Why did we ever close up all those big, beautiful mental health asylums in the first place? I looked at that very question in a 2022 column called "It's Time to Re-Institutionalize the Dangerous Mentally Ill." (It's behind the PJ Media paywall, but you can get a VIP membership right here for less than $20 when you use the code FIGHT.) But here is the summary of what happened from the article:
Most advanced societies throughout history have created institutions of some sort to segregate the mentally ill from the general public. This is certainly a fair policy for normal people who are trying to go about their lives. But in practice, it often meant the institutionalized lived in deplorable conditions. Additionally, people were sometimes “put away” by others who had personal, financial, or political motives. So asylums were always (rightly) susceptible to skepticism but understood to be necessary.
Then, in the 1960s, advances in antipsychotic medicine created speculation that the severely mentally ill would be able to live an unconfined life in society again. Also beginning at this time, the large public mental health facilities, which had chiefly been financed and run by the individual states, began to be influenced by changes in financial policy. There were also a series of legal decisions over the years that chipped away at civilians’ right to enjoy a secure, peaceful society. And finally, the injection of federal money and policy into the mental health system eventually wrested the operation of large institutions away from the states that had traditionally maintained them. Medicaid incentivized states to close their facilities, and in 1981, the federal government ceased funding in-patient facilities and forced the mentally ill onto the community.
As this happened, none of it was lost on the shrewd Donald Trump. Last week, the Daily Caller's Ryan Reese released a transcript of his interview with the president. Here are Trump's thoughts on public custodial care of the irredeemably and dangerously mentally ill.
Reese asked Trump, "Would you be open to the government reopening insane asylums for people with serious mental illness?"
The president replied, "Yeah, I would." He then elaborated:
Well, they used to have them, and you never saw people like we had, you know. They used to have them. And what happened is, states like New York and California that had them — New York had a lot of them — they released them all into society because they couldn’t afford it. You know, it’s massively expensive. But we had, they were all over New York. I remember when I was growing up, Creedmoor. They had a place, Creedmoor. They had a lot of them, Bellevue, and they were closed by a certain governor. And I remember when they did, it was a long time ago, and I said, "They didn’t release these people?" And they did. They released them into society, and that’s what you have. It’s a rough, it’s a rough situation.
I'll say. Women in urban areas, especially, are bearing the brunt. As I wrote in 2022, "Here are some examples from just the past week: In Los Angeles, a man walked into an upscale furniture shop on Thursday afternoon and stabbed a beautiful young grad student to death (he’s still at large); earlier that same day in L.A., a homeless man punched a nurse on her way to work so hard that she cracked her head on the pavement and died three days later; and on Saturday in New York City, still another homeless man shoved a woman in front of a subway train, killing her." And we've seen countless more PREVENTABLE tragedies since then.
In fact, back in Trump's first term, he was already working hard to expand federal support of increased and improved inpatient mental health options. Then-assistant to the president and director of the Domestic Policy Council Joe Grogan wrote in a February 2020 column in The Washington Post:
President Trump is exceptionally focused on fighting for Americans who can’t fight for themselves and confronting problems other administrations, Democratic and Republican, have ignored. This is particularly true for Americans who suffer from addiction and serious mental disorders. […]
Now, we must end the disgraceful way Americans with serious mental illness are treated. They are not receiving the care they desperately need. In 2018, 47 million people experienced some form of mental illness. More than 11 million of these Americans lived with mental illness of such severity that it impaired their ability to carry out normal life functions. And nearly 4 million Americans received no treatment at all. This is unacceptable.
In the 1950s, there were more than 550,000 state psychiatric hospital beds in the United States. By 2016, this number had dropped to 37,679. Instead of receiving care, the sick are locked behind bars, often after encounters with police officers ill equipped to manage these encounters effectively. There are more than 392,000 incarcerated individuals with serious mental illness. That means there are 10 times more individuals with serious mental illnesses in prison beds than in state psychiatric hospital beds.
