Since President Donald Trump unveiled his 2026 budget outline in early May, much of the public attention has focused on his plans to cut $163 billion in federal spending, especially reductions in foreign aid and increases in border security. However, the proposal also reveals key details—though sometimes unclear—about how the administration plans to handle mental health and addiction, two urgent public health challenges.
Recent data show that about 80,000 people die from drug overdoses in the U.S. each year, and nearly 50,000 die by suicide. Trump’s proposal includes over $22.6 billion in cuts to three federal agencies that deal with these issues. It also suggests eliminating programs aimed at preventing suicide and overdoses. The administration claims this will make efforts more efficient. But many advocates, researchers, and health experts worry these cuts could make the problem worse.
It is important to note that this is only an early, limited budget plan—not the final one. Known as a “skinny budget,” it covers only discretionary spending that Congress approves annually. Larger programs like Medicare, Medicaid, and Social Security are not included here. The full budget will be released later, with more details.
Still, the early plan reflects the administration’s priorities. It comes amid actions like reducing the federal health workforce and cutting grants for addiction recovery programs.
Rodney Whitlock, a former Republican Senate staffer and vice president at consulting firm McDermott+, said, “There isn’t enough detail to judge all policies yet. But even a skinny budget shows what the administration plans to do.”
About two weeks before this budget was released, a more detailed draft for the Department of Health and Human Services was leaked. It showed deep cuts and program eliminations. Differences between this leaked document and the official skinny budget have caused confusion about the future of many programs.
Here are three important points people affected by mental illness and addiction should watch as the budget process moves forward:
1. Confusion Surrounds Suicide Prevention Funding and the 988 Crisis Hotline
Trump’s administration says it plans to spend $520 million on the 988 mental health crisis hotline in 2026, the same as the current year. An additional $95 million is proposed for other suicide prevention programs, according to Rachel Cauley from the White House Office of Management and Budget.
But the official skinny budget shows more than $1 billion in cuts to the Substance Abuse and Mental Health Services Administration (SAMHSA), the main federal agency for mental health and addiction. Most of the cuts target “Programs of Regional and National Significance,” which include grants for suicide prevention efforts such as 988 call centers, youth suicide prevention, and healthcare system protocols.
These programs are considered vital, especially given that suicide rates have risen 35% from 2000 to 2018 and returned to their peak by 2022. Since launching in 2022, the 988 hotline has handled nearly 10 million calls and 2.5 million texts.
Experts warn that cutting these programs could have disastrous consequences. Paul Nestadt, a Johns Hopkins psychiatrist, said federal funding is crucial for suicide prevention at the local and state levels.
The budget calls these programs duplicative or too small to matter nationally. Cauley did not clarify why the 988 funding numbers she mentioned differ from those in the skinny budget.
This inconsistency is troubling to advocates. Laurel Stine of the American Foundation for Suicide Prevention said, “The official budget doesn’t mention 988 at all. We want to protect the lifeline.”
The budget also suggests that states could replace some eliminated funds with block grants. However, those grants mainly serve people with serious mental illness and cannot be used for general suicide prevention.
2. Cuts to Overdose Prevention Programs Could Undermine Progress
The budget says the administration is “committed to fighting deadly drugs” but proposes eliminating the CDC’s National Center for Injury Prevention and Control, which handles overdose prevention. It also plans to merge the infectious disease and opioids programs with others, reducing their size and impact.
Advocates worry these cuts could undo gains in reducing overdose deaths. Hanna Sharif-Kazemi of the Drug Policy Alliance said the budget’s words don’t match its actions.
The proposal labels “harm reduction” strategies, such as providing sterile syringes to drug users, as “dangerous activities” and suggests federal funding should stop supporting them.
However, syringe service programs are proven to reduce diseases like HIV and hepatitis and do not increase drug use or crime. They also distribute naloxone, a life-saving overdose reversal drug, and connect people with food, housing, and treatment resources.
Without these programs, infectious diseases may spread more widely, harming the whole community, said Nestadt.
3. Deep NIH Research Cuts Could Worsen Health Disparities
Trump’s budget would slash nearly $18 billion from the National Institutes of Health (NIH) and eliminate centers like the National Institute on Minority and Health Disparities.
This move fits with Trump’s criticism of diversity, equity, and inclusion (DEI) programs, which he calls “woke” ideology.
Experts warn that these cuts could undermine efforts to reduce racial disparities in mental health and addiction. Though overall overdose deaths fell last year, rates rose among Black and Native American populations. Suicide rates are increasing faster for Black Americans than for white Americans, with different trends by group during the pandemic.
Nestadt explained that suicide prevention must be tailored to different communities. For example, reaching affluent populations may happen through doctors, but reaching urban Black teens might involve community places like churches or barbershops.
He is currently studying suicide among Black youth but fears his research funding could end soon.
What Comes Next?
No part of Trump’s budget proposals is final. Congress decides on federal spending.
Whitlock noted, “Congress will make its own decisions and may not accept everything.”
Senate Appropriations Committee Chair Susan Collins has expressed serious concerns about some cuts. When Health Secretary Robert F. Kennedy Jr. testified before Congress, some lawmakers opposed the administration’s plans. Representative Madeleine Dean urged the government to “help save more lives” by supporting effective programs instead of cutting them.
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