Trump budget proposes $1.5B mental health cuts, RFK Jr. dissolves SAMHSA into unbuilt agency

Trump's FY2026 budget proposes cutting $1.5 billion from SAMHSA—$1.065 billion from Programs of Regional and National Significance (PRNS) and $500 million from consolidated state block grants—reducing the agency's budget from $6.8 billion to $5.7 billion, a 22% decrease.

HHS Secretary Robert F. Kennedy Jr. announced on Mar. 27, 2025 that SAMHSA will dissolve into a new Administration for a Healthy America (AHA), but as of Jan. 2026, the AHA doesn't exist and over 450 of SAMHSA's 900 employees have been laid off.

On Jan. 13-14, 2026, Trump sent letters terminating nearly $2 billion in SAMHSA grants affecting 2,000-2,800 programs nationwide, then reversed the decision after 24 hours following backlash from governors, nonprofits, and Congress.

Trump's Office of Management and Budget froze federal grant disbursements in Jan. 2026, forcing three Virginia health clinics to shut down, locking 21 Mississippi centers out of payroll systems, and blocking a West Virginia nonprofit from accessing mental health program funds.

SAMHSA ended the 988 Suicide & Crisis Lifeline's specialized services for LGBTQ+ youth on Jul. 17, 2025, eliminating $50 million in annual funding that supported 1.3 million contacts since the program launched in 2022.

The FY2026 budget consolidates three separate block grants (Community Mental Health Services, Substance Use Prevention/Treatment/Recovery Services, and State Opioid Response) into a single Behavioral Health Innovation Block Grant, reducing total funding from $4.59 billion to $4.13 billion.

Trump never appointed a permanent SAMHSA administrator, leaving Art Kleinschmidt (a Project 2025 contributor) as acting head until he departed in Dec. 2025, creating a leadership vacuum during the largest restructuring in the agency's history.

While Trump's FY2026 budget cuts SAMHSA by $1.5 billion, it increases VA medical care funding by $3.3 billion, but VA management directives ordered therapists to 'terminate treatment with patients receiving long-term psychotherapy,' and the department plans to cut 80,000 jobs.