The decision to eliminate the Substance Abuse and Mental Health Services Administration (SAMHSA) and the proposed cuts to Medicaid by President Donald Trump have left many mental health clinicians and psychiatrists extremely worried.
That’s why, in conjunction with the 2025 American Psychiatric Association (APA) Annual Meeting in Los Angeles last weekend, dozens of psychiatrists and mental health professionals held a rally to urge federal leaders to reverse course and reject the proposed cuts to Medicaid and restore SAMHSA.
“It would really destroy our ability to provide these types of [mental health] services and care that we’ve been providing people all across California,” said Eric Rafla-Yuan, M.D., a psychiatrist who serves as chair of the APA Caucus on the Social Determinants of Mental Health.
“In California, one in three people are on Medi-Cal … and those are folks who are going to lose their coverage, like kids, pregnant women and working families.”
The agency – part of the Department of Health and Human Services (HHS) – has provided national grant funding opportunities for substance abuse and mental health programs; disseminated prevention, harm reduction, treatment and recovery resources; and provided information available for public education programs.
This key agency has notably established and is responsible for the 988 Suicide and Crisis Lifeline, which takes calls nationwide 24/7.
However, SAMHSA and many of its programs have been targets for elimination under the Donald Trump administration. In April, up to half of the agency’s staff have been laid off and under an executive order, SAMHSA and other agencies will be absorbed into the HHS’s newly created Administration for a Healthy America.
Rafla-Yuan was one of the main organizers for the rally and is part of Psychiatrists For Mental Health For All, a coalition of members that range from physicians in training, to psychiatrists and APA presidents who have come together to “raise awareness and respond to the growing assaults on public health and mental health across the nation.”
Rally organizers sought to draw attention to what the federal government is doing, bring awareness to their colleagues and encourage the APA to hold more rallies. Rafla-Yuan recounted how he spoke to an elderly psychiatrist with more than 40 years of experience who had never been to a psychiatrist-led rally before.
The Trump administration’s action to eliminate the agency would impact up to 300 “entities” within California alone that receive support from SAMHSA through programs and grants that include schools, community clinics and universities. Last year, the amount dispersed for those programs was approximately $100 million.
Without SAMHSA and funding for Medi-Cal, the largest health care provider in California, Rafla-Yuan said it would be like leaving a giant gaping hole for psychiatrists to provide adequate care.
“We’re very worried about not just cuts to Medicaid for mental health [reasons], but people rely on Medicaid and Medi-Cal coverage for their diabetes, heart disease, high blood pressure and cancer treatment,” Rafla-Yuan said. “All of these things … are connected, so as physicians [responsible for] taking care of people, all of these things really worry us.”
This would be on top of the increasingly high demand for mental health services that psychiatrists and clinicians are already struggling to keep up with. Many organizations have incredibly long waiting lists that can stretch for months, despite the fact that people in crisis need help immediately.
Rafla-Yuan said that what the federal government is doing to “save money” is very shortsighted. When people aren’t able to get the care they need right away, it can become more costly down the road. For instance, if someone is struggling with their mental health but can’t get support, their condition can worsen, potentially causing them to lose their job and home.
While SAMHSA is not the only health-related agency to be the target of cuts – the National Institute of Health (NIH) and the Centers for Disease Control and Prevention (CDC) are also being affected – Rafla-Yuan said many people may not be aware of it. However, the hope is that the rally brings more attention to this issue and people understand just how dangerous it would be if these programs were eliminated.
“This is a historic time in that there are these major threats that are happening [to our health care] that we haven’t quite faced before, and psychiatrists need to be standing up and paying attention,” Rafla-Yuan said.