Beltway Update is an occasional column keeping you up to date on timely Congressional and administrative action on mental and behavioral health bills and policy in Washington, DC.

With less than a month until the new 2025 Fiscal Year begins Oct. 1, Congress is back in Washington after members split time during the summer between the campaign trail and a hectic round of committee work. Full markups in the relevant House and Senate committees that control appropriations for health, education and workforce issues were included in the flurry of activity.

While there is still a way to go until the FY 2025 appropriations process is finalized, the bill language reveals important details on mental health funding priorities in each chamber, with the Democratic-controlled Senate committee proposing $15.2 billion more than the Republican House committee in spending on health and mental health.

Here are the details on the proposed funding from each.

The Senate

The Senate FY 2025 Labor and Health and Human Services bill set overall funding at $198.66 billion, a 2.2%  increase above the FY 2024 enacted levels. The committee proposes providing the Substance Abuse and Mental Health Services Administration (SAMHSA) total funding of $7.55 billion, a 1.4% increase over FY 2024 levels. Within the SAMHSA portfolio, mental health programs are funded at $2.9 billion, representing a 3.3% increase from last year.

Specifically, the bill includes:

• $2.05 billion for Substance Use Prevention, Treatment, and Recovery Services Block Grant, a $40 million increase over FY 2024
• $1.6 billion for State Opioid Response Grants, a $25 million increase
• $1.04 billion for the Community Mental Health Block Grant, a $35 million increase. Each state must continue to devote at least 5% of its grant to build out crisis care services.
• $540 million for the 988 Suicide & Crisis Lifeline, a $20 million increase
• $400 million for Certified Community Behavioral Health Clinics, a $15 million increase
• $55.9 million for Primary and Behavioral Health Care Integration program, the same level as FY 2024
• $30.2 million for National Strategy for Suicide Prevention, a $2 million increase
• $26.2 million for the Zero Suicide program, continuing the FY 2024 level, plus $2 million for a new suicide prevention pilot aimed at older adults for FY 2025
• $27.9 million for Mental Health Awareness Training, maintaining the 2024 level
• $30 million for Mental Health Crisis Response Grants, a $10 million increase

The House

Much like last fiscal year, the House Appropriations Committee bill made cuts across these same agencies, proposing overall funding of $185.8 billion, a 4% reduction from FY 2024. While the Substance Abuse and Mental Health Services Administration (SAMHSA) would get $7.54 billion, a 1.3% increase over last year, mental health programs within SAMHSA are funded at $2.68 billion, representing a 5% decrease.

Specifically, the bill includes:

• $2.51 billion for Substance Use Prevention, Treatment, and Recovery Services Block Grant, a $500 million increase above the FY 2024 level
• $1.58 billion for State Opioid Response Grants, continuing last year’s level
• $1.02 billion for the Community Mental Health Block Grant, a $15 million increase. As in the Senate, each state must devote at least 5% of its grant to build out crisis care services
• $520 million for the 988 Suicide & Crisis Lifeline, continuing the FY 2024 enacted level
• $385 million for Certified Community Behavioral Health Clinics, continuing the FY 2024 enacted level
• $55.9 million for Primary and Behavioral Health Care Integration program, continuing the FY 2024 enacted level
• $29.2 million for National Strategy for Suicide Prevention, a $1 million increase
• $27.2 million for Zero Suicide Program, a $1 million increase

Notably, the House proposes to eliminate these programs entirely:

• Mental Health Awareness Training, funded at $29.7 million in FY 2024
• Mental Health Crisis Response Grants, funded at $20 million in FY 2024

What could be next for FY 2025?

MindSite News readers will recall that a similar chasm between chambers occurred early in the FY 2024 appropriations process. Despite this, the final FY 2024 bill signed into law earlier this year contained largely consistent mental health spending levels from the year before. So, what’s different this year? The answer is simple: a presidential election. 

When those elections roll around every four years, the use of continuing resolutions (CRs) to keep the federal government open on a short-term basis becomes even more popular. Congress is now busy negotiating a CR and aims to pass it before the Oct. 1 deadline. The CR will likely delay funding discussions at least until after the election, since a month-long recess will also begin in October.   

Specifics on final funding levels, possible vehicles for the appropriations bills and overall timing will all be fiercely debated and determined after the country decides who they will send to Congress in 2025 and who will be the new resident of the White House.

Sarah Corcoran is senior vice president & chief operating officer at Guide Consulting Services (GCS), a government relations consulting practice based in Washington, DC. GCS represents mental health providers, technology companies, patient advocacy organizations and state mental health agencies before Congress and the administration. A complete list of GCS clients can be found here.