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Tracking Key Mental Health and Substance Use Policy Actions Under the Trump Administration

Our tracker lists and briefly describes key federal policy actions during President Trump’s second term that concern issues related to mental health and substance use.
The tracker, which is not meant to be exhaustive, can be viewed in multiple ways, including chronological order of policy actions and by category (Mental Health; Opioids/Substance Use Disorder; Federal Infrastructure/ Data/Guidance; and Gun Violence).

At the Three-Year Mark, Demand for the 988 Suicide & Crisis Lifeline Continues to Grow

Five Key Facts About People Experiencing Homelessness

The Impact of Gun Violence on Children and Adolescents

Mental Health and Substance Use State Fact Sheets

Access and coverage

  • Mental Health Parity at a Crossroads

    More than 25 years after the first federal mental health parity protections were put in place, adequate coverage for behavioral health care remains elusive. This brief explains the federal behavioral health parity requirements and sets out key policy issues.

  • Section 1115 Waiver Watch: Contingency Management

    Of the 800,000 Medicaid enrollees aged 12 to 64 with a diagnosed stimulant use disorder in 2019, about 20% were in states that now have approved 1115 Medicaid waivers for contingency management services.

  • The Landscape of School-Based Mental Health Services

    In the 2024-2025 school year, 18% of students utilized school-based mental health services. This issue brief explores the landscape of mental health services, including services offered, utilization, barriers, and funding, as well as recent federal actions.

  • 5 Key Facts about Medicaid Coverage for Adults with Mental Illness

    Nationwide, an estimated 52 million nonelderly adults live with mental illness, and Medicaid covers nearly one in three (29%) of them, or about 15 million adults.

  • What Federal Medicaid Cuts Could Mean for the Opioid Epidemic

    Medicaid covers 47% of all nonelderly adults with OUD and is the primary coverage source among those receiving treatment services. This brief offers a look at what federal Medicaid spending cuts could mean for this population.

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  • 5 Key Facts About Medicaid Coverage for Adults with Chronic Conditions

    Issue Brief

    Nearly three in four adults enrolled in Medicaid have one or more chronic conditions. Medicaid spending doubles for adults with 1-2 chronic conditions and quadruples for those with 3 or more chronic conditions. Low or no out-of-pocket costs for prescription medications in the Medicaid program help adults with chronic conditions avoid cost-related rationing or delays in prescription access. Uninsured adults were 2.5 times more likely than Medicaid-enrolled or privately insured adults to report skipping or delaying prescription medications due to cost.

  • Examining School Shootings at the National and State Level and Mental Health Implications

    Issue Brief

    According to the Washington Post, at least 390,000 students were exposed to a school shooting (exposure is defined as students attending a school at which a shooting occurred during the current school year) since the 1999 Columbine shooting. This brief analyzes the rate of student exposure to school shootings over time at the national and state level. Exposure rates depend on factors including school enrollment size and state population size. Therefore, even a single school shooting incident in a state can impact many youths beyond those that are physically injured and may significantly increase exposure rates.

  • 5 Key Facts About Medicaid Coverage for Adults with Mental Illness

    Issue Brief

    Nationwide, an estimated 52 million nonelderly adults live with mental illness, and Medicaid covers nearly one in three (29%) of them, or about 15 million adults. More than 1 in 3 Medicaid enrollees has a mental illness. Mental health treatment rates for Medicaid adults are higher than or similar to those with insurance.

  • A Look at Federal Health Data Taken Offline

    Policy Watch

    This post looks at federal government databases with key health data that went offline on Jan. 31, 2025, including several related to HIV, some of which had returned by Feb. 2, 2025. It briefly describing the affected databases, which include widely used, large-scale national health surveys, indices, and data dashboards, that inform research, policy making, and media coverage about health care and public health.

  • The Twin Problems of Mental Health Care: Access and Affordability

    From Drew Altman

    In this column, KFF President and CEO Drew Altman analyzes the serious access and affordability challenges facing people with mental health problems and suggests the issue could be one of a few candidates for bipartisan action in the next Congress.

  • Teens, Drugs, and Overdose: Contrasting Pre-Pandemic and Current Trends

    Issue Brief

    This brief analyzes the latest CDC data on adolescent overdose deaths, finding that from 2022 to 2023, there was a small reduction in overdose fatalities among adolescents (from 721 to 708 deaths). Additionally, the synthetic opioid, fentanyl, has largely driven the increase in adolescent drug fatalities since the pandemic began, accounting for 76% of these fatalities in 2023. This analysis also explores federal and state policy responses to the drug crisis, such as requirements to stock naloxone in schools, accountability for social media companies, and national prevention education efforts.