AYESHA RASCOE, HOST:
The nation's main mental health agency is being dissolved, and it's already lost roughly a third of its staff. The Substance Abuse and Mental Health Administration, or SAMHSA, is being folded into another entity as Secretary Robert F. Kennedy Jr. reshapes federal health agencies. These changes have some lawmakers and health care providers concerned. NPR health correspondent Rhitu Chatterjee is here to tell us more. Hi, Rhitu.
RHITU CHATTERJEE, BYLINE: Hi, Ayesha.
RASCOE: So can you remind us what SAMHSA is and what is the agency's main job?
CHATTERJEE: Absolutely. So SAMHSA, you know, was created in 1992 because of bipartisan legislation that was signed by President George H. W. Bush. And its main job has been to give funds to states, communities, private groups for mental health and addiction-related services, both on the prevention side and on treatment. And, you know, these funds have gone to services like, say, 988, the Suicide and Crisis Lifeline, which served more than 10 million people in its first year. And also things that serve important and vulnerable populations like mental health services in schools, mental health clinics in communities, and medication for overdose prevention. And these funds have been critical for Americans to access care for behavioral health. I spoke with Adriatik Likcani, who's a marriage and family therapist at Recovery Lighthouse. That's an addiction recovery center in Warrensburg, Missouri.
ADRIATIK LIKCANI: Rural communities don't have a lot of funding locally to fund treatment or recovery. So SAMHSA grants really were a lifeline. It sort of brought life into those communities. It funded initiatives that they were never able to fund. And it created these recovery centers that helped us meet the need.
CHATTERJEE: And, you know, Ayesha, that meant that people in these rural communities didn't have to travel anymore for treatment, making recovery more likely. And, you know, Likcani gave me an example of an initiative that SAMHSA not just funded but also introduced to Missouri, and that's using peer support for recovery, and that's when you have people who are themselves in recovery, getting trained to help others.
RASCOE: So how have the recent staff layoffs at the federal level affected things for him in Missouri? Like, has he lost any of his funding?
CHATTERJEE: Not yet, but, you know, he is nervous because President Trump's big, beautiful bill cuts $1 billion from SAMHSA's budget, and he is disappointed and disheartened that the regional SAMHSA office in Kansas City, Missouri, that he and his colleagues relied on so much for guidance and support has been shuttered, along with other regional offices. And I also heard this from health care providers in other states, too. Here's Dr. Eric Rafla-Yuan, a psychiatrist in San Diego.
ERIC RAFLA-YUAN: States and entities have just been really hesitant to reach out to some of the federal staff. Often, their contacts have been fired, the contacts go unanswered. And so it sort of have the sense across a lot of the health agencies that you're just on your own.
CHATTERJEE: And so without that guidance and advice on best practices from people in SAMHSA, there's concern that people won't really be able to be as effective with their money when it comes to providing care.
RASCOE: Does Congress have any say with these changes? Are lawmakers, you know, making any statements on this?
CHATTERJEE: So Congress has not approved these changes, but during a recent hearing by the House Appropriations Committee, Democrats grilled the health secretary about this. Madeleine Dean represents suburban Philadelphia in Congress, and she's had personal experience with the opioid epidemic. One of her sons is in recovery from opioid addiction. And she asked Kennedy about these changes in light of the recent progress in overdose deaths.
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MADELEINE DEAN: Twenty-seven percent reduction in overdose deaths in this country. Overdose is stealing a generation in this country, so why in God's name are we shuttering SAMHSA?
ROBERT F KENNEDY JR: We are not shuttering SAMHSA. And I share your concerns, and I'm anxious to work with you on this problem.
CHATTERJEE: And, you know, Kennedy went on to say that he was bringing SAMHSA into his new Administration for a Healthy America, or AHA, to address chronic diseases, including mental illness and addiction. But Dean pushed him to explain his thinking behind this.
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DEAN: Why would we, when we are finally seeing some success, bury that success, put it in an AHA program? Which, by the way, logically doesn't make any sense. We have to now rehire people and figure out what their roles will be within AHA.
CHATTERJEE: And she asked him if he'd done any analysis to support his decision, and Kennedy didn't really answer that, but he did say that he'd make sure that people with addiction had access to overdose prevention and other medications. And we will be keeping an eye on how all this plays out.
RASCOE: That's NPR's Rhitu Chatterjee. Thank you so much for breaking this down for us.
CHATTERJEE: My pleasure. Transcript provided by NPR, Copyright NPR.
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