RFK Jr. the agency that works on mental disorders and addiction is shrinking

The most important mental health agency of the country, The drug abuse and the administration of mental health care, generally known as Samhsa, is resolved. This year it has lost more than a third of his staff of around 900 as part of recent reductions of the federal workforce. President Trump’s budget account reduces $ 1 billion of the operational budget of the agency, and her mission is are folded in a new entity Formed by health secretary Robert F. Kennedy Jr.

Legislers, researchers and care providers are worried. During a hearing of the Huis Credits committee last month, some Democratic legislators grilled the health secretary about this. Rep. Madeleine DeanRepresentative of the suburbs Philadelphia, Kennedy asked about these changes in the light of recent progress in deaths due to overdose.

“A reduction of 27% in deaths due to overdoses in this country,” said Dean, who has personal experience with opioid addiction through one of her sons who are in recovery. “Overdose still steals a generation in this country. So why did we close Samhsa in God’s name?”

“We don’t close Samhsa,” answered Kennedy and called his own history of addiction and the loved ones he lost through overdose. “What we want to do is that we want to move that function to a place where we can manage it more efficiently.”

In March, Kennedy and the Department of Health and Human Services announced that Samhsa and other divisions, would be combined In a new entity called the administration for a healthy America or AHA.

Samhsa was founded in 1992 By bilingual legislation signed by President George HW Bush. The agency was given the task of supporting community -based mental health care and addiction treatment and prevention. It has usually achieved this through subsidies to states, communities and private groups for mental health and addiction -related services.

In recent years, the agency’s budget has grown to tackle the increasing demand for mental health and addiction care. In 2024, Samhsa’s budget was About $ 7.5 billionof which the majority has streamed to states for specialized programs to tackle psychological problems and addiction.

For example, the agency gave more than $ 519 million for 988, the lifeline of suicide and crisis and behavioral crisis response services and just over $ 1 billion for block fairs for mental health care.

‘Backbone of Behavioral Health’

“The Samhsa subsidies are absolutely necessary” Rachel Winograd At the University of Missouri-Saint Louis. She directs the Addiction Science team of the university that Samhsa financing. They have used the money to buy and distribute medicines for disorders for substance use, overdosis prevention and for a series of services to people with addiction, says Winograd, “whether it is drop-in centers, recovery, housing, treatment, delivery, you name it.”

Those funds “are the backbone of behavioral health in this country,” she says. “If those subsidies were to disappear, we would be sewn.”

Improved access to Naloxon, a drug to reverse opioid overdose, made possible by Samhsa subsidies to states, has contributed to the reduction of the deaths by overdose, says Miriam Delphin-RittmonThe former assistant secretary of the agency. Based on data collected by Samhsa, she says: “The number of [overdose] Conversations have continued to rise. “

Funds of the agency have become a lifeline for rural communities, says Adriatic LikcaniA marriage and family therapist and professor at the University of Central Missouri, in Warrensburg, Mo.

“Rural communities do not have much financing locally to finance treatment or recovery, so Samhsa subsidies brought life to those communities,” says Likcani, which also runs Recovery LighthouseA small non-profit offer of recovery services for addiction. “It financed initiatives that they could never finance and helped to start these recovery centers that helped us meet the need.”

Before that, he says, people with addiction had to travel for an hour or more for treatment.

They would “go to rehabilitation for 21 days or 30 days and then come back home and there is no service to be able to continue to work on their recovery or to go to prison because of drug -related crimes,” he says.

An example of an initiative introduced and funded by Samhsa, he says, was the idea of ​​using Peer specialists – people themselves in recovery to help others with addiction.

“In Missouri we had no pear support and it was via Samhsa fairs at the beginning of 2000, where they financed these systems to hire colleagues to participate in the staff,” says Likcani.

When complying with a shortage of a workforce, he added, he adds, and helped in developing a more effective system for repairing drug use disorders. And it was so successful, he says, that the state finances Peer support programs in Missouri. “It started from zero to more than 60 organizations that are now being contracted within state systems to offer pear support.”

Loss of technical expertise

The immediate impact of the recent changes at Samhsa on Likcani and his colleagues in the Missouri countryside, is the loss of technical support of the regional office of the Kansas City office, which was closed on 1 April, together with all regional offices of the agency in the entire country,

“They came to the site and learned our best practices,” says Likcani. “They worked hands-on with organizations, from developing strategic plans [to helping] You understand how federal financing works. “

And although he has not yet lost financing, he is afraid that he and other communities as he may lose financing to keep their recovery centers open.

Elsewhere in the country there are also government agencies and providers that depend on Samhsa financing and technical support isolated, lost and reluctant to contact the federal staff who have been left at the agency, says Dr. Eric Rafla-YuanA psychiatrist in San Diego, Calif.

“Often their contacts are fired, the contacts remain unanswered. You have a bit of the feeling in many of the health bodies that you are alone,” says Rafla-Yuan, who also works with the California Office or Emergency Services, which is a group to guarantee a fair access to 988.

The agency not only provided the money to its beneficiaries, says Rafla-Yuan, they also gave expertise and guidance to use those funds effectively. For states and communities that have received Samhsa subsidies to set up a crisis response system up to 988, the agency gave guidelines for what a “crisis system should look like,” he says. “Which personnel ratios should be, what kind of qualifications people must have.”

But now with so many of the federal employees, beneficiaries have no one to help them solve problems with their crisis response systems. “That is all really insecure,” he says. “There are no answers at all.”

These issues belonged to the topics that were discussed on a forum organized by Senator Tammy Baldwin, D-Wis., And Peter Welch, D-VT., To understand the possible effects of changes in American health and human services, including the dismantling of Samhsa.

“This dramatic loss of institutional knowledge and subject expertise will be felt by states and communities that depend on Samhsa’s policy and programmatic guidance to promote mental health, prevent abuse of resources and to offer treatments and supports that promote recovery,” said Trina Dutta, the former Staff chef of the staff of the worker.

Recent investments in the agency – by dual legislation – had achieved remarkable successes in reducing both opioid overdose and, in some age groups, suicide sterars in the country, Dutta said.

During the hearing of the Huis Kredietcommissie, Kennedy told the legislators that his relocation of Samhsa in his new administration for a healthy America (AHA) would enable the agency to better tackle all chronic diseases, including mental disorders and addiction. But Rep.Dean pressed him to explain his thinking behind this.

“Why would we, when we finally see some success, buried that success, put it in an AHA program?” Dean asked. “We now have to rent people again and find out what their roles will be within AHA?”

Kennedy did not answer her question, but said he would ensure that people with addiction have access to prevention of overdoses and other medicines.