The Trump administration is doubling down on its efforts to hide major issues facing the nation including the mental health crisis and homelessness.
The U.S agency that oversees substance abuse and mental health services, the Substance Abuse and Mental Health Services Administration, recently revised its strategic priorities to no longer fund harm-reduction initiatives and instead focus on involuntary commitment for those in crisis or those who are unhoused and unable to take care of themselves.
Out of sight, out of mind, appears to be the new modus operandi for the government, and if you want any kind of federal funding, you’re expected to fall in line.
The change in priorities has many clinicians, advocates and experts concerned about the future of mental-health treatment in the nation.
In addition to no longer supporting harm-reduction programs, the document also said it will deprioritize initiatives that look at worse health outcomes for minority populations.
It also says that agencies in areas that have prohibitions on open illicit drug use, urban camping, loitering and squatting will receive funding priority.
Areas that adopt policies for individuals who are a danger to themselves or others, or who are living on the streets and cannot care for themselves, to be moved to “treatment centers or other appropriate facilities via civil commitment or other available means, to the maximum extent provided by law” will also be prioritized for funding going forward.
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Lock ’em up, throw away the key …
SAMHSA’s new set of published priorities are a clear departure from evidence-based approaches to substance use and mental health care, according to the Legal Action Center, who released a statement calling the shift “troubling.”
The document “walks back critical pillars of public health progress—abandoning harm reduction, fostering greater health disparities and inequity and reinserting coercion and law enforcement into systems meant to promote healing,” the statement read.
The current continuum of care for mental health treatment is “grounded in meeting people where they are, reducing harm, uplifting individual dignity and autonomy and investing in community-driven, evidence-informed care.”
Some of the new priorities directly threaten this approach, and in several key areas, reverse course from effective, person-centered approaches toward those that prioritize punishment and civil commitment, according to the LAC.
Syringe service programs, safe consumption sites and overdose prevention efforts “are not fringe ideas,” the LAC said in response to the set of priorities released by SAMHSA.
“These are evidence-based interventions supported by decades of rigorous science and endorsed by leading public health institutions globally. Turning away from these tools will put countless lives at risk,” the LAC statement said.
“At a time when overdose deaths disproportionately affect Black, Indigenous and Latine communities, and when mental health services remain under-resourced for LGBTQ+ youth and other marginalized groups, targeted investment isn’t optional — it’s essential.”
The push toward involuntary treatment options for those in crisis or facing housing insecurity is “deeply concerning,” the LAC said.
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The LAC is asking SAMHSA to “immediately revisit their priorities before decades of hard-won gains are lost.”
“Prioritizing stronger law enforcement partnerships in crisis response threatens to roll back years of work to build health-first alternatives like 988, community responder programs, mobile crisis teams and stabilization units designed to replace police involvement in clinical care,” LAC said.
“This shift does not represent progress — it is a reversion to failed models that criminalize people’s health conditions and deprive them of the health care services and supports they need to get and stay well.”
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Crystal Graham
