Ten years ago, Nancy Winmill\u2019s son survived an opioid overdose. In her search for support, she found almost nothing available in her Burley, Idaho community.\u00a0<\/p>\n
\u201cI had no idea what to do or where to go. I had no help. I had no resources,\u201d Winmill said.<\/p>\n
That experience pushed her to create what was missing: support groups, counseling, and eventually Simply Hope Family Outreach<\/a>\u2014a nonprofit for families struggling with addiction, codependency, divorce, grief, and suicide for rural southern Idaho. The organization has rapidly expanded due, in part, to funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) under the Building Communities of Recovery Grant (BCOR<\/a>).\u00a0<\/p>\n \u201cFor rural communities like ours in Cassia and Minidoka counties, where access to behavioral health and recovery services is already limited, this grant has been nothing short of transformational,\u201d Winmill said.\u00a0<\/p>\n But now, the grant that helped build this community lifeline is on the chopping block.\u00a0<\/p>\n The proposed FY2026 Department of Health and Human Services (DHHS) budget<\/a> would cut nearly $1 billion and dozens of programs from SAMHSA following a March announcement<\/a> that SAMHSA would be one of five agencies folded into a new, centralized Administration for a Healthy America. BCOR is one of the grants eliminated in the current budget proposal.\u00a0<\/p>\n \u201cIn a region where stigma still silences many, this grant has empowered us to bring these issues into the light, and offer pathways to healing and hope,\u201d Winmill said. \u201cEliminating this funding would not only stall progress, but potentially reverse hard-earned gains in recovery support for our rural neighbors.\u201d<\/p>\n Rural mental health stakes<\/strong><\/p>\n \u201cWe\u2019re not being extremist when we say that there is a mental health crisis in rural America,\u201d said Don Hannaford, vice president of public policy at Rural Minds<\/a>, a nonprofit advocating for rural mental health equity.\u00a0<\/p>\n Rural areas face a serious mental health care gap, with similar rates of mental illness as urban areas but nearly double<\/a> the suicide rate, fewer primary care providers, and slower workforce growth. Sixty-five percent of rural counties<\/a> lack a psychiatrist, 81 percent lack a psychiatric nurse practitioner, and 47 percent lack a psychologist.<\/p>\n Rural communities also face a 45 percent higher<\/a> opioid overdose rate than urban areas, yet only 14 percent of behavioral health facilities are rural, and fewer than half treat substance use disorders.<\/p>\n \u201cThe unmet need for treatment in many rural communities continues to outpace the treatment workforce and other resources available to rural communities,\u201d said Katherine McGuire, American Psychological Association\u2019s (APA) chief advocacy officer.<\/p>\n Michael Rosmann, a clinical psychologist and farmer in Iowa, said that while there has been meaningful growth in the behavioral health resources for farming communities, such as the Farm and Ranch Stress Assistance Network program (FRSAN), current federal cuts are jeopardizing this progress.\u00a0<\/p>\n \u201cWe\u2019re facing a pretty critical shortage of supply to meet the demand for assistance in the rural and agricultural communities,\u201d Rosmann said. \u201cFunds are becoming increasingly more difficult to access both at many state levels and the federal level because of cuts to SAMHSA and other funding cutbacks by DHHS.\u201d<\/p>\n Jonah Cunningham, executive director of the National Association for Rural Mental Health<\/a> (NARMH), a professional organization advancing rural behavioral health, said that SAMHSA grants have historically been a critical backbone to serving rural communities, offering opportunities to expand crisis services and connect more people to care.\u00a0<\/p>\n But the ongoing cuts and proposed restructuring put these foundational resources at risk.\u00a0<\/p>\n \u201cThe recent cuts to SAMHSA are an unnecessary disruption to the nation\u2019s capacity to respond to the ongoing mental health and addiction crises, particularly in rural communities,\u201d McGuire said.\u00a0\u00a0<\/p>\n Defunding \u201cPrograms of Regional and Nationals Significance<\/strong>\u201c<\/p>\n The proposed budget from DHHS defunds the vast majority of SAMHSA\u2019s Programs of Regional and National Significance (PRNS).