Conservative activist and Senior Fellow at the Manhattan Institute, Christopher F. Rufo, recently ignited debate with a public call to "reopen the asylums," attributing escalating urban disorder, drug use, and violence to current homelessness strategies. In a recent social media post, Rufo specifically criticized "housing first" and "harm reduction" policies, arguing they have led to severe societal consequences in American cities.
Rufo's tweet, which stated, > "We've seen what happens under the policies of 'housing first' and 'harm reduction.' We've seen the schizophrenics attacking innocent people on the bus or in the streets. We've seen the tents, drugs, mayhem, and murder. Reopen the asylums," underscores his long-standing critique of contemporary approaches to homelessness. He has consistently argued that these policies fail to address the underlying issues of severe mental illness and drug addiction, which he identifies as primary drivers of street homelessness. His proposed solution emphasizes a return to institutional care for individuals struggling with profound mental health challenges.
The call to reinstate asylums revisits a contentious period in American mental health policy. Beginning in the mid-20th century, a movement towards deinstitutionalization led to the widespread closure of state psychiatric hospitals. This shift was driven by factors including the development of new antipsychotic medications, growing awareness of inhumane conditions and overcrowding within asylums, and legal decisions advocating for treatment in the "least restrictive setting." Critics of deinstitutionalization often point to a subsequent rise in homelessness among individuals with severe mental illness and increased burdens on emergency services and the criminal justice system.
Rufo, known for his advocacy for "Treatment First" models, contends that current policies prioritize housing over addressing core behavioral health issues, leading to visible public health and safety crises in many U.S. cities. His perspective aligns with those who believe that a lack of structured, long-term care options for the severely mentally ill contributes to the challenges observed on city streets. The debate over institutionalization versus community-based care remains a complex issue, balancing individual liberties with public safety and effective treatment outcomes.