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State health departments have been left aggrieved following the recent announcement by the U.S. Department of Health and Human Services (HHS) that $12 billion worth of federal funding is being cut. [1] These grants, which were first given during the COVID-19 pandemic, are now thought to be surplus to requirements by government officials. This funding reduction will directly impact the prevention and control of infectious diseases, as well as mental health and addiction services. [1]
The funding cuts
In total, $11 billion in funding will be cut from the Centers of Disease Control and Prevention, with an additional $1 billion being cut from the Substance Abuse and Mental Health Service Administration (SAMHSA). [1] These cuts will have an immediate effect, as affected departments have 30 days to adjust their expenditures accordingly.
The reason for these changes in funding is centered around the fact that they were first issued during the crisis of the COVID-19 pandemic. "The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago. HHS is prioritizing funding projects that will deliver on President Trump’s mandate to address our chronic disease epidemic and Make America Healthy Again," Andrew Nixon, HHS Director of Communications, said in a recent statement.
While some of this funding was indeed being used for COVID-19 testing, vaccinations, and related initiatives, much of it was also spent on other infectious diseases, such as measles, alongside mental health and addiction services. With measles outbreaks on the rise and deaths from drug overdoses still topping 80,000 per year, there is concern these figures could worsen in the wake of these cuts. [3][4]
Additionally, as part of a huge restructure of HHS, SAMHSA is being merged into a new organization called the Administration for a Healthy America (AHA). [5] This move is expected to put thousands of federal jobs in question and will reshape the way services are provided.
Impact on state health departments
From tracking mental health services in Massachusetts to preventing measles outbreaks in Texas, the impact of these funding cuts will be felt across the country. [1] The states of New York and Washington have both acknowledged millions of dollars of funding reductions, which in turn is putting hundreds of jobs at risk. [1] But what specific impact will these funding reductions have on mental health services and addiction treatment?
Effects on mental health and addiction services
While no list of the affected clinics and services is immediately available, many states have acknowledged that their funding cuts will directly impact mental health services and addiction treatment.
Massachusetts has acknowledged that the federal money was used for many mental health services, including addiction treatment. New York has confirmed over $300 million in funding reductions, directly impacting their Department of Health, Office of Mental Health, and Office of Addiction Support and Services. This is likely to lead to job loss and service reduction in these departments.
On a national scale, staff reductions and restructuring in SAMHSA, which is currently responsible for the 988 National Suicide and Crisis Lifeline, amongst other programs, could affect its ability to manage these services effectively [6]. This could lead to less availability of crisis support. Other possible outcomes following these sweeping changes include:
- Cuts to training and education programs relating to addiction treatment
- Reduced ability to make changes relating to best practice in addiction and mental health treatment
- Less ability for the government to oversee community addiction treatment
Researchers and health officials will assess the true impact of this funding change over time.
Reactions from state officials and health advocates
There has been discontent from state officials and health advocates in response to the funding reductions and what the potential repercussions could be.
“Senselessly ripping away this funding Congress provided will undermine our state’s ability to protect families from infectious diseases (like measles and bird flu) and to help people get the mental health care and substance use treatment they need—causing immediate harm for millions of real people and communities across America”, U.S. Senator Patty Murray, a Democrat from Washington state, said a statement. [7]
New Jersey Governor Phil Murphy said, “these irrational and inexplicable cuts have created an unfillable void in funding that will have disastrous ramifications for our most vulnerable neighbors.” [8] In addition, New York Governor Kathy Hochul said that “these cuts will be devastating” and "there is no state in this country that has the financial resources to backfill the massive federal funding cuts.” [5] New York Attorney General Letitia James is concerned these changes will “throw our mental health systems into chaos.” [9]
On the other hand, officials who agree with removing these COVID-19 grants say that states operated without them prior to the pandemic and that the HHS is prioritizing other funding projects to improve public health.
As a response to these cuts, the Trump administration has been subject to a lawsuit from a coalition of 23 states, demonstrating their displeasure at the funding reductions. [9]
Potential consequences for public health
This reduction in funding is likely to result in less accessibility for services and treatment relating to mental health and addiction, as well as infectious diseases. This could lead to challenges in managing any future public health crises, like another pandemic, reducing the available resources to track the spread of disease and provide vaccinations. Measles cases are already increasing in the country, and there are fears this could worsen further, putting children (in particular) at high risk of illness.
From a mental health perspective, less service accessibility could lead to an increase in mental health crises and illicit drug use, with less support available for those already using drugs. This could increase the already high number of drug overdose fatalities, which is a very worrying prospect. Progress has been made with the opioid crisis in recent years, but there are fears this could be reversed as a result of these cuts.
Moving forward
These federal funding reductions are likely to greatly impact public health and mental health services. It will likely take time to see the overall effect of this decision in terms of disease, addiction, and mental health prevalence in the wake of some current services being reduced or scrapped. Thousands of federal jobs are at risk, with the huge restructuring of some government departments affecting how current services will be delivered.
Despite these sweeping changes, it’s still important to seek help from a professional if you’re struggling with your mental health or with addiction. Many online resources and support networks will remain, including here at Recovered. [10] If you’re in a crisis, you can call 911 to speak with emergency services or 988 to speak with the suicide and crisis lifeline. More information about seeking help for your mental health can be found here. [11]
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