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The Trump Administration’s plans to slash or eliminate funding for a growing number of federal agencies are now threatening to decimate SAMHSA’s staffing and impact. Below are excerpts from articles from the NY Times and STAT as well as a letter representing over 50 members of Congress that seeks details and a reconsideration and/or end to the cuts. The articles are long so here’re some headlines:

• Over the last few weeks, roughly 100 employees of the Substance Abuse and Mental Health Services Administration were let go according to insiders’ estimates…more than 10% of the agency’s workforce. By the end of this week, we could see another 50% cuts according to an Administration briefing.
• There is widespread talk that the Trump administration may fold SAMHSA into another health agency or return staff numbers and grant funds to 2019 levels, even though rates of overdose deaths remain significantly higher than in 2019.
• Some newer SAMHSA projects scarcely underway are in jeopardy, like one to map Chicago housing projects to better distribute the lifesaving overdose medication naloxone, and others to establish systems to speedily relay suicide intervention calls to on-the-ground response teams.
• The Office of Recovery was recently formed to develop strategies for how best to curb drug overdose deaths — and it worked. Studies show that stronger behavioral health systems and expanding medications can reduce overdose mortality by 46 percent. Overdose deaths declined by 24% between 2023 and 2024, according to CDC data.
• Over 50 Congress members sent a letter to HHS Secretary Robert F. Kennedy Jr urging him to strongly reconsider and stop further cuts, expecting more information this week.

Come join a very frank discussion about both the impact of these and other federal policy and agency developments and about the actions community agency leaders and advocates should be taking from some 4 experts who have been closest to the action:

• former Deputy Assistant Attorney General for Civil Rights in the Department of Justice and current Deputy Director of the Bazelon Center for Mental Health Law Jennifer Mathis
• former director of SAMHSA’s Office of Recovery Paolo del Vecchio,
• CEO of the very influential National Council for Mental Wellbeing Chuck Ingoglia and
• Senior Director of Policy and Advocacy for Mental Health America Caren Howard

Entitled “Urgent Actions, Bold Solutions: Leadership in Unprecedented Times”
our Executive Seminar will be held April 24-25 at the Albany Marriott Hotel
Register Today ��
E-mail us at eileenc@rightsandrecovery.org for details

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Federal Agency Dedicated to Mental Illness and Addiction Faces Huge Cuts (excerpts)
The Substance Abuse and Mental Health Services Administration has already closed offices and could see staff numbers reduced by 50 percent. It works on two of the most urgent U.S. health problems and has generally received bipartisan support.
By Jan Hoffman ���������� Times���� March 12, 2025

…By the end of this week, the staff of the agency, the , could be cut by 50 percent, according to senior staff members at the agency and congressional aides who attended briefings by Trump officials.

With just under 900 employees and a budget of $7.2 billion for large state grants and individual nonprofits that address addiction and mental illness, SAMHSA (pronounced SAM-sah) is relatively small. But it addresses two of the nation’s most urgent health problems and has generally had bipartisan support.

• The agency’s broad mandate includes overseeing��, the National Suicide and Crisis Lifeline, which fields millions of calls through state offices; regulating outpatient clinics that dispense opioid treatment drugs such as methadone; directing funds to drug courts (also called “treatment courts”); and producing nationwide����of substance use and mental health issues.
• It provides best-practice training and resources for hundreds of nonprofits and state agencies, and helps establish����that provide opioid addiction prevention, treatment and social services. It is also a federal watchdog that closely monitors the spending of taxpayer-funded grants for mental health and addiction.

Both President Trump and Robert F. Kennedy Jr., the federal health secretary, whose portfolio includes SAMHSA, have been outspoken about addressing the country’s drug crises. Mr. Trump has invoked overdose fatalities as a rationale for imposing tariffs on Canada, Mexico and China. Mr. Kennedy has often discussed his ongoing recovery from heroin addiction. During his presidential campaign, he produced a documentary about the impact of addiction in the United States that also explored different  options.

While the rates of U.S. overdose fatalities remain high, they have been  consistently since 2023. Many drug policy experts say SAMHSA is the federal agency most directly responsible.

….In interviews, a dozen current and former SAMHSA employees, including executives, said the threat posed by layoffs and policy shifts is beginning to be felt at sites everywhere, from the heart of troubled city neighborhoods to rural outposts. Some newer SAMHSA projects scarcely underway are in jeopardy, like one to map Chicago housing projects to better distribute the lifesaving overdose medication naloxone, and others to establish systems to speedily relay suicide intervention calls to on-the-ground response teams.

They said it was unlikely that funding for centers focused on treating the mental health or substance use disorders of specific populations, such as Black and L.G.B.T.Q. communities, would be reauthorized.

….Now there is widespread talk that the Trump administration may fold SAMHSA into another health agency or return staff numbers and grant funds to 2019 levels, even though rates of overdose deaths remain significantly higher than in 2019. According to the most recent  between September 2023 and September 2024, roughly 87,000 people died of drug overdoses.

