The emerging Trumpification of mental and behavioral health
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The Trump administration's approach to mental and behavioral health has so far featured federal funding cuts and Health Secretary Robert F. Kennedy Jr.'s deeply controversial approach to autism, but past remarks by the president and Kennedy suggest that more disruption is likely on the horizon.
Why it matters: America is in the throes of a mental health and addiction crisis, while diagnoses of behavioral health conditions like autism and ADHD have been on the rise.
- Advocacy groups and experts are warning that the administration's approach so far threatens to make problems worse, not better.
- The mass reduction in the Health and Human Services workforce "has the potential to jeopardize years of work and recent progress, like reducing overdose deaths," 12 mental health and substance use organizations wrote in a joint statement last month.
The big picture: Though progress against overdose deaths is finally being made, drugs are still killing tens of thousands of Americans a year and affecting the lives of millions more.
- Meanwhile, Americans' mental health remains relatively poor, both in terms of general unhappiness and severe mental illness.
- And neurodevelopmental conditions like autism and ADHD continue to be diagnosed in larger numbers, at least in part due to improvements in diagnostics.
Between the lines: Although the mental health crisis comes under Kennedy's focus on chronic disease, advocates say the federal government's actions so far may do more harm than good.
Where it stands: The DOGE-directed slashing of the federal bureaucracy and other cuts have hit targeted programs and offices designed to improve Americans' mental health.
- The Education Department recently halted $1 billion in spending for mental health services for children, funding authorized by Congress in 2022 as a response to gun violence, the New York Times reports.
- What was formerly the Substance Abuse and Mental Health Services Administration has reportedly had its funding slashed and is being rolled into a new umbrella organization called the Administration for a Healthy America.
- HHS says the change will "increase operational efficiency and assure programs are carried out." The agency has remained active throughout the first few months of Trump's presidency.
Trump's proposed 2026 budget calls for more than $1 billion more in cuts to SAMHSA, saying it aims to eliminate "inefficient funding."
- "Cuts of this magnitude would certainly disrupt critical research and programs that help people with mental illness get well and stay well, resulting in more people's symptoms getting worse and putting people out of work, on the streets, and in jails and emergency rooms," Hannah Wesolowski, chief advocacy officer at the National Alliance on Mental Illness, said in a statement responding to the budget request.
Meanwhile, Kennedy's quest to better understand the roots of autism, and belief that "environmental factors" including drugs play a part, is gaining momentum, though it's viewed with heavy skepticism by many experts.
- The National Institutes of Health and the Centers for Medicare and Medicaid Services announced a data-sharing partnership Wednesday giving NIH researchers access to the data of Medicare and Medicaid enrollees diagnosed with autism spectrum disorder, a neurological and developmental condition.
- Kennedy's mission is viewed by many experts as a thinly veiled attempt to resurface his false assertions that certain vaccines cause autism, and his characterizations of people with autism have already received blowback from those people themselves.
Yes, but: Yet to surface in government policy are some of both Kennedy's and Trump's most controversial ideas on mental health and addiction.
- Trump during the campaign called for the return of mental institutions, although even some progressive-led cities and states are beginning to embrace forms of involuntary commitment.
- Kennedy has expressed skepticism of psychiatric drugs, including those used to treat common conditions like depression and ADHD, and called for a network of "healing farms" as a response to addiction.
What we're watching: The expected release of an assessment by the administration's Make America Healthy Again Commission in the coming weeks may provide clues about what's next, at least when it comes to psychiatric drugs.
- The commission is required to "assess the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs."
