, and at times confused, we're identifying him only by his first name. I ask if he's getting any kind of help and David shakes his head - he tells me he fears being abducted.
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David isn't threatening or frightening. But this kind of encounter with vulnerable homeless people - many mentally ill or addicted to drugs like fentanyl - is common in the U-S. People HERE in Portland's downtown tell me they want this problem solved. Logan Whalen runs a barbershop.
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Whalen says public safety has improved a lot since the darkest days of the COVID pandemic when tent encampments were more widespread. But he still deals with homeless people daily, often passed out on sidewalks or using drugs openly.
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I've come to Portland in part because this is one of the cities President Trump singled out as a hotspot for homelessness, drug use, and crime — problems he promises to eradicate quickly. When Trump declared a crime emergency last month in Washington DC he described Americans living on the streets as a threat.
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Trump said he wants homeless camps purged nationwide. One part of his plan - laid out in an executive order - urges state and local governments to expand use a policy known as civil commitment. The idea is that judges should have broader authority to mandate care for homeless Americans diagnosed with mental illness and addiction.
Trump's executive order says putting people in what he describes as "long-term institutional settings" would help "restore public order." This idea alarms many experts - including Morgan Godvin.
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Godvin is a drug policy researcher who spent years addicted to heroin on the streets here in Portland. She was pressured by a drug court to accept addiction treatment against her will - a process similar to civil commitment - and says that experience actually slowed her recovery, making her more fearful of care providers, more resistant to public health services.
Like many experts interviewed by NPR, Godvin thinks civil commitment IS a valid tool but only in rare cases when homeless people pose an immediate danger to themselves or others. She thinks the best answer for most homeless people is affordable housing and affordable voluntary healthcare.
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Despite concerns over personal freedoms and cost, Trump isn't alone pushing for wider use of civil commitment. This is the other big reason I've come to Portland.
Oregon is one of a growing number of BLUE states governed by Democrats - including California and New York — that are already making it easier to force people off the streets into medical care. Oregon Democratic state Representative Jason Kropf <
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Kropf says the law he sponsored — which was enacted last month - means a more modest expansion of civil commitment than envisioned by Trump.
For one thing, the Oregon measure actually discourages "long-term" institutionalization. He thinks Oregon found the right balance between personal freedom and public safety. I ask Kropf about the other issue - the price tag — and he agrees it's a big concern.
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Oregon IS already investing an additional 65 million taxpayer dollars in new residential facilities. But Emily Cooper with a group called Disability Rights Oregon says costs could spiral out of control.
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Cooper says Oregon's healthcare system is already straining to help people who seek care for addiction and mental illness. She's skeptical lawmakers will spend enough money as more people are taken off the streets.
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Many experts on homelessness and public health told NPR this question — cost — needs to be answered before Trump's executive order is implemented.
A spokesperson for the White House declined to be interviewed on tape but speaking on background they said institutionalization of homeless people can be expanded by state and local governments without big new taxpayer investments. They said that could be achieved by shifting dollars - including federal grants — from other programs and spending money more efficiently. But Dr. Kenneth Minkoff, a national expert on civil commitment and institutional care disagrees.
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Remember - the federal government says there are more than a quarter million people living on U-S streets on any given day. Minkoff and others say caring for even a small fraction of that population in institutional settings would be expensive if done right. Meanwhile Republicans have actually cut funding for Medicaid, the government insurance program that funds most addiction and mental health care in the U-S. Again Kenneth Minkoff.
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Here in Oregon, it's too soon to know how many more homeless people will be forced into care because of the new law - and how much that will cost.
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Back on the street, in Portland, two people huddle in a doorway next to Logan Whalen's barber shop - they're getting high. I ask Whalen if he's impatient enough for a fix to this problem to want homeless people swept off the streets.
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Homeless advocates say they'll be watching closely to see how expanded civil commitment policies are implemented here in Oregon and around the country. Will people get the help some desperately need? Or will the push to clean up streets quickly force homeless Americans out of their communities and out of sight? Brian Mann NPR News Portland Oregon
Tu 9.23.25 Script
Episode Card ID: https://nexus.npr.org/app/?ws=7226e776-ae78-468c-a8e8-aa0dc92de194
Broadcast Card ID: https://nexus.npr.org/app/cards/5538115
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1963, two years after John F. Kennedy told Congress he wanted to put a man on the moon, he came to them with a challenge that would prove even tougher.
Mental illness.
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Kennedy's proposed law would fund research into the causes of mental disabilities..
It would also change the way the country treated people with serious mental illness.
<<0:50 our chief aim is to get people out of state custodial institutions and back into their communities and homes without hardship or danger>>
At the time more than half a million people were confined to state-run psychiatric hospitals, many involuntarily.
Conditions in these facilities were often abysmal, as Kennedy laid out.
<<1:11 nearly half of the five hundred and thirty thousand persons in our state mental hospitals are in institutions with over three thousand patients getting little or no individual treatment many of these institutions have less than half of the professional staff required forty five percent of them have been hospitalized for ten years or more>>
The Community Mental Health Act, would be the final bill Kennedy signed into law, just a few weeks before his assasination.
The idea was that people with mental illness could live independently in their communities, and receive care at local health centers.
And in its wake, the number of people in large psychiatric hospitals DID decline dramatically.
The law was one factor.
So were advances in treatments, and court decisions that made it harder to confine mentally ill people against their will.
But the new system was underfunded.
And today, many people with severe mental illness end up in hospital emergency rooms… in jail…or on the streets.
<<We are making many suffer for the whims of a deeply unwell few. And they are unwell indeed.>>
President Trump campaigned on a promise to clear homeless people from the streets.
Including by pushing people with mental illnesses into hospitals:
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And now he has a new executive order aiming to do it.
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Consider This:
Trump's plan could force homeless people into treatment against their will.
We'll go to a state where that's already happening.
From NPR I'm Juana Summers.
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It's Consider This from NPR.
President Trump's executive order calls for quote "shifting homeless individuals into long-term institutional settings for humane treatment."
The tool to do this – forcing people into treatment for addiction or mental illness – is called civil commitment.
Critics say Trump's policy raises big concerns about civil liberties and cost.
But "civil commitment" is gaining traction with some Democratic leaders.
Brian Mann dug into it.
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That was NPR's Brian Mann in Portland, Oregon.
This episode was produced by Connor Donevan and XX, with audio engineering by ENGINEER.
It was edited by Andrea de Leon <
Our executive producer is Sami Yenigun.
It's Consider This from NPR.
I'm Juana Summers.
Copyright 2025 NPR