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The Honorable Robert F. Kennedy Secretary
U.S. Department of Health and Human Services 200 Independence Avenue SW
Washington, DC 20201

Dear Secretary Kennedy,

We are deeply concerned by the Department of Government Efficiency’s (“DOGE”) reckless staff reductions at the Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA staff work in supporting our shared mental health and addiction prevention, treatment, and recovery priorities. Recent reporting notes that the agency lost 1 out of 10 of its staff, including team members responsible for the operation of the 988 National Suicide and Crisis Lifeline.

It has also come to our attention that almost all staff located in Regions Four and Five have been terminated. Currently, the SAMHSA website no longer lists the staff contacts for those regions. Even more concerning, we are told that additional reductions of up to 50 to 70 percent of SAMHSA’s staff are under consideration. Cutting SAMHSA employees without understanding the impact is extremely dangerous given the behavioral health crises impacting every corner of our nation.

From October of 2023 to September of 2024, overdose deaths in the United States decreased by nearly 24 percent after trending upward for nearly two decades. SAMHSA staff have been instrumental in supporting this decline in deaths. SAMHSA staff have worked to increase access to the life-saving drug naloxone and have helped promote evidence-based treatment for both mental health and substance use disorder treatment. They also ensure that addiction treatment is safe and available by ensuring that Opioid Treatment Programs (OTPs) comply with federal regulations. There are at least 1,500 of these opioid treatment programs across the country who are relying on this support.

Without adequate staff at SAMHSA, OTPs cannot operate, and patients will not receive addictions medications, counseling and other behavioral health services.

SAMHSA staff certify mobile medication units which are critical in increasing access to medications for opioid use disorders especially in rural areas. Without SAMHSA staff, these mobile medication units won’t be deployed in our communities.

SAMHSA staff also support providers with the most updated evidence-based practices to treat patients. SAMHSA staff at the Center for Substance Abuse Treatment (CSAT) work with states to administer the Substance Use Prevention, Treatment, and Recovery Services (SUPTRS) Block Grant which helped serve over 2.5 million people with lifesaving substance use disorder prevention, treatment, and recovery services.

SAMHSA staff in the Center for Substance Abuse Prevention (CSAP) have worked to ensure that states and communities have access to the most up to date, evidence-based prevention strategies, which have resulted in among the lowest rates of non-use of any substance among middle and high school students ever recorded by the Monitoring the Future Study.

From 2002 to 2022, suicide deaths in the United States generally increased; with a tragic spike in the post-pandemic years after briefly trending down from 2018 to 2020. In 2023, over 49,000 Americans died by suicide. Given these statistics and the current mental health crisis, we are deeply concerned by reports that nearly 25 percent of the team working on 988 awareness campaigns have been cut. As of January 2025, 988 has fielded an astounding 14 million calls, texts, and chats while the Veteran’s Crisis Line (VCL) has routed nearly 2 million contacts since July 2022.

SAMHSA staff at the Center for Mental Health Services (CMHS) also work with states to manage the Mental Health Block Grant (MHBG) which helped serve approximately 2 million individuals with serious mental illness and children with serious emotional disturbances.

SAMHSA staff oversee technical assistance centers that ensure that providers across the U.S. know how to best treat and support those with mental health and substance use disorders, ranging from eating disorders to schizophrenia to alcohol addiction. Without this support for the workforce, individuals seeking treatment may not receive the most effective, evidence-based care, potentially leading to poorer health outcomes, increased relapse rates, and greater strain on healthcare systems. A fully staffed SAMHSA is essential to continued success.

Given the effects that HHS and DOGE’s actions are expected to have on the agency’s mission and operations, we ask that you provide the following information by March 10, 2025:

1. A list of employees who have been terminated since January 20, 2025, including a copy of SAMHSA and DOGE’s charts and other documents reflecting staff reduction plans by program office and further disaggregated by field office and DC headquarters.
2. A specific line-item by line-item analysis of the impact of SAMHSA staffing reductions in the 50 percent range. Please produce any written communications including texts, emails, memorandums, white papers and other documents indicating whether the intent of the proposed staffing reductions is to shut down SAMHSA programs by eliminating the staff needed to administer them.
3. A detailed list of the types of employees terminated (schedule a, veterans, disabled veterans, military spouses, etc.).
4. A detailed analysis of the impact on the Veteran’s Crisis Line from 988 funding cuts.

We strongly urge you to reconsider these cuts and stop any further cuts before fully informing Congress of any impacts to overdoses, suicides, and access to mental and behavioral health treatment. Too many people across the country are suffering without necessary resources. We must ensure that SAMHSA staff are there to ensure those lifesaving resources reach our communities. Please respond to this letter by March 10, 2025. We appreciate your prompt attention.

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‘Deliberate Trauma’: SAMHSA Employees Detail A Federal Agency In Shambles (excerpts)
The Impact On People In Mental Health Crises Could Be ‘Cataclysmic,’ Insiders Warn
By O. Rose Broderick Disability in Health Care Reporting Fellow ����Stat March 12, 2025

The new administration’s decision to fire a tenth of the workers at the federal government agency that oversees mental and behavioral health will imperil efforts to curb suicides and drug overdose deaths, according to current and former employees.

