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Instead of the “treat and street” approach for homeless individuals, this facility will offer long-term care.

The facility will have various tiers to get each person individualized care and treatment.

The facility will be watched by advocates nationwide to determine if this model should be replicated.

This post is Part 4 of a series. Part 1 can be found here, Part 2 can be found here, and Part 3 can be found here.

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 is my fourth and final article analyzing the executive order and how it is being implemented in Utah. I share facts about this new facility, as well as my personal experience, having lived outside for 13 months in 2006-2007 as a homeless person in Los Angeles, suffering from schizophrenia.

A national unmet need

One of the most tragic things I have encountered in the field of psychiatry over the years is the lack of care for many vulnerable people who are forgotten by our mental health system. Many experience a “revolving door” where they are either living on park benches or under bridges, transferred to hospitals for short periods of time when their psychosis becomes worse, and then picked up by police for petty crimes such as looking for food in trash cans. Then the cycle begins again, to go round and round, sometimes for decades.

What many members of this forgotten population really need is long-term care, or even indefinite care. It is heartbreaking to see people living on the streets, still wearing hospital scrubs because they have been discharged with no possessions and no place to go.

Today, in Utah, as well as in most of the country, state hospitals are filled with forensic patients, with very little room for those who are gravely ill but have not committed crimes. Many people wait for months in crowded and miserable conditions while waiting for a bed to open. I hope this new facility being built in Utah will solve this problem in their vicinity.

It is my hope that this new Utah homeless facility will bring an end to the revolving door in Salt Lake City, and I hope it will bring an end to the “treat and street” approach, where people who need structured care are denied it.

Why I am passionate about the new Utah facility for the homeless

At 17, in 1999, I traveled from my childhood home in Cleveland, Ohio, to LA, where I began classes at USC on a Presidential Scholarship. I studied biochemistry and molecular biology. But soon, schizophrenia took over my life. Rather than entering a Ph.D. program, I dropped out of school and spent four years homeless in the Los Angeles area.

I quickly became an unwelcome visitor at USC, sleeping in libraries and lounges, and scavenging through garbage to find food. After three years of sleeping in buildings where I was not supposed to be, I was incarcerated briefly for behavior stemming from my untreated illness. But on March 3, 2007, after screaming back at the voices in my mind, a neighbor was called, and I was taken to a psych ward for evaluation. This hospitalization would essentially save my life.

I hated being taken to a hospital and would never have gone by choice. But I was unaware that the mandated treatment I received in the hospital would enable me to return to school and pursue both a thriving career and a meaningful social life.

Getting people experiencing homelessness help sooner

Looking back, I often question: Why was I allowed to sleep outside in the first place? Why was this allowed to continue for over a year? Didn’t someone realize that I had become wholly incapable of caring for myself? I am sure that I stood out as someone with serious mental illness.

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The main reason I support this new facility being built in Utah is because, had this system of care been set up in Los Angeles when I was sleeping outside, I would have been taken to the facility to get help. Namely, I would have been given a comfortable and clean place to stay, and I also would have been mandated to accept treatment.

About the facility’s tiers

Following my first, two-week hospitalization in Los Angeles in 2007, my doctors and treatment team determined I was ready for discharge. But I experienced significant hurdles, not understanding or accepting the fact that I had schizophrenia.

I went off my antipsychotic, relapsed, and found myself hospitalized again. Following my second hospitalization, I made a commitment to always take my antipsychotic, and I have since that time, about 19 years ago.

It is common in the United States to release psychiatric patients from hospitals although they are not ready for discharge.

Devon Kurtz of the Cicero Institute, an influential proponent of the new Utah facility, is advocating for the Utah facility to have several tiers of care that can meet the varied needs of people with mental illness—including long-term care for the vulnerable people who need it.

Specifically, he envisions portions of the Utah psychiatric facility being designed to supplement the state hospital for recovery care, and other people will receive 18- to 24-month residential substance abuse care, which may include co-occurring serious mental illness. Finally, others will be designed for long-term out-of-hospital care (inpatient care with more freedom, or assisted outpatient care in the community). Of course, those who make a faster recovery will be assisted with housing and with help finding volunteering opportunities and employment to rebuild their lives outside the facility. Clearly, it would be impossible to operate a sustainable recovery system without these several levels.

Notably, a facility that can treat people and release them in 10 days to one month needs much less capacity than a substance abuse recovery center or a long-term assisted living facility where people with longstanding or chronic illness may remain indefinitely. Those building this facility carefully consider the needs of this diverse homeless population and will see each person entering the facility as unique, with their own needs.

Over the next two years, I suggest we watch this facility closely to see if the leaders will be true to their commitments, offering the standard of care, recovery, both long-term and short-term options, and hope. I love hearing stories of recovered lives, and I am hopeful to see what happens in Utah.

1. Ellen Barry and Jason DeParle. In Utah, Trump’s Vision for Homelessness Begins to take Shape. New York Times. October 29, 2025. https://www.nytimes.com/2025/10/29/us/politics/utah-trump-homeless-camp… Retrieved January 11, 2026.

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