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Trump Is Straining Our Mental Health Then Gutting Support Services
Despite the administration’s cuts, there appears to be surprising agreement among people with divergent political beliefs that it’s time to expand services for those who are struggling.
Apr 27, 2025
The United States has been in the throes of a mental health and overdose crisis so severe it has spanned five presidential administrations and been classified as an official state of emergency in three of them. No one knows exactly how this emergency will play out during the current Trumpian cocktail of uncertainty, fear, and cuts to social services, but charts of the recent turbulence of the stock market suggest a relevant visual: Imagine the nervous systems of millions of already struggling Americans, along with millions more who are being pushed to the limits of what they can handle, all experiencing deep emotional crashes, briefly recovering, only to collapse again into new lows. And while it might be tempting to think that many of us aren’t affected by the present gut-wrenching emotional tumult because we appear fine and don’t seem to care about what’s happening to the more desperate among us, our recent research suggests that people do care—including, perhaps, those you’d least expect to do so.
Last year brought a widely reported piece of news in mental health. Overdose fatalities in the United States declined substantially, a notable but qualified victory. As overdose deaths fell 9% from 2021 to 2023 for white Americans, such deaths increased 12% for people of other races, according to a Reutersanalysis of data from the Centers for Disease Control and Prevention. Street drugs continue to kill more than 84,000 people in the United States annually, and overdoses remain the leading cause of death among Americans ages 18 to 44.
In such a devastating moment, in all corners of American society, people are in ever greater need of mental health services, just as funding for them is being slashed.
In other words, many young Americans and people of all ages attempt to numb difficult, even unbearable feelings, and sometimes that numbing is fatal. Depending on who you are, your preferred numbing agent might be wine, work, prescription pills, social media, street drugs, or something else entirely. But in the second age of Donald Trump, as well as long before him, all too many of us have been grappling with profound pain, whether from a sense of hopelessness about the future, oppression, trauma, grief, job loss, or general financial strain in ever more economically difficult times. Those among us who are not U.S. citizens are increasingly seized with the fear of being deported due to false, unknown, or unsubstantiated allegations and without due process. In addition to sowing terror, this has also been exacerbating an already widespread sense of loneliness, as people stay inside for fear of being detained.
Another source of despair is the urgent overseas humanitarian crisis over which noncitizens and legal permanent residents are now being seized, shackled, and imprisoned or disappeared for expressing moral protest. One (but not both) of the authors of this article has the protection of U.S. citizenship, although experts now question whether even citizenship will continue to provide protection, and so, for safety’s sake, we’re not naming that crisis or the widely shared sense of grief and powerlessness as men, women, and heartbreaking numbers of children die there. Students and people in all walks of life continue to take to the streets in protest, including the one of us who is a citizen.
Indeed, in such a devastating moment, in all corners of American society, people are in ever greater need of mental health services, just as funding for them is being slashed. May is Mental Health Awareness Month and so a ripe moment to take stock of the damage being done and to report that there appears to be surprising agreement among people with divergent political beliefs that it’s time to expand services for those who are struggling.
Dismantled?
In late January, the Trump White House issued a vague memo that put a temporary freeze on the disbursement of federal financial assistance. By early February, NBC News had reported that some health clinics were closing their doors. Then, in March, the Trump administration announced the cancellation of more than $11 billion in funding to deal with addiction, mental health, and related issues. A federal judge subsequently halted that cancellation of funds, saying such a sudden termination caused “direct and irreparable harm to public health.” The Trump administration requested a stay of the order, with plans to appeal.
By mid-April, around the same time that Elon Musk’s DOGE took over responsibility for posting federal grant opportunities for the public, Reuters published an extensive investigation on the subject. It drew on interviews with dozens of experts to conclude that funding cuts and associated layoffs were “dismantling the carefully constructed health infrastructure that drove the number of overdose deaths down by tens of thousands last year.”
In Philadelphia, where one of the authors of this article resides, the Inquirerreported that a forensic research lab that tests the nation’s illicit drug supply for new and harmful substances hadn’t received crucial funds from the federal government. That, in turn, meant the furloughing of staff and a growing backlog of untested samples. If you’ve followed news about the evolving nature of illicit and counterfeit drugs, you know that novel and dangerous molecules are continually turning up in unexpected places, whether the veterinary sedative xylazine or the more potent medetomidine found in batches of fentanyl, or as deadly levels of nitazenes in seemingly innocuous pills. Slowing or halting drug-testing is a dangerous proposition.
