In a political moment defined by division, it is telling that former Rep. Patrick Kennedy (D) and health secretary Robert F. Kennedy Jr. are attempting to find common ground on one issue: the urgent need to take mental health and addiction seriously as national priorities.
Despite the fact that mental health parity has been paused and Medicaid financing (responsible for more than a quarter of all behavioral health expenditures) is on the ropes, there are some promising recent developments on mental illness and addiction.
First, the Trump administration, following public outcry, restored $2 billion dollars of funding that had been chaotically cut from addiction and mental health services. Second, the administration launched the Great American Recovery Initiative, which signifies a potential commitment to addressing addiction as a chronic, treatable condition which requires coordination across federal agencies, awareness, and access to treatment.
The urgency for our nation’s leaders to act is underscored by sobering data. Suicide remains one of the leading causes of death for young people. Anxiety and depression among adolescents have risen sharply over the past decade. Alcohol-related deaths continue to climb while overdose deaths remain high, particularly in communities already facing economic and health disparities. The economic toll of mental illness and addiction now reaches hundreds of billions of dollars annually — costs borne by families, employers, health systems, and taxpayers.
In the discussion about this crisis, one fact is routinely overlooked: These conditions are often preventable in the first place. If the health secretary is serious about making America healthier, preventing behavioral health disorders is one place to start.
We recently worked on a National Academies of Sciences, Engineering, and Medicine (NASEM) report that lays out a clear blueprint for a national prevention infrastructure for mental and behavioral disorders. Prevention works — but only if it is adequately funded, coordinated, and sustained.
Research consistently shows that risk and protective factors are shaped early in life and embedded in families, schools, and communities. Adverse childhood experiences — including abuse, neglect, parental mental illness, and poverty — significantly increase the risk of later behavioral health disorders.
Conversely, evidence-based interventions such as nurse home-visiting programs, family-strengthening models, and school-based approaches like the Good Behavior Game have been shown to improve outcomes and reduce long-term costs.
Policies that strengthen families and schools — such as those related to nutrition, housing, and income support as well as regulation of consumer products with proven harm to children, like firearms and social media — are equally important.
These programs and policies are not experimental. They are proven. But they are also resource intensive. Effective prevention requires a trained workforce, technical assistance, data infrastructure, and long-term funding stability. Short-term grants and shifting federal priorities undermine the very objectives policymakers say they want to achieve.
Our report calls for more federal funding for state and local programming, not less. To fund prevention of behavioral health disorders, President Trump’s 2027 budget should increase funding for Health and Human Services agencies such as the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Administration for Children and Families.
Concurrently, the Centers for Medicare and Medicaid Services should encourage states to use Medicaid 1115 waivers to implement evidence-based approaches, focusing on school-based strategies and partnerships in community settings (such as schools, faith-based organizations, and aging services) that are implementing population-based universal interventions (e.g., environmental change, media campaigns).
Equally important, the White House should elevate prevention of behavioral health disorders to the same level of coordination afforded to other national priorities. The Great American Recovery Initiative offers a useful model, but its focus on addiction should be complemented by a permanent, senior-level White House mental health task force or coordinator. This role should be charged with aligning federal agencies, tracking outcomes, and ensuring that prevention, early intervention, and recovery supports are embedded across health, education, justice, and workforce policy.
Congress should also expand SAMHSA’s ability to support prevention efforts by either establishing a Center for Prevention of Behavioral Disorders that integrates the agency’s prevention activities, or by establishing a Center for Mental Health Promotion (equal to and working closely with the existing Center for Substance Abuse Prevention). The agency could further support states and localities by developing a centralized and dynamic clearinghouse that practitioners can use to find evidence-based programs, with standard criteria for inclusion and evaluation.
Ultimately, mental illness and addiction are not partisan issues. They are health and economic issues with deep repercussions for the productivity of our country, the readiness of our military and the well-being of our families and communities. Sustained funding and clear federal leadership are not luxuries; they are prerequisites for the competitiveness of our nation.
Marcella Alsan, M.D., Ph.D., is the director of the Health Inequality Lab and the Annie and Ned Lamont professor of international studies in the Department of Economics at Stanford University. Anand Parekh, M.D., M.P.H. is the chief health policy officer and adjunct professor of health management and policy at the University of Michigan School of Public Health.
