On March 27th 2025, RFK Jr, Secretary of the US Department of Health and Human Services for the Trump Administration, announced that SAMHSA will effectively cease to exist. The remaining staff at SAMHSA will now be absorbed into a new agency, called the Administration for a Healthy America (AHA).
Moving forward, SAMHSA’s remaining staff will join staffers from OASH, HRSA, ATSDR and NIOSH under the AHA umbrella. AHA’s divisions are planned to be composed of: the Primary Care Division, the Maternal and Child Health Division, the Mental Health Division, the Environmental Health Division, the HIV/AIDS Division, and the Workforce Division.
It’s not immediately clear where SAMHSA’s remaining staff will be placed within the agency, although it’s likely they will be spread out across many different divisions, with a concentration of staffers being retained in the Mental Health Division. Secretary Kennedy has promised to “do more” with less, but the National Association for Mental Illness (NAMI) has said that they are “deeply concerned” about the new plan.
Wait - I thought SAMHSA was experiencing staff reductions and budget cuts, not closing entirely. What happened?
You’re not wrong. There were cuts to SAMHSA that happened in the weeks leading up to the agency’s dramatic restructuring announced on March 27th.
In the last month, SAMHSA has seen reductions in staff, as well as deep funding cuts. Roughly 10% of the staff was laid off. Grants previously distributed by SAMHSA to state health departments under COVID-era provisions, set to expire in September 2025, were cancelled early, leaving states scrambling to adjust and respond.
At SAMHSA, leaders described a “doom loop” during those cuts reminiscent of the low morale that permeated the agency during the first Trump administration, which brought an earlier round of budget cuts and staff reductions to the chronically under-funded agency. Many federal workers at SAMHSA called this second round of layoffs and budget cuts “traumatic.”
What was SAMHSA, the Substance Abuse and Mental Health Services Administration?
SAMSHA was a department in the Federal government tasked with protecting our nation’s mental and behavioral health. SAMHSA operated with about 1000 employees until last week, when the administration cut about 10% of the agency, slashing payroll by roughly 100 individuals.
Now, SAMHSA has been rolled into a new umbrella organization, called the Administration for a Healthy America, AHA.
What role did SAMHSA play in the behavioral health and addiction treatment fields?
SAMHSA had a broad mandate for advocating for people with mental health and Substance Use Disorder in the United States.
SAMHSA administrated grants to state-based programs to treat mental and behavioral health concerns, published and distributed “TIPS” for substance abuse treatment providers on evidence-based best practices for addiction treatment, advocated for evidence-based addiction treatment policy, and trained nonprofits and state agencies in best practices for behavioral health treatment.
SAMHSA also oversaw the implementation of 988, the National Suicide and Crisis Lifeline (which was implemented during President Trump’s first term), regulated OTPs and methadone clinics, and funded drug courts. SAMHSA also undertook data collection on substance use and mental health trends nationwide.
What will replace SAMHSA? Will there be more cuts to staff who specialize in behavioral health after SAMHSA has been fully integrated with AHA?
There’s a lot that we don’t yet know about what will - or will not - replace SAMHSA’s efforts to address the mental health and addiction crisis in this country.
There have been rumors - reported in the New York Times - that SAMHSA’s remaining ranks, now folded into AHA, will continue to shrink by up to 50% of its currently reduced size. It’s not clear if this level of reduction continues to be a possibility now that the entire organization has been subsumed into AHA.
What impact will the closure of SAMHSA have on behavioral health and addiction treatment providers in the United States?
While it’s difficult to know exactly how this cataclysmic shift in federal public health administration will impact individual addiction treatment providers, businesses, and organizations, it is clear that we should keep an eye out for a few possible developments.
They are:
Lessened ability of the federal government to perform oversight or “watchdog” duties when it comes to the addiction treatment community
A reduction of overall grant-making for addiction treatment organizations from the federal government
A reduction in the speed and quality of administration of the federal government’s grant-making activity for addiction treatment, making the grant application and review process more onerous for existing orgs
A slower turnaround time for best-practices updates and timely dissemination of public health information of interest to addiction treatment providers and SUD patients
Cuts to or elimination of federal educational and training programs for addiction treatment providers, nonprofits, and state-level organizations
A discontinuation of all federal funding and support for population-specific addiction treatment services, including programs that are designed specifically for the LGBTQ community and/or patients of a particular race, such as programs designed to meet the specific needs of people of color
A possible expansion of federal funding opportunities for faith-based programs, as well as other programs - such as 12-step organizations - that fall outside the evidence-based best practices long championed by SAMHSA
A reduced ability for the federal government to raise awareness of and advocate for evidence-based addiction treatment best practices, including a reduced capacity for public health policy advising and guidance
A reduced capacity to withhold funding at the federal level from organizations that don’t meet the established criteria for evidence-based treatment
A reduced capacity to make evidence-based changes to federally recognized best practices for addiction treatment
Longer lag time for the incorporation of new evidence and new addiction treatment modalities into federally recognized best practices
Related blog posts about the future of Addiction Treatment and Behavioral Health under the Trump Administration
Update on Trump's Addiction Treatment Policies, and What the Future May Hold for Behavioral Health
Forecasting Trump's Behavioral Health Plan for Addiction Treatment Providers in 2025
2025 Federal Addiction and Mental Health Treatment Policies Under the Trump Administration Part 2
Predictions for Trump's Behavioral Health Policy for Recovery Residence Operators in 2025
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