Punishment instead of treatment: Why Trump’s repressive policies only worsen America’s homeless problem

The Trump administration ignored the statistics: thanks to housing first programs, the number of homeless people in Finland fell by 68% from 2008 to 2024, and in Norway, it nearly halved between 1996 and 2020.

No more safe consumption

Trump’s order explicitly bans funding for harm reduction and safe consumption programs for people with addictions. These initiatives included measures such as syringe exchange points to reduce the spread of HIV/AIDS and methadone therapy to support gradual addiction treatment. These approaches, which have proven effective in reducing mortality, are being replaced by forced treatment.

There are two other recognized methods for helping people with addictions, neither of which is being pursued by the Trump administration. First, there is Assertive Community Treatment (ACT), which offers round-the-clock support from mobile teams of psychiatrists, nurses, and social workers. Meta-analyses show that such programs reduce homelessness by 37% and improve the mental health of participants by 26% compared with standard case management. In other words, ACT helps those suffering from addiction maintain housing longer and be hospitalized less frequently.

A second proven approach involves the use of mobile teams and outreach clinics, which consist of doctors, nurses, and social workers who assist the homeless on the streets or in shelters. A recent review showed that Mobile Medical Units (MMUs) can effectively provide addiction treatment, primary care, and psychiatric support for the homeless. While research is still largely descriptive, preliminary data suggest that these services significantly increase access to care, reduce homelessness, and are generally well-received by patients. Similarly, homeless people with acute mental disorders are also willing to engage with mobile crisis team programs. In one interview, all respondents favored an approach employing a mobile police or ambulance team, noting that these services helped address urgent needs such as access to food, temporary shelter, and psychological support.

Homeless or insane?

In recent years, the number of homeless people in the U.S. has been rising, primarily due to economic factors that include soaring housing costs and the end of COVID-19 relief measures. According to estimates from the Department of Housing and Urban Development, in January 2024 the U.S. had a record 771,000 people without permanent housing for at least one night. Adults with serious mental health conditions accounted for 22% of this group (about 140,000 people), far exceeding the 5–6% rate in the general adult population.

Notably though, between 2018 and 2024, the number of unsheltered individuals in the country increased by 43%, while the share of homeless people with a mental illness remained relatively stable, declining slightly from 28% to 26%. In short, while those with a mental illness are more likely to become homeless, studies show that most homeless people do not suffer from severe mental disorders.