KFF Tracker: Trump Administration’s Mental Health and Substance Use Policies

KFF released a tracker on April 7, 2026, detailing federal policy actions regarding mental health and substance use during the second term of President Trump. The tracker monitors how federal priorities have shifted since the administration began in 2025.

The second Trump administration has emphasized law-and-order strategies and has scaled back several services related to substance use and mental health. However, the administration has also continued some initiatives focused on treatment.

Policy Tracking Categories

The KFF tracker organizes federal policy actions into several specific categories to allow for different methods of analysis, including chronological order. These categories include:

• Mental Health
• Opioids/Substance Use Disorder
• Federal Infrastructure/Data/Guidance
• Gun Violence

Public Health Context

These policy changes occur as the United States continues to manage significant mental health and substance use crises. In 2024, more than 61 million adults in the U.S. Experienced a mental illness.

During that same period, deaths resulting from drug overdoses, gun violence, and suicide remained high. The COVID-19 pandemic and the associated public health responses further exacerbated existing crises in substance use and mental health.

Barriers to treatment remain a primary concern for many individuals. Among insured adults who described their mental health as fair or poor, 43% reported at least one instance in the year preceding the April 7, 2026 report where they needed medication or mental health services but did not receive them.

The report notes that certain groups experience even greater barriers to care, specifically youth, young adults, and communities of color.

Evolution of Federal Policy

The current policy direction follows different approaches adopted by previous administrations. During the first Trump administration, the government passed the SUPPORT Act, which expanded overdose prevention and access to opioid treatment. That term also included the passage of legislation that created the 988 crisis hotline.

The subsequent Biden administration focused on strengthening federal agencies, including the Substance Abuse and Mental Health Administration (SAMHSA). Federal policies during the Biden term emphasized the implementation of evidence-based treatments, improving access to care, and expanding coverage.

Recent data indicates that some indicators related to mental health and opioids have either improved or stabilized.