NAMI Voices Alarm Over Proposed Department of Health Overhaul Impacting Mental Health Services

NAMI's Response to HHS Overhaul Proposal

On March 27, 2025, the National Alliance on Mental Illness (NAMI) issued a statement highlighting serious concerns regarding the U.S. Department of Health and Human Services' (HHS) plan for a major overhaul. This initiative aims to reorganize the agency and implement substantial staff reductions, which could adversely affect national efforts to tackle mental health issues, suicides, and substance use crises across the country.

The CEO of NAMI, Daniel H. Gillison, Jr., articulated that the reorganization could dismantle the existing framework of the Substance Abuse and Mental Health Services Administration (SAMHSA), diminishing the nation’s ability to improve care for individuals suffering from mental health disorders. Gillison emphasized, "Having a dedicated agency for mental health and substance use has significantly elevated the national discourse and helped in reducing stigma surrounding these challenges. The proposed changes, along with budget cuts to other critical HHS agencies like the National Institutes of Health (NIH), could lead to detrimental consequences for millions of Americans facing mental health issues."

In these proposals, HHS suggested a workforce reduction of approximately 10,000 full-time employees. This comes on the heels of another 10,000 staff members who left HHS earlier in the year, meaning a reduction of nearly 25% of the agency's workforce. This drastic change will include about 1,200 positions at NIH and an undetermined number within SAMHSA. As the principal agency focused on mental health and substance use, SAMHSA plays a pivotal role in supporting state-level initiatives that provide necessary treatment services, including vital education for the behavioral health workforce, prevention and early intervention programs, and operating the 988 Suicide Crisis Lifeline.

The potential reorganization would see SAMHSA placed under a newly proposed Administration for a Healthy America (AHA). The staff at SAMHSA are responsible for overseeing nearly $7 billion in grants that directly assist states in serving individuals with mental illnesses. NAMI warns that any drastic restructuring and personnel cuts could potentially disrupt the flow of these essential resources, which are critical to saving lives.

Hannah Wesolowski, NAMI's Chief Advocacy Officer, echoed similar concerns, stating, "The staff at SAMHSA are lifesavers. While we welcome constructive discussions on improving SAMHSA's operations based on data-driven outcomes, we cannot afford to reduce the agency's capacity and hinder our hard-won progress in addressing the mental health crisis that affects countless families across the nation."

Around 84.5 million adults in the U.S. suffer from either a mental health disorder or a substance use condition, as the nation continues to grapple with a substantial mental health, overdose, and suicide crisis. Recent statistics reveal that over 49,000 individuals tragically succumbed to suicide in 2023 alone. SAMHSA, being the only federal agency committed to supporting mental health and substance use conditions, has played a crucial role in the advancements achieved over the years, which include a notable 24% decrease in overdose deaths last year and the successful establishment and optimization of the 988 Lifeline.

The NAMI community recognizes that virtually every family has been touched by an incident related to overdose death, suicide, or by someone grappling with mental health challenges. The organization has urged national leaders to sustain the bipartisan advancements that have been made in addressing the mental health and substance use crises and to ensure that both HHS and SAMHSA personnel can persist in their essential work at a time when it is urgently needed.

Conclusion

The concerns raised by NAMI paint a sobering picture of the potential risks looming over mental health services in the U.S. As discussions about restructuring the HHS continue, it is critical that advocacy organizations, policymakers, and the broader community engage in dialogue to protect and enhance the services necessary for millions of Americans struggling with mental health and substance use disorders.