DOGE-ing HUD: Why ROI Must Drive Homelessness Solutions

This analysis is in response to breaking news and has been updated. Please contact pr@rstreet.org to speak with the authors.

In the name of “government efficiency,” the Trump administration is slashing budgets for the U.S. Department of Housing and Urban Development (HUD), stalling over $60 million in funds for affordable housing projects across the country—a portion of which supports people experiencing homelessness. In lieu of housing, the administration has offered a problematic alternative to address homelessness: forcing people with mental health or substance use disorders into treatment. But coerced treatment will not provide long-term recovery or address record homelessness that so many communities are facing. If the goal is to improve public safety, reduce homelessness, and increase government efficiency, there are much better solutions.

Real solutions require a smarter approach to efficiency. Lawmakers must invest in prevention—ensuring access to behavioral health support, supportive services, or early intervention before a crisis hits—and prioritize research-backed treatment shown to be successful and cost-effective.

Homelessness is not a simple problem to understand, let alone to solve. Roughly two-thirds of Americans facing eviction or foreclosure struggle with medical debt, and over 80 percent of unhoused mothers are domestic violence survivors. And while mental health and substance use issues are more common among people experiencing homelessness, the connection is often overstated. For example, only about one-third have a substance use disorder—far fewer than policies that would mandate treatment suggest. What’s more, in many cases, homelessness is what led to or exacerbated their substance use rather than the reverse.

Due to this complexity, forced treatment—through a false choice of jail or treatment—often fails. Research on the efficacy of involuntary treatment efforts, such as civil commitment and drug courts, is mixed at best. At worst, the programs erode trust, cause trauma, and even increase overdose risk. In the most severe cases, when individuals are so impaired by mental health disorders or addiction that they are unaware of their surroundings and unable to care for themselves, targeted, temporary forced intervention may be a needed first step toward stability, but should always be a last resort. However, the current mental health and substance use treatment infrastructure in the United States cannot meet the demand from people who voluntarily seek it out, let alone serve those forced in against their will.

If homeless individuals—most of whom do not have a behavioral health issue—decline treatment and face jail instead, the cycle will only continue. Many jails are overwhelmed, understaffed, and not set up to be de facto homeless shelters or treatment facilities. Enforcing anti-homelessness laws, which criminalize activities like sleeping or camping in public spaces, costs taxpayers about three times more than simply providing housing. Jails cost taxpayers billions and often perpetuate homelessness, making it harder for individuals to find jobs, regain stability, and rebuild their lives. Even if criminalization or mandated treatment offer some short-term relief, there are long-term consequences.

Instead, policymakers must take a multipronged approach: Implement more holistic prevention, reduce barriers to evidence-based treatment, and ensure access services meet demand.

Housing First programs, first promoted by George W. Bush but facing criticism by the current administration, have proven effective for promoting long-term stability. While housing does not treat mental health or substance use issues, the stability it provides can help people engage in recovery if effective treatment is available.

While effective treatment options that improve public safety, reduce drug use and overdose, and improve stability do exist, many remain out of reach due to excessive bureaucratic red tape. Removing government barriers and aligning regulations with federal guidance would provide gold-standard medication to those suffering from opioid use disorder. The federal government can also help improve access to this treatment. Further, extending and expanding telehealth for treatment would ensure patients in rural areas have better access to expert providers. Medicaid has been proven to help individuals with substance use disorder access services and remain drug-free. Anticipated changes to the Medicaid program should prioritize these communities alongside other vulnerable populations.

Preventing homelessness is critical. Given the connection between physical health, mental health, and homelessness, improving treatment options and accessibility in our communities will help people stay housed and likely reduce encampments. Lawmakers should look to their local communities for successful innovative solutions, such as a voucher program for people on the verge of homelessness or removing regulatory barriers that hinder affordable housing developments.

If government efficiency is the goal, then cutting funding and mandating treatment is the wrong approach. Real savings come from investing in proven solutions. Prevention, housing, and sufficient access to treatment will deliver far better returns on investment than coercion or criminalization, which only seek to shift costs around for temporary solutions.