Meanwhile, a Philadelphia outreach program run by Unity Recovery was recently forced to shut down, while its workers who had offered services in addiction, nutrition, and other kinds of healthcare suddenly lost their jobs. At the time of this writing, the organization’s website features a red warning symbol and the message: “Due to federal funding cuts enacted on March 24, 2025, Unity Recovery has lost critical access to resources to provide peer support services.” It also notes that “information is changing rapidly”—a nod to the fact that a judge halted the cancellation of funds and no one now knows exactly how the pending cuts will (or won’t) unfold.
And while there is supposedly stark disagreement between the Trumpist and non-Trumpist halves of this country about whether such cuts should be taking place at all, extensive data from the purple state of Pennsylvania suggests there is far more agreement than anyone might have guessed.
“It Is in All Our Interests to Give Help and Support”
Over the past year, the two of us have worked on a research project that collected perspectives from thousands of Pennsylvanians about mental health, substance use, and the state’s criminal justice system. We also collected hundreds of surveys from Pennsylvanians who work in law enforcement and criminal justice. We guessed that such anonymous surveys would capture punitive viewpoints and a belief that people who use drugs should be put behind bars. And, yes, there was a bit of that, but to our surprise, on the whole, we found something quite different.
More than a quarter of Pennsylvanians said that, in recent years, they had become more sympathetic toward people who struggle with drugs or alcohol. A majority of the respondents identified stress and traumatic life events as a primary cause of problematic substance use. And most surprising of all, we found broad agreement on policy priorities across—yes, across—the political spectrum.
It’s notable that, in this purple state where the current president won more than 50% of the vote, there is majority support across the political spectrum for providing genuine assistance to people who need it.
Eighty-three percent of Pennsylvanians agreed that “addressing social problems such as homelessness, mental health, and substance use disorder” was a greater priority than “strengthening social order through more policing and greater enforcement of the laws.” That view was shared across political affiliations: 71% of respondents identifying as conservative agreed with it, as did 88% of those identifying as liberal.
Asked whether they agreed or disagreed with the statement, “It is in all our interests to give help and support to people who struggle with drugs and/or alcohol,” 68% of respondents identifying as conservative or very conservative agreed, as did 77% of liberal or very liberal respondents. Notably, there was majority support (61%) for increasing government spending for this cause. Even 54% of conservatives said they supported increasing spending to improve treatment and services for substance-use disorder.
We assumed that Americans who work in law enforcement and criminal justice would have more hardline views. Again, we were wrong. Compared with Pennsylvanians overall, over the past five years, those who work in the criminal justice system were—yes!—more likely to report feeling greater sympathy toward people who struggle with drugs or alcohol, and an overwhelming 70% of them believed that this society was obliged to provide them with treatment. Asked what services they believed could help prevent people struggling with substance use from becoming involved in the justice system, 71% said “more access to mental health treatment providers or services.”
Because much drug use in this country is criminalized, those who work in criminal justice are on the frontlines of our mental health crisis. These new findings suggest that, at least in Pennsylvania, justice system workers feel a responsibility to offer genuine help and see bolstering mental health services as the best way forward.
Of course, the opposite is happening. Yet it’s notable that, in this purple state where the current president won more than 50% of the vote, there is majority support across the political spectrum for providing genuine assistance to people who need it.
The ongoing axing of services will likely prove devastating. It leaves many feeling like there is nothing they can do. Yet, as individuals, count on one thing: We are not powerless (as we so often believe).
Looking Out for Others
When life feels scary and uncertain, as it increasingly does in the Trump era, many people respond by thinking a lot about what might happen in their world and trying to anticipate the future in order to make plans and gain at least some minimal sense of control. Both authors of this article—one of us a doctor, the other a writer—struggle with our ruminations on the state and direction of this country, which can lead us deeper into anxiety and isolation.