Roughly 100 employees of the Substance Abuse and Mental Health Services Administration were let go according to insiders’ estimates. That’s more than 10% of the agency’s workforce, the 2025 fiscal report shows.

….Primarily a grantmaking agency, under the Health and Human Services department, with an $8-billion budget, SAMHSA is the “connective tissue” that channels the funds and training that the federal government doles out to on-the-ground service providers. Need better access to opioid addiction treatments? Want additional EMS services for your rural county? Call your local SAMHSA representative and apply for their grants.

But if you live in the Midwest and the South, that figurative switchboard operator is no longer there. Two of the federal agency’s regional offices were completely gutted and are no longer staffed, according to former employees. The leaders of the 988 national crisis hotline and the Office of Recovery — an office within SAMSHA —have also stepped down or retired from the agency in the last month.

…The loss of institutional knowledge and relationships built with health providers on the ground could be “cataclysmic,” especially as the drug overdose epidemic still rages. Deaths dropped in recent years but still top 80,000 annually, according to provisional Centers for Disease Control and Prevention data. The country’s mental health crisis is similarly troubling: the suicide rate increased by roughly 30% from 2002 to 2022.

“These are life and death issues,” said the former employee. “The [cuts] compromise the agency’s ability to provide grants and support and guidance on how to reduce the tragedies, the loss associated with the overdose epidemic that the nation has faced.”

At a recent virtual press conference of former SAMHSA employees, people detailed similar stories about the agency’s critical role in addressing the nation’s behavioral and mental health needs.

“This is not a switch you can turn on and off after years of increasing overdose deaths and behavioral health crises,” said Brian Payne, who served as SAMHSA’s deputy director of legislative affairs under the Biden administration. “Our prevention, treatment and recovery services are finally starting to reverse this trend, but if we decimate the staff of the lead federal behavioral health agency now, that jeopardizes not only that work, but could have devastating ripple effects for years to come.”

Flipping the switch can be particularly dangerous for the vulnerable populations that SAMHSA serves. A disruption of services or guidance for people dealing with a mental health crisis or managing their recovery from substance use can be jarring or even deadly. Many SAMHSA employees know such disruptions intimately: a recent internal survey of SAMHSA employees found that 20% of the staff identifies as being in recovery from addiction or mental health concerns.

The Biden administration formed the Office of Recovery to develop strategies for how best to curb drug overdose deaths — and it worked. Studies show that stronger behavioral health systems and expanding medications can reduce overdose mortality by 46 percent. Overdose deaths declined by 24% between 2023 and 2024, according to CDC data. The success makes the impending retreat particularly tough to stomach for the agency’s staff.

“We regularly get calls where we triage,” said a former agency employee, who spoke on condition of anonymity. “We’ve had the general public reach out and be like, ‘I can’t get my lifesaving buprenorphine because my pharmacy stopped selling it or because my insurance denied me,’ and my boss will reach out to the state and make sure it gets fixed.”

While the exact impact of the 988 program on the country’s mental health crisis remains to be seen, the hotline has already received over 14 million calls, texts or chats since it launched in 2022. Trump signed the program into law in 2020. Cutting the infrastructure to help states manage the calls will likely hurt states whose voters swung for Trump, where mental health crisis services are “almost non-existent,” said Kevin Martone, executive director at the Technical Assistance Collaborative, a Massachusetts nonprofit that advocates for better solutions to housing and community support needs.

“When a person calls 988, they are going to get a behavioral health person on the phone and data shows that most calls to the crisis are deescalated on the line and never need an in-person response,” said Martone in an email. “Without a functioning 988/crisis line system, people call 911 and 911 almost always gets you a police response even if not needed.”

Pairing a mental health provider with someone undergoing a mental health crisis has saved countless lives, according to a former regional SAMHSA director.

…But that morale and momentum boost has quickly cratered, replaced by dread. The Trump administration has instructed agencies to submit memos by Thursday for how they could further reduce their workforce. In a letter to HHS secretary Robert F. Kennedy Jr., some Democratic congressmen estimated that the cuts could amount to 50-70% of the agency’s workforce. Some former employees said they worry that SAMHSA might be stripped for parts and absorbed into the CDC or the Health Resources and Services Administration.

The Trump administration recently allowed agencies to rehire probationary employees that had been laid off. While health agencies such as the Centers for Disease Control and Prevention and the Food and Drug Administration have started asking some employees to return, SAMHSA leaders are yet to do that.

Health and Human Services officials recently selected Chris Carroll as SAMHSA’s acting head until a political nominee is named. The choice even surprised Carroll, according to a source familiar with his thinking. His decades-long career in SAMHSA has focused on finance, rather than policy. His lengthy tenure at SAMHSA has never included a stint in leadership, according to agency sources and a review of several organizational charts published since 2020.