Jazmine Mapes has spent most of her life on the move.
When she was a young child, she shuttled from city to city in Southern California as her parents broke up and got back together. Her dad was abusive, Mapes said, and around age 9, she and her younger brother started bouncing around the foster care system.
Now 31, Mapes has spent much of her adult life homeless, living in riverbeds and tents on the sidewalk. She’s dealt with regular “sweeps” — police officers and other city workers ordering her to leave so they can clear the area.
Mapes has lost clothes, sleeping bags and — perhaps most importantly — medications for her anxiety and depression. One cleanup crew threw away a photo album filled with pictures of the four children she gave up for adoption.
After a sweep, “I would just stay in my depression,” Mapes said. “I would stay getting high because getting high was a way of me coping. Me not feeling.”
Local governments across the U.S. have increasingly turned to sweeps and arrests as the number of people living on the nation’s streets exploded by nearly 60% between 2015 and 2024. But growing evidence shows that forcing people to move can harm their health. That’s prompting several cities to try a new approach in some cases, which experts on homelessness say can get rid of encampments, while also protecting the health of people living there.
City and county officials say they need to clear encampments to clean up excessive trash, address open drug use, and make parks available to neighborhood kids. Elected leaders often face pressure from surrounding businesses and residents to respond quickly.
More than 200 cities have outlawed sleeping outside, and arrests for homelessness have spiked since a 2024 Supreme Court decision gave local governments the green light to disperse folks without offering them shelter. President Donald Trump upped the pressure this summer with an executive order that threatened to pull federal funding from any city that didn’t make it harder for people to set up encampments.
Proponents of clearing encampments say it’s inhumane to let people live outside in dangerous and unsanitary conditions. Local officials argue sweeps give people a chance to move inside and receive medical and social services.
But advocates who work with homeless populations say people often remain unhoused following a sweep. And numerous studies in recent years have found that clearing encampments without offering people shelter can worsen their mental and physical health.
Mapes remembers one cold and wet November morning in 2023, when Los Angeles city workers demanded that she and about 65 others leave the tents they’d been living in across the street from City Hall. The previous evening, Mapes’ ex-boyfriend had burned down her tent. “I was covered in ashes and dirt,” she said.
She was also pregnant. Her stomach ached as she tried to save what she could of her torched possessions. Mapes said a police officer grabbed her arm and pulled her across the street. At a nearby bathroom, she started digging through her purse for soap to clean herself up. Instead, her hand landed on a bottle of pills.
“I’m done,” Mapes recalled thinking. “I’m done with everybody judging me. I’m done with fighting against the world. I’m tired of missing my kids.”
She swallowed “just about the entire bottle of pills.”
A friend who had also been staying in the encampment found Mapes slumped over on a toilet. The friend forced her to vomit the pills.
“Had that person not found me, I probably wouldn’t be here,” Mapes said.
Researchers in recent years have documented the health impacts of sweeps. When folks with chronic conditions are forced to move, street medicine teams who had been caring for them often struggle to find them again. Important medications and medical supplies — like wheelchairs or walkers — regularly get thrown away in sweeps. And the repeated displacement can aggravate mental health problems and decrease people’s trust in future offers of help.
A large national study published in JAMA: Journal of the American Medical Association in 2023 estimated that sweeps increase the risk of infection, hospitalization and overdose among people who live on the streets and inject drugs. Lead researcher Josh Barocas said the team also found that displacement increased a homeless person’s likelihood of dying prematurely.
“We’re looking at substantial numbers of deaths,” Barocas said — as much as a 25% increase over 10 years, according to the findings. “It’s hard to ignore that from a scientific perspective.”
Barocas said some city officials criticized the study, calling it misleading because the researchers assumed that people are not offered housing or services when they are forced to leave an encampment. The study is also based on limited and imperfect data from a handful of large cities that may not be applicable to the rest of the country. And it says nothing about the potential benefits of closing encampments to the broader community.
“We’re not trying to tell you that [removing an encampment] is going to add three more deaths or decrease risk by 12.2572%,” Barocas said. “We’re just trying to give you a sense of what might work and what might not work. If you continue going down the path of sweeps, then it looks like we’re going to cause more harm to people than if you were to go down a different road.”
In recent years, several cities have used a handful of best practices that officials — and some experts on homelessness — say can clear encampments while limiting the potential health consequences of traditional sweeps.
Marc Dones led the Regional Homeless Authority in Washington’s King County, which includes Seattle, and is now a senior advisor for the Benioff Homelessness and Housing Initiative at the University of California, San Francisco. Dones said a core principle of these new approaches is to make sure, as often as possible, that people go from an encampment to long-term housing with appropriate services — as opposed to going to large shelters or just moving to another sidewalk.
The first step, Dones said, is spending time getting to know the people in an encampment. “I need to know everyone who lives there. I need to know what their needs are and what motivates them,” Dones said. This includes figuring out who has a serious mental illness, who needs addiction treatment, and who has a job that depends on access to public transit.