And while we probably can’t escape those fearful feelings (and probably shouldn’t try to), we can at least stay in touch with others instead of giving in to the common urge to withdraw. That isn’t easy, of course. Both of us find ourselves struggling to pick up the phone. But this is a time when picking up that phone couldn’t be more important. A time when so much of our world is endangered is distinctly a moment to put special effort into looking out for one another and regularly experiencing the energy that comes from human connection.
We also understand that many Americans are living on the edge. We often don’t know who among our neighbors and loved ones is wrestling with the question of whether life is worth living. (Suicide rates remain high for Americans generally and especially for those with drug and alcohol use disorders.) Right now, there is a dire need for better services, but even if every person had access to quality mental healthcare, our actions as community members would still matter. It’s sometimes possible to save the life of someone you care about just by telling them you care.
Each of us, including you, has a role to play in keeping all of us alive and safe as best we can in ever more difficult times.
From Crisis to Care
No one yet knows exactly how the Trump administration’s potentially staggering cuts to community healthcare and social services will unfold. But amid the chaos, people across this nation continue to do meaningful, lifesaving work.
The Drug Policy Alliance, a nonprofit outfit that seeks to prevent harms associated with drug use and drug criminalization, recently published a report entitled “From Crisis to Care.” It presents an intelligent roadmap for improving mental health and addressing substance use and homelessness, including investing in treatment options that are evidence-based and voluntary, as well as housing programs and community-based crisis response systems. These are anything but radical ideas. They’re grounded in research and can serve as a model for the future. Of course, funding and some political power will be necessary to accomplish such things, and that might sound farfetched in our current situation. But simple actions in the present make it more likely that such services will be launched in the future.
We can save a life by reaching out to friends and neighbors, and it’s no less important to recognize when we ourselves are struggling. Sometimes we worry about others without acknowledging that we, too, are on the edge. With that in mind, we’re writing the following words for you and every other reader but also for ourselves: When you’re struggling, contact someone you trust for support. By doing so, you’re also implicitly giving them permission to ask for help from you when they need it, and by giving and receiving help, you create a new pattern of reciprocity.
Such reciprocity has political significance. It fosters social cohesion, a precursor for coordinated action on a far larger sale.
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Trump Pledges to 'Vigorously Pursue the Death Penalty'
"In the last six months of his first term, President Trump executed 13 individuals—more than any administration in 120 years," one critic noted.
Dec 24, 2024
Republican U.S. President-elect Donald Trump vowed Tuesday that his administration will "vigorously" use capital punishment as part of his "make America safe again" agenda, despite copious evidence that the death penalty does not deter crime, is racially biased, and results in wrongful executions.
Responding to Democratic President Joe Biden's Monday commutation of 37 federal death sentences—an action that cannot be reversed—Trump took to his Truth Social platform to condemn the move.
"Joe Biden just commuted the Death Sentence on 37 of the worst killers in our Country," Trump fumed. "When you hear the acts of each, you won't believe that he did this. Makes no sense. Relatives and friends are further devastated. They can't believe this is happening!"
"As soon as I am inaugurated, I will direct the Justice Department to vigorously pursue the death penalty to protect American families and children from violent rapists, murderers, and monsters," Trump said in a separate Truth Social post. "We will be a Nation of Law and Order again!"
ACLU executive director Anthony Romero called Biden's move "the most consequential step of any president in our history to address the immoral and unconstitutional harms of capital punishment" and a bulwark against Trump, who "has a proven penchant and track record of conducting rushed executions."
"In the last six months of his first term, President Trump executed 13 individuals—more than any administration in 120 years," Romero noted.
Death penalty foes are particularly worried about Trump's campaign promise to seek federal death sentences for crimes other than murder.
"When I am back in the White House, I will immediately end the Biden border nightmare that traffickers are using to exploit vulnerable women and children," Trump said in July 2023. "I will urge Congress to ensure that anyone caught trafficking children across our border receives the death penalty immediately."
There is a higher likelihood of a compliant Congress given Republicans will control both the Senate and House of Representatives.
"We're going to be asking everyone who sells drugs, gets caught selling drugs, to receive the death penalty for their heinous acts," Trump said earlier while announcing his 2024 run for president.
During his first term, Trump praised then-Philippines President Rodrigo Duterte, who oversaw the extrajudicial execution of thousands of drug dealers and users, for doing "an unbelievable job on the drug problem."
