Key points

in the 1990s, a program called Housing First offered the homeless free housing with no strings attached.

Many persons reject comfortable, clean, and generous living arrangements, preferring to live rough outside.

A complete lack of insight into one’s mental illness, preventing acceptance of treatment, is “anosognosia.”

On July 24, 2025, President Donald Trump signed an executive order to move those living in homeless encampments around the United States into treatment facilities with both mental health and substance use services (1). This executive order marks an abrupt change in direction and policy.

The Housing First Program

Beginning in the 1990s, an accepted idea on how to deal with the chronic homelessness crisis was a program called “Housing First.” This program of

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