Alliance Alert: As we approach the beginning of a new federal administration and the start of many states’ legislative sessions, leaders in mental health services across the nation have been preparing for a year which will bring many opportunities and challenges for expanding effective services to support more people with mental health challenges. On Monday, Mental Health Weekly released their 2025 Special Preview issue in which national leaders, including the Alliance’s CEO, Harvey Rosenthal, weighed in on what they see as the most pressing issues for this year. Some areas discussed included advancing peer support, fighting calls for increased forced treatment, uncertainties around Medicaid and Medicare funding, addressing workforce challenges, and investing in more community-based services. Read below to learn more.
Funding, Policy Changes, Workforce Needs Lead 2025 Concerns
Mental Health Weekly | January 6, 2025
Editor’s note: For our 2025 Special Preview Issue, we asked our readers to tell us about their post-election expectations and about the challenges and opportunities that await them this year and plans for addressing them.
Here are some of their comments. More will appear in next week’s issue.
Debra L. Wentz, Ph.D., president and CEO of the New Jersey Association of Mental Health and Addiction Agencies, Inc., (NJAMHAA) and executive director of the New Jersey Mental Health Institute:
The challenges and opportunities the New Jersey Association of Men-tal Health and Addiction Agencies (NJAMHAA) faces in 2025 are significant and it will be like surfing in tumultuous waters or even a tsunami! With policy and funding changes expected from the new administration in Washington, an ongoing workforce shortage, New Jersey facing a structural budget deficit, and behavioral health services beginning to be transitioned to managed care Jan. 1, 2025 with anticipated administrative, cash flow and staffing burdens, NJAMHAA has been and will continue to “ride out the chop,” strongly advocating for investment and flexibilities in treatment and supports. Our many requests are described in our latest campaign publication, Untold Stories — Why Access to Care Must Be the Highest Priority. While opportunities are also plentiful, they too offer challenges as payers, providers and regulators adopt artificial intelligence (AI), work to improve cybersecurity and experiment with home health care as well as new technologies such as remote monitoring. Yet unknown possibilities may also come from the new administration. As the tumultuous local, state and federal environment brings new challenges, NJAMHAA and its members will continue to adapt, always focused on optimum outcomes for the individuals served, fighting stigma and moving the system forward with equity — metaphorically seeking the perfect wave!
Joseph Rogers, founder and executive director for the National Mental Health Consumers’ Self-Help Clearinghouse:
Over the next four years, we should be prepared to work as much as possible at the federal level, but we should look to the state level to keep the ball moving forward. The biggest challenge at the federal level is how the incoming administration might tinker with Medicare, Medicaid, and other federal entitlement programs, which could cause serious problems. We must be ready to fight for those programs; so, we must take this opportunity to grow the consumer/survivor movement and use it as an instrument of resistance and change. We know from our history that, when we organize, we can have a great impact on the policies and programs that affect us.
In fact, I believe we are going to see a general shift from advocating on the federal level to the state level. Mental health policy, services, and structure are mostly at the state program level anyway; so, working to elect state-level candidates who support our issues should become more important. We should pay more attention to moving state funds into community programming and less into large institutions that cost lots of money and do little to help people. What we accomplished in Pennsylvania is a good model.
Harvey Rosenthal, CEO of the Alliance for Rights and Recovery (formerly NYAPRS):
I don’t think I’ve ever seen us being faced with such a disparate mix of bright advances and dark challenges as I do today. Over the past year, we have continued to see steady increases in the public’s willingness to acknowledge the profound impact of mental health, addiction and trauma in both people’s personal lives and in state and national policy. The focus has decidedly moved to promoting wellness tools, recovery pathways and more holistic approaches that address health-related social needs and to promote what’s now being called ‘social care.’
Peer led recovery and crisis innovations are taking hold everywhere in both the public and private sector and clubhouses are coming back across the nation. There’s a greater [emphasis] on strategies that promote meaningful engagement and that help divert people from avoidable emergency room visits, arrests, hospitalizations and incarceration. CMS [Centers for Medicare and Medicaid Services] has been willing to fund services that address the social determinants of health and forensic re-entry services and the Department of Justice has successfully sued states that failed to send mental health workers in advance or in place of police personnel at times of crisis.
At the same time, a climate of rising fear, anger and acts of violence has led policy makers and the public to look for easy answers and quick solutions and so, once more, our people are being scapegoated and targeted as threats to public safety who should be subjected to the increased use of coercive inpatient and outpatient and a rebuilding of hospital beds and the institutions of the past. Fearful of being viewed as ‘soft on crime,’ public leaders, political parties and media outlets that once promoted self-determination and prized human rights are looking at lowering inpatient commitment criteria and, here in New York, authorizing more classes of practitioners to facilitate involuntary admissions.
And recovery and disability rights advocates fear that the incoming administration will fundamentally reverse a great deal of the progress we’ve made as a community and field and at key federal agencies including CMS, SAMHSA [Substance Abuse and Mental Health Services Administration] and the U.S. Department of Justice.
At its best, peer support is about sharing our fears and our pain and working together to foster hope, healing, dignity, freedom and shared power. We’ll need to come together and give each other a lot of peer support in 2025 to protect and promote all of the very good things we have successfully accomplished over the past decades.
Sabrina Trocchi, Ph.D., MPA, president and CEO of Wheeler Health:
Looking ahead to 2025, we face persistent challenges and new opportunities that require thoughtful preparation and focus. A primary concern is anticipating funding and reimbursement trends amid a new governmental landscape. Whether as community-based, grant-funded providers or federally qualified health centers (FQHCs), organizations like ours are navigating an era where long-term planning often feels like an informed guess, requiring strategic decision-making, agility, and focus on our values.
National trends demand attention. From serving vulnerable populations like undocumented residents to addressing LGBTQIA-affirming care and women’s health, FQHCs face complex questions about how necessary care aligns with federal and state frameworks. Our values remain our compass — why we chose health care as a career, transitioned to an FQHC model, and remain committed to equitable, integrated care.
As demand for services rises, we must scale and sustain access and quality. Wheeler’s integrated model of primary and behavioral health care positions us well, but staying ahead in care management and innovation will be critical. Recruiting, retaining, and compensating a skilled, compassionate workforce remains a daily challenge. Pandemic-era workforce shifts and increasing competition require us to align with what employees value most in 2025. To succeed, we must embrace resilience, innovation, and our principles. We remain hopeful.