The next step is matching people with the right kind of housing. Traditionally, cities have offered people spots in large congregate shelters when clearing encampments. But shelters offer little privacy, and they often don’t work for people with significant health or addiction issues, or people who want to bring their partners or pets. Many cities in California — including Los Angeles, San Jose and Berkeley — are converting old motels into temporary housing to give people their own space and access to services while they wait for something more permanent.
Once housing is found, Dones said, cities should give encampment residents multiple weeks to prepare to leave, and then move folks out gradually. Helping people who may have been homeless for years make the move inside is often complicated and overwhelming, so Dones recommends moving only five to six people per day.
Dones acknowledged that many communities need to include law enforcement to plan clearings, but Dones argued police and sheriffs should have a limited role in actually interacting with people in encampments. Research shows that police interactions can be stressful for people living on the streets and undermine trust in offers of support. Several local officials said they try to lead with non-law enforcement staff during sweeps, though one analysis showed a significant spike in homeless-related arrests and citations in the last 18 months across California.
“If you run it the right way and attach people to the appropriate supports and services,” Dones said, “you can get people on a path to stability and community reintegration, and that’s what we want.”
Clearing an encampment using this model, Dones said, usually takes six to eight weeks.
That process is not easy. Emergency situations, such as an infectious disease outbreak, or rising public pressure can prompt local officials to decide to clear encampments more quickly, and without offering unhoused people a place to go. That’s true even in cities with best-practice policies, according to San Jose Mayor Matt Mahan.
“We have to measure and understand the health impacts of allowing encampments to grow and persist, as well as the health impacts of moving people,” he said. “We find that the longer a given encampment persists, the more likely we are to have serious issues of public health and public safety.”
Peter Radu, who oversees Berkeley’s homeless response, says this work is crisis management. “I hate to say it, but that oftentimes means choosing the least bad amongst terrible options.”
Radu described an encampment that cropped up in a popular park in Berkeley last year. His team resisted calls to clear it immediately, instead doing outreach and trying to connect the unhoused residents to services.
But as the encampment grew to around 20 people, so did neighbors’ frustrations — especially after a high schooler was groped near the park. Radu knew it would take weeks, if not months, to figure out everyone’s needs and line up housing for all those in the encampment.
“We had to make the unfortunate decision,” Radu said, “that we didn’t have that luxury.”
The city gave folks in the encampment a few weeks’ notice and offered them short-term motel vouchers before clearing the park this past April.
“We were doing right by them, I think, to offer them a temporary respite from the streets,” Radu said, “but we knew that was a Band-Aid. We knew full well that once those motel stays were up, folks were going to be back out on the streets. And they were.”
Radu and other local officials said the biggest barrier to moving people to long-term housing is the lack of available low-income units and places for people with significant mental health and addiction issues.
“We know more housing is what’s going to solve this problem,” Radu said. “That is the root-cause intervention.”
Cities rely heavily on federal grants to help them build more housing for homeless people. But the Trump administration moved to change the rules for some of that funding earlier this year. It wants to require local governments and nonprofits to align with the administration’s ideology around denying support to transgender people and undocumented immigrants, for example. That’s a nonstarter for many California cities. Advocacy groups sued, and a federal judge has temporarily stopped the new rules from going into effect.
The federal government also announced plans last week to cut billions of dollars that cities have historically used to get homeless people into permanent housing. Experts say that could push as many as 170,000 people nationwide back into homelessness.
In the absence of more permanent housing, cities are spending millions to get people into temporary spots. In early 2025, Berkeley earmarked $10 million for a four-year lease on a motel that can house 26 formerly homeless people and offer them medical and social services.
The city of Los Angeles has spent more than $320 million on Inside Safe, its encampment resolution program, over the last three years. That has helped the city move 5,200 people inside. About one-quarter of those individuals have found permanent housing, but more than a third are back on the streets, according to the city.
The rest are in interim housing, including Jazmine Mapes.
A few days after a sweep pushed Mapes to try to end her life, representatives from Inside Safe offered her a spot in a motel near Dodger Stadium. She moved into her own private room a few weeks later.
“That was my time of very much ‘finding me,’” Mapes said, “and starting to be okay with Jazmine again.”
Moving inside brought its own challenges, including flare-ups of anxiety and depression. But she’s been able to stay on her medications, in therapy, and off street drugs much better than when she was living outside.
And she’s been able to raise her infant son, she said, without fear that someone is going to come by without warning and tell her to move along.
This story was originally produced by Tradeoffs, a nonprofit newsroom reporting on health care’s toughest choices. Sign up for their weekly newsletter to get their latest stories every Thursday morning. Tradeoffs reporting for this story was supported, in part, by the California Health Care Foundation and the Sozosei Foundation.