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The federal government has launched a "Treatment First" toolkit that requires homeless individuals to enroll in behavioral health treatment before accessing temporary housing — a major pivot away from the "Housing First" approach. HHS Secretary RFK Jr. championed the shift, but addiction experts warn the evidence favors housing first, and treatment capacity remains a critical gap.
The Trump administration has released a "Treatment First" toolkit, signaling a major policy shift in how the U.S. addresses homelessness. Rather than prioritizing immediate housing — the cornerstone of the "Housing First" model — the new approach requires individuals experiencing homelessness to enroll in behavioral health treatment as a condition for accessing temporary housing. HHS Secretary Robert F. Kennedy Jr. unveiled the toolkit, calling the current system "fragmented" and emphasizing the need for better coordination across behavioral health, housing, law enforcement, and employment services.
The toolkit, developed from a national summit in April 2026, also promotes personalized recovery plans, faith-based integration, and outcome-based program evaluation. However, addiction experts are pushing back. Dr. Vicky Stergiopoulos of the Centre for Addiction & Mental Health notes that Housing First is better supported by evidence, and that many homeless individuals simply won't agree to treatment first — leaving a critical gap in care.
By the Numbers:
Why it matters: This policy shift could affect millions of vulnerable Americans. If treatment capacity isn't significantly expanded, experts warn that a Treatment First mandate may leave the most at-risk individuals without housing or care — regardless of which model is in place.