We see the result of this crisis every day in America’s cities. There are at least 111,122 individuals with serious mental illness who are homeless, including 52,180 who have no form of shelter. We walk right past them as they suffer from exposure to the elements, inadequate nutrition, poor hygiene and lack of protection from violent thugs. The areas where these Americans live can also become public health nightmares when conditions there facilitate the spread of communicable diseases. It is not compassionate, and it is not humane to discard these citizens and ignore their suffering.
That is why the president declared at the first White House Summit on Mental Health, “My administration is strongly committed to helping Americans suffering from mental illness.” And the administration has already taken action. Last year’s funding bill provided $3.9 billion for mental health programs, a $328 million increase. We invested in evidence-based programs including early detection, assisted-outpatient treatment and supported our law enforcement professionals. Finally, the administration solicited and approved the first-of-their-kind demonstrations for states to improve access to the full continuum of care these individuals desperately need.
Back in office for his second term, Trump has once again undertaken the heavy lift of shifting policy and opinion to try to get help for the seriously mentally disturbed, including institutionalization. This past July, he issued the executive order, "Ending Crime and Disorder on America's Streets." In the preamble, he noted:
Shifting homeless individuals into long-term institutional settings for humane treatment through the appropriate use of civil commitment will restore public order. Surrendering our cities and citizens to disorder and fear is neither compassionate to the homeless nor other citizens. My Administration will take a new approach focused on protecting public safety.
Civil commitment, of course, means involuntarily committing someone to inpatient treatment for extended periods. The practice has long been frowned upon after a cultural and legal PR campaign shifted public opinion against it decades ago. Developments since then, however, have done much to swing the public back in its favor.
Trump's EO goes on to detail a comprehensive range of measures the federal government will take, mostly through various federal agencies, to address the complex, vast, and entrenched problem of the under-treated seriously mentally ill.
But it won't be easy, and it will take buy-in from a lot more officials and levels of government. In his column, Grogan pointed out:
Righting this wrong will not be solely accomplished by work at a federal level. It is vital that the states confront this issue as well and share in the financial obligations of caring for residents with mental illness. And they must reassess their civil commitment standards and processes to ensure that families have the tools to give their loved ones with serious illness the care they need. State and local leaders will be the ones who build mental health systems with crisis intervention services to meet the homeless on streets and create continuums of care so individuals with mental illness aren’t shuffled into prison. Lastly, all large metropolitan areas must end policies that contribute to keeping people experiencing mental illness on the streets.
It is debatable if that last item can ever happen so long as big cities are run by leftists.
Of course, not every case of untreated or undertreated mental illness is an Iryna Zarutska situation, but many are still plenty harmful to society. A far less sensational situation that is still extremely costly to society is the struggle families go through as they attempt to keep a mentally compromised loved one afloat. I've seen it myself plenty of times — the years-long grind of fear and care, the expense, the upheaval. And sometimes, it still ends in violent death, often that of the caregiver. This has happened more than once over the past decade right in my hometown.
Trump is the only prominent elected official currently leading the charge on cleaning up yet another of society's messes, and he's doing it with compassion — not just for the victims of the criminally insane but for the Americans suffering from severe mental illness and their families. And he didn't even need a specific high-profile tragedy to begin this difficult work; he's been trying to fix it for years.
Related: The Image That Killed the Democrats in 2026 and Beyond
Zarutska's tragic killing has been a blow to our society, but perhaps some good will come from it. Perhaps the president — and anyone else who is serious about protecting law-abiding Americans from senseless violence — can leverage her death to take meaningful steps to fix the problem. Congress should be working to write and pass the Iryna Act at this very moment.
President Trump seems to know what America needs to do before most of us even understand we have a problem. The writers at PJ Media strive to bring you the behind-the-scenes stories of the most remarkable administration of our lifetimes. Help us chronicle history in the making! For less than $20, you can become a PJ Media VIP for a full year! Lose the ads, take advantage of all the perks, hang out with everyone in the comments section, and best of all, enjoy the satisfaction of doing your part to keep conservative media alive and well! Use the promo code FIGHT when you join for a 60% discount off the regular price of VIP membership! Thank you for your support!