The Trump administration’s second term, beginning in 2025, has marked a shift in federal mental health and substance use policy. The administration has moved toward a heavier law-and-order approach while narrowing the scope of federal leadership capacity in mental health and substance use services, though continuing some treatment-focused initiatives such as the SUPPORT Act reauthorization.
The context for these policy changes is significant. In 2024, over 61 million adults in the U.S. experienced a mental illness, and deaths due to suicide, gun violence, and drug overdose remained high. The COVID-19 pandemic and necessary public health responses exacerbated an already existing mental health and substance use crisis. Among insured adults who described their mental health as fair or poor, 43% reported at least one time in the past year when they needed mental health services or medication but did not receive them, with communities of color, youth, and young adults experiencing greater barriers.
Policy Direction Shift
The second Trump administration’s policy directions mark a departure from the previous administration. During the first Trump administration, the SUPPORT Act—legislation that expanded access to opioid treatment and overdose prevention—was passed along with legislation that created the 988 crisis hotline. The Biden administration focused on expanding coverage, improving access to care, implementing evidence-based treatments, and strengthening support for federal agencies such as the Substance Abuse and Mental Health Administration (SAMHSA).
Recent data showed that some opioid and mental health-related indicators had stabilized or improved. The second Trump administration has initiated key actions including signing the HALT Act related to opioids, canceling school-based mental health grants, proposing to reduce and reorganize SAMHSA under another agency, and rescinding community violence intervention grants. These policy directions align with themes highlighted in President Trump’s campaign materials and are consistent with proposals in Project 2025. The administration continues to update its policy actions in the areas of mental health, opioids and substance use disorder, federal infrastructure and data guidance, and gun violence.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.kff.org/mental-health/tracking-key-mental-health-and-substance-use-policy-actions-under-the-trump-administration/