Under Secretary of Health and Human Services Robert F. Kennedy Jr., the Substance Abuse and Mental Health Services Administration will be consolidated with other organizations into a new Administration for a Healthy America, or AHA. The SAMHSA has already lost a third of its staff of 900 employees from the dramatic downsizing of the HHS. In addition, President Trump’s budget bill will cut $1 billion from the agency’s budget.

The SAMHSA was created in 1992 by bipartisan legislation in Congress and signed by then President George H.W. Bush. With an $8 billion budget, it provides crucial mental health and addiction services across all of America, largely through federal grants administered by individual states. Key initiatives of the agency include grants supporting community-based treatments, the 988 crisis helpline, naloxone distribution programs and the administration of methadone clinics.

Although the future of mental health care remains uncertain under the new AHA, dissolving the SAMHSA will have major effects on public health. Here’s how.

For starters, massive layoffs and restructuring breeds chaos, disruption and workforce turmoil. As in other agencies where highly qualified seasoned professionals have been asked to resign or retire across the HHS, so too could expert mental health professionals who are essential in combating addiction and mental health conditions like depression and anxiety. With less qualified experts to treat mental health conditions, more Americans could suffer from drug overdoses and mental conditions like schizophrenia.

The restructuring and consolidation of mental health services into the new AHA could undermine addiction treatment and evidence-based medicine. As an example, SAMHSA regulates methadone clinics and promotes evidence-based treatments like Buprenorphine and Naloxone to treat opioid addiction. RFK Jr., on the other hand, is known to tout unconventional treatments that have no basis in science. He has proposed implementing the use of camps and farms where people experiencing addiction would be sent to recover. These types of interventions have no basis in science and may reverse decades of progress in addiction treatment. There has already been a nearly 27% decrease in drug overdoses in America comparing 2024 to 2023, according to the CDC .

If RFK Jr. were to implement such initiatives into the AHA, this would erode scientific integrity for the advancement of addiction and mental health treatments. A shift from evidence-based to “wellness-centric” models of treatment could leave many Americans without access to high-quality proven scientific treatments.

Dismantling the SAMSHA will also affect vulnerable populations, particularly the 60 million Americans that live in rural parts of the country. Rural communities rely on SAMSHA grant funding for addiction treatment and mental health services, according to NPR . With massive funding cuts on the order of $1 billion, Americans living in these areas will have less resources and funds to fight off addiction and mental health conditions. Consolidating an organization that specializes in mental health care into a broader agency will weaken the mental health infrastructure in America.

In its announcement document , the HHS states, “Transferring SAMHSA to AHA will increase operational efficiency and assure programs are carried out because it will break down artificial divisions between similar programs.” But how similar exactly are the programs? The SAMHSA, which focuses on addiction and mental health conditions, is drastically different than the National Institute for Occupational Safety and Health which focuses on health hazards related to the workplace. Despite having two very different focuses, both agencies will be consolidated under RFK Jr.’s AHA.

The shrinking of the SAMHSA marks a notable shift in national policy. Although proponents of the move may site reduced bureaucratic overlap and streamlined coordination of health efforts in support of the AHA, the move represents a fundamental change in how America will approach addiction and mental health. Scientists, public health officials and the American people will be watching closely whether evidence-based treatments are promoted and if further progress will be made with respect to decreasing drug overdoses.