Trump’s Order & Utah’s New Facility: A Psychiatrist’s Perspective on Homelessness & Mental Health

A new facility in Utah, authorized by a July 24, 2025 executive order from President Donald Trump, aims to address the complex challenges of homelessness, mental illness, and substance use disorder with a novel approach: long-term, and potentially indefinite, care. This initiative, part of a broader effort to move individuals living in encampments into treatment facilities nationwide, is generating both hope and controversy. As a psychiatrist, and having personally experienced homelessness while struggling with schizophrenia, I’ve been closely following the development and implementation of this plan in Utah.

The Revolving Door of Untreated Illness

Throughout my career in psychiatry, I’ve witnessed a heartbreaking pattern: vulnerable individuals with severe mental illness cycling through a system that often fails to provide sustained support. This “revolving door” involves brief hospitalizations triggered by worsening psychosis, followed by release into homelessness, often with minimal resources or follow-up care. Individuals may then be repeatedly arrested for minor offenses stemming from their illness – seeking food in trash cans, for example – only to be re-hospitalized and released again. This cycle can persist for decades, perpetuating suffering and preventing genuine recovery.

What many of these individuals desperately need is consistent, long-term care. It’s a tragic sight to see someone discharged from a hospital still wearing their hospital gown, possessing no belongings and no place to go. The current infrastructure often lacks the capacity to provide the extended support necessary for lasting change.

The hope is that the new Utah facility will address this critical gap, offering a much-needed alternative to the cycle of crisis and temporary intervention. State hospitals are frequently overwhelmed with forensic patients, leaving limited space for those with severe mental illness who haven’t committed crimes, often resulting in lengthy waits for available beds.

A Personal Perspective

My own journey with schizophrenia began in 1999, when I moved from Cleveland, Ohio, to Los Angeles to attend the University of Southern California on a Presidential Scholarship, intending to study biochemistry and molecular biology. However, the onset of my illness derailed those plans. I dropped out of school and spent thirteen months experiencing homelessness in Los Angeles.

During that time, I became a frequent, unwelcome presence at USC, sleeping in libraries and lounges and scavenging for food. After three years, my behavior, driven by untreated illness, led to a brief incarceration. The turning point came on March 3, 2007, when a neighbor called for help after I was heard screaming at the voices in my head. I was taken to a psychiatric ward for evaluation, an intervention that ultimately saved my life.

While I initially resisted hospitalization, I came to recognize the profound benefit of the mandated treatment I received. It enabled me to return to school, pursue a fulfilling career, and rebuild a meaningful social life. This personal experience fuels my support for initiatives like the Utah facility, which prioritize both treatment and a safe, stable environment.

Addressing a National Unmet Need

Looking back, I often wonder why I was allowed to remain on the streets for so long. Why wasn’t my obvious distress recognized and addressed sooner? Had a facility like the one being built in Utah existed in Los Angeles during my period of homelessness, I believe I would have been identified and offered the help I desperately needed – a safe place to stay and mandated treatment.

The Facility’s Tiered Approach

The Utah facility, as envisioned by proponents like Devon Kurtz of the Cicero Institute, will incorporate a tiered system of care designed to meet the diverse needs of its residents. This includes dedicated spaces for recovery care to supplement the state hospital system, residential substance abuse treatment programs lasting 18 to 24 months (often addressing co-occurring mental illness), and long-term assisted living options for individuals requiring ongoing support. The facility will also provide assistance with housing, volunteering opportunities, and employment to help those who are able to transition back into the community.

Kurtz emphasizes the importance of recognizing that a facility offering short-term treatment – releasing patients after just ten days to a month – requires significantly less capacity than a comprehensive recovery center or a long-term assisted living facility. The Utah facility aims to tailor its approach to each individual, acknowledging their unique needs and circumstances.

A common challenge in psychiatric care is discharging patients who do not fully understand or accept their illness. Following my initial hospitalization, I initially refused to continue taking my antipsychotic medication, leading to a relapse and a second hospitalization. It was only after that experience that I committed to consistent medication management, a decision I’ve maintained for the past nineteen years.

Looking Ahead

Over the next two years, it will be crucial to closely monitor the implementation of the Utah facility, ensuring that leaders remain committed to providing a high standard of care, offering a range of recovery options, and fostering a culture of hope. I am eager to see the outcomes of this innovative approach and to learn from its successes and challenges. I remain optimistic that this facility can offer a pathway to recovery and a more dignified life for individuals who have been marginalized and forgotten by the system.