Yesterday, Secretary Robert F. Kennedy Jr. announced a restructuring of the Department of Health and Human Services (HHS), including a reduction in workforce by an estimated 25%, and merging the Substance Abuse and Mental Health Services Administration (SAMHSA) into a new Administration for a Healthy America. Mental Health America (MHA) fully supports integrating mental health into all efforts to make America healthy. At the same time, we have two strong concerns about this proposed merger: the lack of focus on behavioral health during a time of crisis and the risk of losing critical behavioral health expertise across HHS.

We appreciate the Secretary’s focus on “whole-person health” and ask him to reconsider the merger—and, if not, to take steps to address the following important health issues:

First, there is an urgent need to focus on the most pressing public health crises of our times: suicide, overdose, and youth mental health. The proposed change comes just as the country is beginning to see progress—recent research shows signs of improvement in the opioid crisis and teen mental health. SAMHSA has played a key role in these improved outcomes. Despite this progress, far too many people continue to suffer.

America will only be healthy again with a sustained focus on these essential issues.

The HHS press release itself highlights the concern that merging SAMHSA will lead to HHS affording less priority to mental health and substance use by failing to mention behavioral health as a priority. The restructuring is described in terms of efficiency and breaking down silos, with no mention of reducing deaths of despair, addressing key mental health factors like sleep, social media, and loneliness, or expanding access to behavioral health services. MHA supports national goals which focus on impact first and foremost, and next on our efficiency and effectiveness in meeting them.

Second, SAMHSA’s mental health expertise is essential to guiding other agencies within HHS and improving America’s overall health. The lessons of COVID-19 must not be forgotten. We now recognize the tremendous impact of the pandemic on all Americans’ mental health. Given this, it is imperative that SAMHSA work with the Centers for Disease Control and Prevention (CDC) to maintain a strong focus on mental health within its work.

In addition, the most important lever to improving health is financing, which is under the jurisdiction of the Centers for Medicaid and Medicare Services (CMS). SAMHSA is a key partner to CMS. For example, just in the past three years, SAMHSA implemented the 988 suicide and crisis lifeline, and worked with CMS to help states provide other critical crisis services. Since its implementation in 2022, the 988 lifeline has routed more than 9.8 million calls.

And, as the Secretary looks to address chronic diseases, SAMHSA’s expertise in integrative healthcare will be critical. Nearly 40% of those with a chronic disease also have a mental health or substance use condition.

MHA strongly urges Secretary Kennedy to reconsider the merger of SAMHSA. If the merger does go forward, HHS should set explicit goals for behavioral health and ensure that SAMHSA collaborates with other agencies on key policies. A Republican-led bill created the Assistant Secretary for Mental Health as the leader of SAMHSA to give behavioral health a direct voice at the highest levels of HHS. That leadership must not be lost.

Only by keeping a sharp focus on mental health and substance use can we achieve the administration’s goal of making America healthy again. Mental Health America stands ready to assist in making sure that everyone has access to the resources and information they need to achieve and maintain their optimal mental health.