222: The Return of the Asylum State
The Weaponization of Psychiatry in the Authoritarian Imagination
They don’t care if it works.
They don’t care if it helps.
They only care that it hurts in public.
On July 24, the Trump administration signed an executive order directing states to criminalize homelessness, addiction, and mental illness. It calls for the forced institutionalization of unhoused individuals deemed unable to care for themselves. It defunds harm-reduction programs and Housing First strategies. It uses coercion, surveillance, and involuntary commitment as its tools.
Witness the return of the asylum state.
Throughout the 19th and 20th centuries, state-run psychiatric institutions served as warehouses for people deemed socially unfit. They were hidden away, drugged, punished, sterilized, and forgotten. Deinstitutionalization in the 1960s and 70s, bolstered by civil rights rulings like Olmstead v. L.C. and the Americans with Disabilities Act, began to unravel this carceral system—but never fully replaced it with care.
Trump’s executive order picks up where that system left off.
But today’s institutionalization is more fragmented. Less visible. Its violence is outsourced to police, shelters, emergency rooms, and jails. What this new order does is recentralize that violence, re-legitimizing the practice of forced confinement under the pretense of public order. It doesn’t pretend to offer long-term solutions. It offers a cage, a diagnosis, and a warning.
The use of psychiatry to punish political dissent is not new. The Soviet Union labeled critics as mentally ill, locking them in asylums indefinitely. In the United States, Black liberation activists were surveilled and pathologized. LGBTQ+ people were institutionalized as “deviants.” The message was clear: disobedience is a disease, and the cure is isolation.
This executive order follows the same logic. It transforms poverty into pathology. It turns addiction into moral failing. It makes visibility a threat. To be seen sleeping in public, asking for help, or breaking under the weight of systemic neglect becomes a symptom to be treated—not with care, but with confinement.
It’s not just a war on the poor. It’s a war on perception. A political program designed to convert suffering into criminality and difference into deviance.
There’s no data to suggest this will reduce homelessness. There’s no public health evidence that coerced psychiatric hospitalization is effective. And yet, that’s not a failure—it’s the point.
The executive order is a threat dressed as policy. Its function is symbolic. It’s meant to be seen.
What matters is the performance: the clearing of encampments, the rounding up of the visible poor, the spectacle of “order restored.” What matters is the deterrent effect on everyone watching. Submit, conform, stay quiet—or this is your fate.
Authoritarianism 101. Power doesn’t need to be efficient when it can be theatrical.
Just as the asylum once served to disappear the unruly, this policy serves to discipline the public imagination. It tells us what is acceptable, and what will be erased. And in doing so, it quietly expands the definition of who is punishable—until everyone becomes a potential target.
Those who comply may think they are safe. But fear is not safety. And obedience is not freedom.
When care is wielded like a weapon, and medicine is used to manage political problems, we are no longer governed—we are institutionalized.
This is why police cannot be reformed. This is why prisons cannot be fixed. This is why the carceral state—whether dressed in riot gear or white coats—must be abolished.
A system that responds to suffering with handcuffs, to illness with cages, and to difference with disappearance, cannot be salvaged. It must be dismantled.
We need housing, not hospitals. Mutual aid, not mandatory treatment. Solidarity, not surveillance.
We must refuse the asylum state.
We must build a future where no one is punished for being visible.
We must abolish the institutions that treat care as coercion.
Because if we don’t, we are all just waiting for our turn to be committed.