\u00a0<\/p>\n PRNS are discretionary grants and initiatives that fund a wide range of mental health, substance abuse treatment, and prevention efforts, with most aimed at expanding services and some focused on training and technical assistance.<\/p>\n Cunningham said these programs are specifically designed to meet certain community needs.\u00a0<\/p>\n \u201cBehavioral health comes in all shapes and sizes,\u201d Cunningham said. \u201cThese grant programs are ways to build upon proven, evidence-based practices, expand them, and then also to respond to pressing issues.\u201d\u00a0<\/p>\n The BCOR grant is one of the dozens within PRNS up for elimination.\u00a0<\/p>\n While Simply Hope in Burley, Idaho, initially focused on teens, the SAMHSA BCOR grant allowed them to expand to include programming for adults, such as recovery coaching, sound therapy, walking groups, sober activity groups, case management, and more.\u00a0<\/p>\n The grant Simply Hope received was a three-year grant that distributed just under $300,000 each year. After spending the first year investing in program development, Project Director Sheri Allred is unsure what the future holds for Simply Hope\u2019s adult programming.\u00a0<\/p>\n \u201cWe were supposed to receive just under $300,000 for a second and third year,\u201d Allred said. \u201cAnd that\u2019s when we realized that we haven\u2019t gotten the approval for the continuation grant.\u201d<\/p>\n \u201cYou spend the first year building the program,\u201d Allred said. \u201cYou\u2019re in the third quarter or fourth quarter of the program, and you\u2019ve got all these projects going on, and then to have it stopped, we just have to go back to the drawing board and decide how we\u2019re going to fill that void if (the cut) does happen.\u201d\u00a0<\/p>\n Winmill said they recently used grant funds to hire a new counselor scheduled to start in July.\u00a0<\/p>\n \u201cI made a promise,\u201d Winmill said.\u00a0 \u201cShe left her job and she\u2019s coming over starting July first. It\u2019s concerning to me that they don\u2019t realize that there\u2019s people with families. It\u2019s stressful.\u201d<\/p>\n Another BCOR grant recipient in Minnesota, Recovery Alliance Duluth<\/a> (RAD), is facing similar uncertainty. Now in the first year of a three-year grant contract, RAD has received no word from SAMHSA about future funding and is eyeing the next phases of its grant-supported programming with a mix of hope and fear.<\/p>\n RAD has used its BCOR grant to expand and strengthen recovery support services across St. Louis and Carlton counties. The funding has enabled RAD to hire peer recovery support staff for five treatment courts<\/a>\u2014three of them in rural areas\u2014and to grow its outreach through community events and wellness programming. BCOR funds have also supported the development of a recovery alumni network and allowed RAD to offer free trauma-informed yoga and other wellness classes to people in recovery.<\/p>\n Jenny Swanson, executive director of RAD, said that if the BCOR grant gets eliminated, they will likely have to cut peer recovery support staff, end some of their wellness programming, reduce their community events, and not launch the alumni network.\u00a0<\/p>\n \u201cWhat\u2019s at stake is not having peer staffing in those treatment courts,\u201d Swanson said. \u201cIt\u2019s not having that peer being that voice of recovery-oriented, person-centered care, or being that one-on-one support when they need it\u201c<\/p>\n \u201cWe would definitely have to stop the whole wellness program immediately,\u201d Swanson added. \u201cThere\u2019s no way we can pay for those instructors and those passes without this grant and we also would have to not do the alumni program.\u201d<\/p>\n Swanson noted that while the grant is currently funding active programs in St. Louis and Carlton counties, it was also intended to support expanded services to two other rural counties, Lake and Cook, in the coming years. Now, not only is RAD at risk of losing critical services in its existing communities, but its planned expansion into Lake and Cook counties is also in question.\u00a0<\/p>\n
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