December 2025
After more than three decades working in mental health advocacy, policy development, and service delivery, I never imagined I would witness what is unfolding in 2025. The federal commitment to mental health services that took generations to build is being dismantled with stunning speed—and the human cost will be measured in lives.
The Scale of What We’re Facing
The numbers are staggering, but behind each statistic are real people who will lose access to care:
Medicaid Cuts: In July 2025, Congress passed legislation cutting federal Medicaid funding by $1 trillion over ten years—a 15% reduction. The Congressional Budget Office estimates nearly 12 million Americans will lose their Medicaid coverage as a direct result. Since Medicaid funds roughly one-quarter of all mental health and substance use treatment in this country, these cuts strike at the heart of our treatment infrastructure.
SAMHSA Gutted: The Substance Abuse and Mental Health Services Administration, the federal agency responsible for behavioral health services, has seen its workforce cut by more than half since January 2025. At the Center for Mental Health Services, more than half of the staff have been let go, including nearly everyone working on youth mental health programs. Of the agency’s 17 most senior leaders present in January, only 5 remain.
Grant Terminations: In March 2025, approximately $11.4 billion in COVID-era grants supporting addiction and mental health programs were abruptly canceled—despite being scheduled to continue through September 2025. States lost hundreds of millions of dollars overnight: Washington $160 million, New York $300 million, Colorado $250 million. Hundreds of community organizations, peer support programs, crisis services, and school-based initiatives had their funding pulled with no warning.
School-Based Services: Up to 174 school mental health initiatives face the end of funding, affecting programs that placed counselors in schools, provided professional development, and connected students to community mental health providers.
What This Means in Real Terms
These aren’t just budget line items. They represent:
- Crisis hotlines that will go silent
- Peer support specialists who will lose their jobs
- Recovery cafés that will close their doors
- Young people who will no longer have a counselor at school
- Community mental health centers forced to eliminate services
- People with serious mental illness who will lose their treatment providers
- Individuals in recovery who will lose their support systems
The ripple effects extend beyond those who directly lose services. When people can’t access mental health treatment, they end up in emergency rooms, jails, and on the streets. Families struggle alone. Communities bear the burden.
A Personal Reflection
I began my career in mental health as a patient myself—someone who found recovery through a combination of clinical treatment and spiritual healing. I spent decades building consumer/peer support programs, training professionals, consulting/advoating on federal and state policy, and advocating for integrated approaches to mental wellness.
This work has always been about more than policy or budgets. It’s about recognizing that every person deserves access to care, that recovery is possible, and that community support saves lives. The funding structures we built weren’t perfect, but they represented a commitment—a recognition that mental health matters.
What we’re witnessing now is the abandonment of that commitment.
Where Do We Go From Here?
Legal challenges are underway. Several states have secured temporary injunctions to restore some funding while litigation proceeds. Advocacy organizations are mobilizing. Mental health professionals and people in recovery are speaking out.
But the trajectory is clear, and we must be honest about what we’re facing: the federal infrastructure for mental health services is being dismantled.
For those of us who have dedicated our lives to this work, this moment requires both grief and action. We grieve for what is being lost and for the people who will suffer. And we must determine how to sustain support and care in our communities despite these devastating cuts.
This isn’t about politics—it’s about people. It’s about the teenager who needs a counselor. The veteran struggling with PTSD. The mother battling postpartum depression. The person in recovery who needs peer support to stay sober. The families who don’t know where to turn.
These are our neighbors, our family members, our community. And they deserve better.
What You Can Do
- Contact your representatives in Congress: Let them know you support funding for mental health and substance use services. Be specific about programs that matter in your community.
- Support local organizations: Community mental health centers, recovery programs, and peer support initiatives will be on the front lines of this crisis. They need volunteers, donations, and advocacy.
- Share your story: If mental health services have impacted your life or the life of someone you love, speak up. Personal stories matter.
- Stay informed: This situation is developing rapidly. Follow trusted mental health advocacy organizations for updates and action alerts.
The work of building accessible, compassionate, effective mental health services took decades. We cannot let it be undone without raising our voices.
