Mental Health Groups Decry Potential SAMHSA Cuts

A coalition of executives from more than a dozen organizations dedicated to prevention and treatment of mental health and substance use disorders said it was “deeply concerned” about the potential gutting of the federal Substance Abuse and Mental Health Services Administration (SAMHSA). 

On March 18, the CEO Alliance for Mental Health issued a statement that reported cuts to SAMHSA “have the potential to cause widespread harm to our communities.” 

The organizations in the Alliance, which includes the American Psychiatric Association, the American Foundation for Suicide Prevention, the American Psychological Association, and the National Council for Mental Wellbeing, said the “cuts would reduce oversight of the important grant programs that SAMHSA operates that help people with the most severe mental illnesses, hamper efforts to improve 988 awareness and crisis response systems for people, curtail the progress we have made on reducing overdose deaths, and harm SAMHSA’s work in bringing mental health resources to rural communities.”

In mid-February, an estimated 10% of SAMHSA’s employees — approximately 80 employees — were reportedly fired because they were still in a probationary period. It is unclear whether any will get their jobs back. On March 13, a federal judge in Maryland ruled that those firings, and thousands more at other federal agencies, were not legal. 

Federal authorities were reportedly targeting SAMHSA for another 50% reduction in staff, and employees of the agency, along with those working for the Health and Human Services department (HHS), were also offered $20,000 to leave their jobs by March 14, The New York Times reported.

SAMHSA has a broad mandate to work with states and community organizations to address behavioral health and substance use disorder. The agency conducts the National Survey on Drug Use and Health (NSDUH). 

It is responsible for overseeing harm reduction grants and initiatives, increasing access to opioid overdose reversal medications like naloxone, helping provide medication-assisted treatment for opioid use disorder, and funding efforts to detect and respond to emerging drug threats such as fentanyl adulterated with xylazine. 

Losing Hard-Won Gains

The agency’s programs “helped turn the tide on record-high overdose deaths — leading to a 14% decline in deaths in 2023,” according to a statement decrying the potential reduction in staff by the National Alliance on Mental Illness (NAMI). 

“We simply cannot turn back the clock on this hard-fought progress,” the CEO Alliance said in its statement.

SAMHSA also has a focus on helping the 15 million Americans with a serious mental illness, and it assists with programs aimed at suicide prevention. The Centers for Disease Control and Prevention estimates that more than 49,000 Americans died from suicide in 2022, with rates highest among American Indians and Alaska Natives.

The CEO Alliance noted that in 2020, President Donald Trump signed the law establishing the 988 Suicide & Crisis Lifeline. More than 14.5 million people have sought help from the crisis line since 2022, the Alliance reported. 

SAMHSA had a budget of $7.3 billion in fiscal year 2024, with 865 employees. It was seeking $8.1 billion and to add 143 more workers in its fiscal year 2025 budget request. 

Earlier in March, Rep. Paul D. Tonko (D-NY) and Rep. Andrea Salinas (D-OR) called on HHS to “halt reckless staffing cuts” at SAMHSA and asked for more details on the administration’s plans to further reduce the number of employees. 

HHS had not released any further information as of press time. The CEO Alliance urged the administration to collaborate with providers and members of Congress in a bipartisan fashion to explore ways “to enhance SAMHSA’s operations.”

Improving the behavioral health system can reduce long-term costs, said the CEO Alliance. “This focus is consistent with the Administration’s stated policy that the federal government should ‘aggressively combat the critical health challenges facing our citizens, including the rising rates of mental health disorders,’” they wrote.

Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in many health and science publications, including Smithsonian.com. You can find her on X @aliciaault and on Bluesky @aliciaault.bsky.social.