This advocate’s son has serious mental illness. She sees promise in Trump’s order on homelessness

President Donald Trump signed an executive order last month that marks a major change in the way the United States handles homelessness and serious mental illness.

It targets homeless encampments, expands involuntary civil commitment and pushes for people to be put into mental health or addiction treatment.

Many see it as a move backward toward forced institutionalization of people with mental illness. But others say the system we have now has gone too far the other direction — and it isn’t working.

Deborah Geesling is the founder of P82 Project Restoration — a nonprofit that works with people who suffer from serious mental illness. Geesling is in favor of the executive order.

Geesling thinks services like safe injection sites and guaranteed housing are misguided. In her view, they keep people trapped in a dangerous cycle, instead of focusing on treatment. And she’s encouraged by the parts of Trump’s order that seem to shift the government’s focus more in that direction.

Geesling’s point of view is informed by her own experience of having a son with a serious mental illness.

Full conversation

DEBORAH GEESLING: About the time he turned 18 — I mean, we struggled during his teen years. We didn’t really know what was going on as it was developing. But when he was 18, he had his first psychotic break. He was running through the neighborhood. He was knocking on people’s doors. And the police came. And they ended up in this big chase, and they had to taser him. But thankfully, they recognized it was a mental health crisis. And they took him to the hospital.

And the next day, they transferred him to an evaluation center to see if he was a candidate for court order treatment, civil commitment. And when I called that number to check on him that day, the person who answered the phone said — laughed at me — he said, “Your son is a psychopath. Give him the number to a homeless shelter and pack his bags.” And —

SAM DINGMAN: That’s what they said to you on the phone?

DEBORAH GEESLING: That is what a behavioral health technician said to me. And so that little interaction right there, I realized, “Wow, we’re in trouble.” But once we got our bearings, my son was transferred to a hospital that has a mental health court. And then after being examined by a psychiatrist and hearing testimony, the judge ordered him into court-ordered treatment for a year.

And so he did stay in the hospital for a little while. He was difficult to stabilize. But then they released him to our home. And a very kind psychiatrist did call us after hours — because we really weren’t getting a lot of information —- and said, “I’m going to recommend an ACT team,” which is an assertive community treatment team, to support him, which is rare. The way that all flowed for us is not common.

DINGMAN: Right.

GEESLING: It was, I feel like we won the lottery with that doctor and how he recommended that.

DINGMAN: This person just somehow sensed that you probably needed a phone call.

GEESLING: Yeah. And we needed help. But it saved his life. Because without that, what were we going to do? We would have been faced with a choice that a lot of families have to face: trying to care for them at home or letting them become homeless. So that’s a long way to say, when I saw that the president is signaling we’re going to incentivize states and cities to implement this. I see that as very humane. And if you haven’t walked through this process, you’re not going to understand that.

The Show

Arizona disability advocate says Trump order is an attack on people with serious mental illness

Lauren Gilger

President Donald Trump signed an executive order last month that marks a major change in the way the United States handles homelessness and serious mental illness. Disability advocate J.J. Rico, CEO of Disability Rights Arizona, says this order is a blatant attack on people with serious mental illness.

Listen • 8:32

DINGMAN: And so, to be clear, you’re talking about the part of the executive order where the president is directing — I believe it’s the Department of Health and Human Services —  to provide grants to agencies that want to create these outpatient facilities, like the one you’re talking about.

GEESLING: Correct.

DINGMAN: So it’s called the Ending Crime and Disorder on America’s Streets Executive Order, and there’s a lot in here about enforcement on illicit drug use and urban camping, loitering, unhoused people. It seems like they are, perhaps, likely to be targeted by the mechanisms that this executive order would put in place, which I think for people who are less supportive of this executive order makes them worried about officers who are not equipped to deal with people with serious mental illness going into situations where they have this directive to enforce local ordinances, get people off the street type thing. Does that part concern you at all?

GEESLING: I’ve seen a lot of hyperbolic op-eds on this, and I’m choosing to remain positive about that because I think, to me, the whole overall executive order is signaling a focus on treatment. And I’m looking at it from the perspective of, for example, a family that — I could tell you a lot of stories — but one that really sticks out to me. And this mother testified in hearings. I’m not saying anything private.

Her daughter, she’s seriously mentally ill. She calls her mother and says, “Mom, could you bring me some super glue? My teeth got knocked out.” She was assaulted. So that’s how the mother found her. So when I think about just letting people encamp on the streets, there’s victims. And we’re not protecting them.

DINGMAN: So, if I’m hearing you right, it sounds like you’re seeing a lot of these op-eds that are focused on the enforcement components of this executive order, which, just to read from the order, “enforce prohibitions on open illicit drug use, enforce prohibitions on urban camping and loitering, enforce prohibitions on urban squatting.”

But, there is a fourth item there in the executive order, which is, “enforce and, where necessary, adopt standards that address individuals who are a danger to themselves or others and suffer from a serious mental illness or substance use disorder by moving them into treatment centers or other appropriate facilities via civil commitment or other available means.” It seems like that’s the clause in this that you’re saying we should also be paying attention to?

GEESLING: Absolutely.

DINGMAN: I think probably people who feel differently about the order than you are supposing that the enforcement part of this will ramp up very quickly, and that the adoption of standards and treatment centers and things like that won’t be ramped up as quickly.

But you’re saying, if I’m hearing you right, that’s the part you choose to remain optimistic about?

GEESLING: I do, and of course it’s not going to happen quickly. I mean, it’s a huge shift. But I think what’s going to motivate the systems and the states to start acting, which they should have been doing all along, is because there’s funding attached to this.

DINGMAN: And it even has something in there about fostering competitiveness between potential grantees to see, I guess in the administration’s framing, who might do the best job of creating these newer facilities. These outpatient facilities. 

GEESLING: Exactly. Which, honestly, the system needs it. There’s no competition, there’s no accountability. And so, what I see in there is a glimmer of hope that they’re saying, “Well, if you’re going to get these grants, you need to show us that people are getting better.” And I like that.

I don’t see it as this magical answer and everything is just overnight going to be great. It’s going to take time to redo this. But it’s been a long time coming. And the most severely mentally ill, it’s literally a revolving door system of treat, street, repeat. That’s what we’re funding right now. And no one’s getting better in that unless you have a mom or somebody who can really strenuously advocate.

DINGMAN: Well that’s something I wonder about, because I hear you saying that it could be really transformative for people like your son. I suppose it could be argued that something that your son, thankfully, did have going for him is you.

GEESLING: Right.

DINGMAN: And your husband. 

GEESLING: Definitely.

DINGMAN: I think people who are concerned about this executive order might be worried about people who are living in urban camping environments or squatting somewhere, have the serious mental illness but don’t have the support system.

GEESLING: Exactly. So that’s why I advocate. I mean, I could stop right now. I think my son will be OK. I have — I’ve really fought for my son, and that’s what compels me, because we can do this. We can fund a system that heals. We just need to prioritize the ones who need it most and the ones who do have a voice.

And I am concerned for that person who doesn’t. There’s a lot of those people. A lot of those people have burned bridges, and I understand that families can’t take care of them. But they deserve a shot. And if that means the state needs to get off its duff, then they need to do it. And that’s to me what I’m hoping that I see here in this order.