Layoffs hit Colorado programs for substance abuse and mental health services – Colorado Public Radio

Federal Agency Layoffs Threaten Progress on Sustainable Development Goal 3

Introduction: Setbacks for National Health and Well-being

Recent mass firings within the U.S. Department of Health and Human Services (HHS), particularly at the Substance Abuse and Mental Health Services Administration (SAMHSA), pose a significant threat to national progress on key Sustainable Development Goals (SDGs). According to U.S. Representative Brittany Pettersen, these reductions in force are dismantling critical systems established to combat the substance abuse crisis and support mental health, directly undermining the objectives of SDG 3: Good Health and Well-being.

Direct Challenges to SDG 3: Good Health and Well-being

The federal layoffs create immediate and severe obstacles to achieving specific targets within SDG 3. The dismantling of the workforce responsible for public health initiatives jeopardizes recent gains and future progress.

• Target 3.5 – Strengthen the prevention and treatment of substance abuse: SAMHSA, which has reportedly been reduced to half its size since the beginning of the year, is the primary federal agency overseeing funding and strategy for substance abuse treatment. The loss of approximately 125 employees in a recent reduction in force, on top of previous cuts, cripples the agency’s ability to administer grants and support state-level treatment and recovery programs. This action threatens to reverse the first recorded reduction in overdose deaths seen last year.
• Target 3.4 – Promote mental health and well-being: Representative Pettersen highlighted that the impact extends beyond substance abuse to general mental health services. In a state like Colorado, which has one of the highest suicide rates in the nation, the reduction of federal support systems for mental health, including services for students, represents a critical regression.
• Target 3.8 – Achieve universal health coverage: Concerns were raised about legislative actions, such as H.R. 1, which could reportedly remove the ability for states to use a Medicaid waiver to fund substance use disorder treatment. This policy change, combined with proposed cuts to Medicaid, directly conflicts with the goal of ensuring access to quality essential health-care services for all.

Cascading Effects on Multiple SDGs

The consequences of the federal actions extend beyond public health, impacting a broader range of Sustainable Development Goals.

1. SDG 10 (Reduced Inequalities): The erosion of federally funded health services disproportionately affects vulnerable populations who rely on programs like Medicaid. Limiting access to substance abuse and mental health treatment exacerbates health inequalities for low-income individuals and communities.
2. SDG 16 (Peace, Justice and Strong Institutions): The mass firings and withholding of grant funding weaken the effectiveness and accountability of key public institutions like HHS and SAMHSA. The inability to get responses or administer funds efficiently undermines the institutional capacity required to address national crises.
3. SDG 8 (Decent Work and Economic Growth): The termination of 1,100 to 1,200 HHS employees, including those at SAMHSA, represents a direct loss of stable employment, impacting the economic security of federal workers and their families.
4. SDG 17 (Partnerships for the Goals): The federal cuts disrupt the essential partnership between national and state governments. States like Colorado rely on federal grants and administrative support to implement health programs. Without a functional federal workforce to oversee and deliver this funding, state-level initiatives to build treatment capacity are at risk of collapse.

State-Level Consequences and Institutional Challenges

At the state level, the impact is already being felt. Colorado’s behavioral health experts have reported significant delays and a lack of staff capacity from federal agencies even before the latest layoffs. The state’s ability to fill the resulting funding gaps is severely limited by its own budgetary constraints, such as the Taxpayer Bill of Rights (TABOR). Representative Pettersen noted that the infrastructure for treatment and recovery, which took nearly a decade to build and increased treatment access from one in ten to nine in ten individuals seeking help, is now at risk of being completely decimated. Efforts by congressional members to demand a reversal of the layoffs have reportedly received no response from the administration.

SDGs Addressed in the Article

• SDG 3: Good Health and Well-being

  This goal is central to the article, which focuses on the negative impacts of federal layoffs and funding cuts on mental health services and substance abuse treatment. The discussion revolves around overdose deaths, suicide rates, and access to necessary healthcare for addiction and mental health disorders.

• SDG 16: Peace, Justice and Strong Institutions

  The article addresses this goal by highlighting the weakening of a key public institution, the Substance Abuse and Mental Health Services Administration (SAMHSA). The mass firings and reduction in staff capacity are described as “dismantling the very systems” needed to support public health, which relates to the effectiveness and accountability of government institutions.

Specific SDG Targets Identified

1. SDG 3: Good Health and Well-being

   • Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

     This target is relevant as the article explicitly mentions concerns over mental health services and suicide rates. Rep. Pettersen states, “it’s also mental health services. We have one of the highest suicide rates in the country.” The cuts to funding that support these services directly threaten progress on this target.

   • Target 3.5: Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.

     This is the most prominent target in the article. The entire discussion centers on the layoffs at SAMHSA, the federal agency responsible for this area. The article details the fight against fentanyl overdoses and the importance of federal grants for “substance use disorder treatment and recovery programs.” The layoffs are seen as undermining the recent progress made in reducing overdose deaths.

   • Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services…

     The article connects to this target by discussing access to care. Rep. Pettersen highlights a significant improvement in access, stating, “one out of 10 people who wanted treatment had access to treatment, and now we’re up to nine out of 10 people who want treatment have access.” The funding cuts and potential removal of a Medicaid waiver are presented as direct threats to this access, jeopardizing the principle of universal health coverage for those with substance use disorders.

2. SDG 16: Peace, Justice and Strong Institutions

   • Target 16.6: Develop effective, accountable and transparent institutions at all levels.

     The article directly addresses the weakening of a federal institution. It describes SAMHSA being reduced to “half their original size,” which has led to “huge delays” and a lack of “staff capacity to oversee the work.” This dismantling of the agency’s workforce undermines its effectiveness and its ability to implement programs and deliver critical funding and support to states, as Rep. Pettersen notes, “…if you are unwilling to have the workforce necessary to oversee these grants to support states… then it doesn’t matter.”

Indicators for Measuring Progress

1. Indicators for SDG 3

   • Suicide mortality rate (Implied by Target 3.4): The article directly references this indicator by stating, “We have one of the highest suicide rates in the country,” pointing to it as a key metric of mental well-being in the state.
   • Coverage of treatment interventions for substance use disorders (Indicator 3.5.1): This is explicitly mentioned with a quantifiable measure of progress. The article states that access to treatment improved from “one out of 10 people who wanted treatment” to “nine out of 10 people,” providing a clear indicator of service coverage.
   • Mortality rate due to substance abuse (Implied by Target 3.5): The article repeatedly refers to “overdose deaths” and “fentanyl overdoses.” The statement that “last year was the first time we started to see a decrease in fentanyl overdoses” uses this mortality rate as a key indicator of success or failure in addressing the substance abuse crisis.

2. Indicators for SDG 16

   • Effectiveness of government institutions (Implied by Target 16.6): The article provides several qualitative indicators of declining institutional effectiveness. These include the reduction of SAMHSA’s workforce to “half their original size,” “huge delays” in getting responses from the agency, and the inability to “oversee” and “implement” federal grants. These points serve as measures of the institution’s capacity to perform its functions.

Summary Table of SDGs, Targets, and Indicators

Source: cpr.org