In 1994, then-President Bill Clinton signed into law the Violent Crime Control and Law Enforcement Act—commonly known as the Crime Bill—which expanded the federal death penalty to approximately 60 crimes, including three that do not involve murder: espionage, treason, and large-scale drug trafficking. In addition to Republicans and mainstream Democrats like Biden, then a senator, the legislation had the support of progressives including then-Rep. Bernie Sanders (I-Vt.).
Trump's enthusiastic embrace of capital punishment comes amid an international and national trend toward abolition. Twenty-three U.S. states and the District of Columbia have abolished the death penalty, while five other states have gubernatorial holds on executions. In 2021, Biden's Justice Department paused federal executions.
However, Biden never succeeded in his campaign goal of pushing Congress to end the federal death penalty and2024 also saw a
surge in executions in Republican-controlled states.
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Big Pharma Drug Patent Abuses Cost Medicare Billions: Report
"As CMS negotiates the prices Medicare will pay for top-selling drugs, it should take into account the billions we've already lost due to these patenting tactics," said one researcher.
Dec 11, 2024
When the Inflation Reduction Act became law in 2022, it included a historic provision that gave the Centers for Medicare and Medicaid Services (CMS) the ability to negotiate maximum fair prices for select drugs. This means that CMS now has an important tool to resist high prices imposed by pharmaceutical companies and lower the cost that Medicare recipients pay for their drugs. So far, Medicare has negotiated the maximum fair prices for 10 drugs, which will go into effect January 1, 2026.
But according to a report released Wednesday by the watchdog group Public Citizen, the manufacturers behind these drugs are able to rely on another method to protect their profits: patent abuses and evergreening tactics.
The report defines "evergreening tactics" as the practice of "patenting trivial and/or obvious modifications of existing medications to lengthen exclusivity on branded medicines."
The makers of the drugs Eliquis, Imbruvica, Jardiance, Farxiga, and Entresto, for example, obtained patents on what constitute trivial or minor changes to earlier patent claims, "such as crystalline forms of drug compounds which would be discovered and managed during routine testing that is part of the drug approval process," according to Public Citizen. These new patents allow the manufacturers to extend their monopoly on these drugs.
"Big Pharma patent abuse is cheating Medicare enrollees of more affordable drugs and costing taxpayers billions," said Public Citizen Access to Medicines program researcher Jishian Ravinthiran in a statement.
"Patent abuses enable Big Pharma companies to unfairly extend their monopolies and keep prices artificially high. As CMS negotiates the prices Medicare will pay for top-selling drugs, it should take into account the billions we've already lost due to these patenting tactics," he added.
The report makes this same point, arguing that the agency's initial offers on pharmaceuticals should take into account how long-monopoly drugs have been able to obtain longtime exclusivities on medicines by manipulating patents.
This is paramount, Public Citizen argues, given the scope of lost savings. The group estimates that Medicare will lose somewhere between $4.9 and $5.4 billion in savings that should have accrued to taxpayers if four out of the 10 drugs did not take advantage of patenting tactics, and therefore would have faced greater competition prior to negotiation.
"These lost savings are nearly as much as what Medicare is expected to save if negotiated prices go into effect on all of the selected drugs in the first year of the program ($6 billion)," according to the report.
As an example, the drug etanercept, which is marketed as Enbrel, is on the list of 10 drugs that will be subject to a negotiated cap come January 2026. Etanercept's maker Amgen did not contribute to the original research and development of etanercept, per Public Citizen, it just acquired the original maker of the drug, Immunex, in 2002.
Immunex's patent of etanercept was set to expire in 2019, but "by using abusive patent practices" Amgen was able to extend the patent protections through 2029, according to Public Citizen. Amgen was able to evade competition of two potential "biosimilar" competitors, Erelzi and Eticovo, which received FDA approval in the 2010s.
Referencing analysis done in a separate report, Public Citizen estimated "that biosimilars could have entered the market after August 2019 were it not for Amgen's unwarranted patent exclusivities, and we calculated Medicare would have spent $1,891,500,836 less on a net basis had enrollees been able to use lower-cost alternatives by the time negotiated prices go into effect on January 1, 2026."
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