Research psychiatrist and Treatment Advocacy Center founder E. Fuller Torrey has called for federal budget cutters to abolish the agency charged with seeing that mental health and addiction services are delivered to those who need them the most. The Substance Abuse and Mental Health Services Administration (SAMHSA), Dr. Torrey wrote in the June 20 issue of National Review that SAMHSA “is a federal health agency distinguished by the fact that the health of its clients would improve if it went out of business.” He has called on members of Congress to examine the use of taxpayer dollars to oppose treatment law reform for mental illness and for frivolous programs and activities. 

To learn more:   

• Read Dr. Torrey Takes Questions About SAMHSA 
  • Watch Dr. Torrey presenting the “Worst Government Agency Award” “for spending millions of taxpayer dollars while making problems worse instead of better” (3:42).
    • Hear a reading of Dr. Torrey's June 2011 article, "Bureaucratic Insanity" or read the full text in National Review.       

WHAT IS SAMSHA? 
SAMHSA (Substance Abuse and Mental Health Services Administration) is an agency of the federal Department of Health and Human Services. It is located in Rockville, Maryland, has 537 employees and a budget of $3.4 billion. Its official mission is to reduce "the impact of substance abuse and mental illness on America's communities." Pamela S. Hyde, a lawyer, is the administrator. 

WHere did SAMHSA come from? 
SAMHSA’s origins go back to the 1970s and a federal program that was initiated to coordinate services for one particularly vulnerable population—adult psychiatric patients whose disabilities are severe and persistent. After several reformulations, it emerged in 1992 as the organization it is today. (Learn more about the history of SAMHSA here.)

WHY DOES THE tREATMENT ADVOCACY cENTER CRITICIZE SAMHSA?

Untreated severe mental illnesses such as schizophrenia and severe bipolar disorder have a devastating impact on communities. SAMHSA’s current funding priorities do not adequately address this impact or the desperate needs of people unable to seek treatment for these disorders. Moreover, SAMHSA provides support for state campaigns to raise the legal barriers to needed treatment. In other words, SAMHSA is making matters worse, not better. Here’s how:

1. SAMHSA ignores people with the most serious mental illness. In its 41,000-word long-term plan for the next half-decade, SAMHSA makes not one reference to schizophrenia, schizoaffective disorder or bipolar disorder. In other words, there is nothing in SAMHSA's planning that addresses the brain diseases that most impair mental health.
2. SAMHSA funds organizations that actively defend cruelly restrictive treatment laws and fights reform efforts to improve them. Organizations in Maine, Vermont, California, Florida, New Mexico, Pennsylvania and other states receive millions of dollars in SAMHSA subsidies and then actively fight assisted outpatient treatment (AOT) laws, improved “need for treatment” standards, and the effective use of these laws. These activities are carried out despite laws prohibiting the use of federal monies for lobbying that thwarts treatment for people with persistent mental illness. (See “Lawyers Who Break the Law: What Congress Can Do to Prevent Mental Health Patient Advocates from Violating Federal Legislation” by attorney Amanda Peters for information.)
3. SAMHSA wastes money for frivolous, duplicative, administrative and other activities that would be better spent on treatment. Sen. Tom Coburn’s (R-OK) July 1991 “Back in Black” report to Congress said, “The entire SAMHSA agency should be folded into (another federal agency) in order to reduce duplication and establish a more appropriate and strategic public health approach to addiction and mental health disease. Consolidating these two agencies will save taxpayers significant funds – SAMHSA’s salary and expenses totaled $342 million in 2011.” (Read Sen. Coburn’s recommendations for SAMHSA here.) 
4. SAMHSA’s activities have failed to reduce the impact of mental illness on our communities. Since SAMHSA’s formation in 1992:

• Homelessness among individuals with severe mental illness has increased.
• Incarceration of mental illness through the incarceration of individuals with severe psychiatric disorders has increased.
• Suicide rates among individuals with severe mental illness have increased. Violent episodes caused by individuals with untreated severe mental illness have increased
• Costs for government programs such as SSI, SSDI, Medicaid and Medicare for individuals with severe mental illness have increased sharply.
• Treatment options for individuals with severe mental illness have decreased. 

It is not uncommon for ineffective agencies to be restructured. In fact, SAMSHA was created when previous ineffective agencies were restructured. Any of the roles SAMSHA plays that directly address mental health and substance abuse could be appropriately and more competently handled by the National Institute of Health. States and counties could continue to administer important services funded by block grants.

In the current environment when every government program and service is being scrutinized, it makes sense to hold accountable any agency that spends taxpayer dollars making life worse for the population Congress originally set out to protect.