SAMHSA Walks Back Nearly $2 Billion in Grant Cuts

The US Substance Abuse and Mental Health Services Administration (SAMHSA) has reversed its decision to terminate nearly $2 billion in grants to thousands of mental health and addiction treatment programs, following strong criticism from clinical organizations, patient advocates, service providers, and legislators.

SAMHSA sent a late-night letter to affected grantees on January 13 informing them that their awards were being terminated, effective immediately. 

The letter, shared with Medscape Medical News, said the agency was “adjusting its discretionary award portfolio” to “better prioritize agency resources” towards “programs and interventions that address the rising rates of mental illness and substance abuse conditions, overdose, and suicide and their connections to chronic diseases, homelessness,” and other conditions.

Awardees were told they could not take corrective action, “since no corrective action could align the award with current agency priorities.”

Thirty-six hours later, SAMHSA emailed grantees to “please disregard the prior termination notice.”

Neither SAMHSA nor the Department of Health and Human Services responded to requests for comment by press time.

Medical Organizations Express Relief 

A spokesperson for the American Psychiatric Association (APA), which had issued a statement criticizing the cuts, told Medscape Medical News that the organization was “extremely pleased to hear that the funding is restored.” 

Two APA programs were among those that were slated to lose SAMHSA awards: the APA Workforce Development Initiative and a program that provides free mental health training for K-12 school staff

The National Alliance on Mental Illness (NAMI) said that, in the 24 hours after news of the terminations broke, its advocates sent 16,000 messages to Congress and made hundreds of phone calls. 

“We are greatly relieved to hear of the administration’s reversal,” Hannah Wesolowski, NAMI’s chief advocacy officer, said in a statement. “These cuts caused great — and warranted — panic,” she said, adding, “they should never have been considered in the first place.”

The National Council for Mental Wellbeing (NCMW) said in a statement that the programs slated for cuts are vital to those with a serious mental illness and patients who rely on medication-assisted treatment. 

“The decision to rescind cuts to SAMHSA-funded programs will save lives. We applaud everyone who stood up in support of these congressionally-appropriated grants — members of Congress and the many organizations throughout the behavioral health field,” Chuck Ingoglia, CEO of NCMW, said.

The American Medical Association (AMA) also weighed in on the reversal, noting that the affected programs provide services to individuals across the country. 

“The broad-based, bipartisan push to restore this funding, combined with massive grassroots support, speaks to the immense impact of these programs and their vital role in ensuring access to care for patients in need,” David Aizuss, MD, chair of the AMA, said in a statement.

Impact Would Have Been Immediate 

The cuts would have had an outsized impact on smaller behavioral health service providers, some of whom were planning to immediately start laying off staff, Linda Hurley, president and CEO of CODAC Behavioral Healthcare, Cranston, Rhode Island, told Medscape Medical News.

CODAC, which provides substance use and mental health services, was already preparing for a potential reduction in SAMHSA funds. Hurley said that when they received the agency’s email Tuesday evening notifying them that their funding would be terminated, the institute’s leadership quickly pivoted to its backup plan. 

But other affected organizations may not have the staff or wherewithal to function without SAMHSA funding, she added.

Many providers rely on the SAMHSA-funded Addiction Technology Transfer Center Network and the Opioid Response Network to help with training and education; both were slated to lose funding, said Hurley. 

It appeared initially that the 988 Suicide and Crisis Lifeline — which often refers callers to services in the community that were slated to lose SAMHSA funding — was spared from the cuts. But SAMHSA put out a notice of a $213 million funding opportunity for a new 988 Lifeline administrator the same day it issued the termination letter.

Hurley said it has been a “chaotic” few days for those in behavioral health. 

“We as a field have worked really hard with SAMHSA dollars to create programs that are evidence-based, that assist people. And it just, it all went away, like between 10 and 12 at night,” she said.

The cuts are reversed for now, but Hurley said the initial action is likely a sign of the future. It “lays the groundwork for us to start thinking about what we’re going to do moving forward,” she said.