Alliance Alert: The Alliance for Rights and Recovery shares the serious concerns raised by advocates and leaders across the field in this Mental Health Weekly preview of 2026. The year ahead will be shaped by the fallout from major federal policy and funding changes enacted in 2025, including deep threats to Medicaid, housing, and SAMHSA-funded services that millions of people rely on to live and recover in the community.
As these changes begin to take effect, the Alliance will continue to push back against harmful policies that undermine access to community services, increase institutionalization, or shift costs onto states and communities without adequate resources. At the same time, we are actively working with New York State leaders and members of Congress to mitigate the most damaging impacts of these federal decisions and to protect community-based, voluntary, and recovery-oriented services wherever possible.
Looking ahead to 2026, we know there are additional harmful proposals on the horizon. The Alliance remains committed to stopping further negative changes, advancing peer-led and person-centered approaches, and ensuring that any changes do not come at the expense of dignity, access, or rights. We will continue to organize, advocate, and partner with stakeholders across the state and nation to defend and strengthen the behavioral health system New Yorkers need.
Field Cites Funding Strains, Urges Innovation in Care For 2026
Valerie A. Canady | Mental Health Weekly | January 6 2026
Editor’s Note: For our 2026 Special Preview Issue, we invited leaders, advocates and providers from across the mental health field to share the most pressing challenges and opportunities they expect to face in the year ahead — and how they plan to respond. Their insights are presented here. We are grateful for their thoughtful contributions and are pleased to share their insights with our readers as we look toward 2026. More to come next week.
Luke Sikinyi, vice president of public policy for the Alliance for Rights and Recovery:
As we look ahead to 2026, the Alliance for Rights and Recovery sees a defining year for the future of community-based mental health and substance use services. The most immediate challenge will be the federal funding fight, particularly as Congress debates a full-year budget amid proposals that would cut SAMHSA [Substance Abuse and Mental Health Services Administration] grant programs and fundamentally reshape housing investments. These decisions will have direct consequences for access to services, workforce stability and the ability of communities to respond to growing need.
Housing is a central concern. Proposed and litigated changes to HUD’s [The Department of Housing and Urban Development’s] Continuum of Care funding threaten permanent supportive housing and Housing First models that have proven effective in reducing homelessness, hospitalization and incarceration. At the same time, the current federal administration is signaling a shift toward coercive responses and institutionalization, including executive actions encouraging forced hospitalization and the criminalization of homelessness.
Despite these challenges, there are opportunities. Bipartisan efforts such as the reintroduction of the Peers in Medicare Act and reauthorization of the SUPPORT Act reflect growing recognition of peer-led, recovery-oriented services. In 2026, innovation must mean doubling down on voluntary, community-based and peer-informed approaches while resisting policies that move us backward toward institutionalization.
Debra L. Wentz, Ph.D., president and CEO of the New Jersey Association for Mental Health and Addiction Agencies, Inc.:
Marking its 75th anniversary in 2026, the New Jersey Association of Mental Health and Addiction Agencies, Inc. (NJAMHAA), with its legacy of impact, welcomes working with Governor-elect Mikie Sherrill and her new administration as an excellent opportunity to address the challenge of the continuing behavioral health care workforce crisis. Based on a discussion NJAMHAA had with Lieutenant Governor-elect Dr. Dale Caldwell, a leader in higher education, we anticipate support for workforce development including increased resources to recruit and retain all types of behavioral health care providers, a strong network of Certified Community Behavioral Health Clinics and truly integrated health care. These positive steps will help mitigate the negative impact of the dire ramifications of H.R.1.
The fiscal and regulatory landscape may very well lead to more of our smaller member organizations seeking mergers, affiliations or other types of partnerships with larger entities or health care systems to ensure viability and delivery of integrated care that addresses physical and behavioral health disorders, as well as the social determinants of health.
And all eyes will be focused on the refinement of the use of artificial intelligence, behavioral health apps and other technologies to improve outcomes and increase clinicians’ productivity and effectiveness in documentation, billing and personalized care without sacrificing the human factor.
While 2026 may be the most difficult year in decades for the behavioral health care field, NJAMHAA and our colleagues across the nation will use innovation, advocacy and creativity to overcome barriers and move forward with positive impacts for children, youth and adults.
Chuck Ingoglia, president and CEO, National Council for Mental Wellbeing:
The future of behavioral health is more uncertain than ever.
H.R.1, also known as the One Big Beautiful Bill, will cut Medicaid by more than $900 billion and decrease the number of people with health insurance by about 7.5 million people by 2034, according to the Congressional Budget Office. About 40 programs under the Substance Abuse and Mental Health Services Administration (SAMHSA) are on the chopping block.
Here’s the challenge for the behavioral health field: Because of the massive disruption these changes will cause, we must join together to tackle regulatory and reporting simplification and drive clinical innovation now.
We believe mental well-being is achievable for everyone — including individuals living with or recovering from a mental health or substance use challenge — and that it is the foundation for a strong, healthy and fulfilling life. But that won’t be possible unless we modernize our inefficient health care system. We can’t get distracted from this urgent goal to achieve modernization through innovation.
Nearly one-quarter of people surveyed say the country’s health care system is in crisis, according to a new Gallup poll (https://www.msn.com/en-us/politics/government/nearly-1-in-4-americans-say-the-us-health-care-system-is-in-crisis/ar-AA1SmI7u). They aren’t wrong. Our nation has ignored mental health and substance use challenges for far too long. We haven’t had the will to invest in evidence-based care that will help communities reduce suicides, overdoses or overdose deaths.
Now is the time for meaningful change. Long-overdue systemic changes that introduce simplification and innovation will result in a vastly more efficient continuum of care that benefits providers and patients and — perhaps mostly importantly — drives down costs.
But it won’t happen just because we want it to. As we begin the New Year, my appeal to organizations throughout the behavioral health field is to make a commitment and join this effort to embrace modernization. I look forward to a healthy dialogue on this important topic, so please reach out to me at ChuckI@TheNationalCouncil.org.
Joseph Rogers, founder and executive director, National Mental Health Consumers’ Self-Help Clearinghouse:
One of the biggest problems is the current administration’s lack of a coherent health care policy. President Trump has long promised to articulate a plan that would improve upon the Affordable Care Act; yet all we have seen are rollbacks and regulations that threaten individuals’ behavioral and physical health. More than 20 million Americans are facing huge increases in their insurance premiums, and some 4 million people will lose coverage, unless something happens to prevent this — which, at this writing, does not seem likely.
At the same time, the $1 trillion in Medicaid cuts in Trump’s “Big Beautiful Bill” will have an enormous impact on the more than 70 million people who depend on Medicaid, including those who are least able to survive such cuts: individuals with serious behavioral health challenges who are dependent on Medicaid for behavioral health and other health services.
Also, the Trump administration is contriving to destroy the SAMHSA. What could go wrong?
Meanwhile, we continue to organize and fight back and look forward to the chance to elect a Congress in 2026 that is more sensitive to the needs of people with serious and persistent behavioral health challenges.