The Plot Against America's Mental Health Care System
A long-term vision to dismantle SAMHSA and to reorient the mental health care system toward involuntary treatment of serious mental illness seems to be coming together.
In January 2025, the City Journal, which is published by the conservative Manhattan Institute, posted an article that called for the Trump administration to abolish the small federal agency charged with reducing the impact of mental illness and substance use in American communities.
“The agency has not only failed to reduce the impact of mental illness in American life but also has undermined proven solutions by derailing resources from high-quality, intensive psychiatric treatment and advocating against involuntary commitment,” wrote Carolyn D. Gorman, who is a fellow at the Manhattan Institute.
Several months later, that idea has largely come to fruition, with the Trump administration announcing that the Substance Abuse and Mental Health Services Administration (SAMHSA) would soon cease to exist.
This follows severe staffing reductions—potentially 50 percent of the 900 people who worked at the agency at the beginning of 2025—as well as bu…