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Despite the administration’s cuts, there appears to be surprising agreement among people with divergent political beliefs that it’s time to expand services for those who are struggling.
The United States has been in the throes of a mental health and overdose crisis so severe it has spanned five presidential administrations and been classified as an official state of emergency in three of them. No one knows exactly how this emergency will play out during the current Trumpian cocktail of uncertainty, fear, and cuts to social services, but charts of the recent turbulence of the stock market suggest a relevant visual: Imagine the nervous systems of millions of already struggling Americans, along with millions more who are being pushed to the limits of what they can handle, all experiencing deep emotional crashes, briefly recovering, only to collapse again into new lows. And while it might be tempting to think that many of us aren’t affected by the present gut-wrenching emotional tumult because we appear fine and don’t seem to care about what’s happening to the more desperate among us, our recent research suggests that people do care—including, perhaps, those you’d least expect to do so.
Last year brought a widely reported piece of news in mental health. Overdose fatalities in the United States declined substantially, a notable but qualified victory. As overdose deaths fell 9% from 2021 to 2023 for white Americans, such deaths increased 12% for people of other races, according to a Reutersanalysis of data from the Centers for Disease Control and Prevention. Street drugs continue to kill more than 84,000 people in the United States annually, and overdoses remain the leading cause of death among Americans ages 18 to 44.
In such a devastating moment, in all corners of American society, people are in ever greater need of mental health services, just as funding for them is being slashed.
In other words, many young Americans and people of all ages attempt to numb difficult, even unbearable feelings, and sometimes that numbing is fatal. Depending on who you are, your preferred numbing agent might be wine, work, prescription pills, social media, street drugs, or something else entirely. But in the second age of Donald Trump, as well as long before him, all too many of us have been grappling with profound pain, whether from a sense of hopelessness about the future, oppression, trauma, grief, job loss, or general financial strain in ever more economically difficult times. Those among us who are not U.S. citizens are increasingly seized with the fear of being deported due to false, unknown, or unsubstantiated allegations and without due process. In addition to sowing terror, this has also been exacerbating an already widespread sense of loneliness, as people stay inside for fear of being detained.
Another source of despair is the urgent overseas humanitarian crisis over which noncitizens and legal permanent residents are now being seized, shackled, and imprisoned or disappeared for expressing moral protest. One (but not both) of the authors of this article has the protection of U.S. citizenship, although experts now question whether even citizenship will continue to provide protection, and so, for safety’s sake, we’re not naming that crisis or the widely shared sense of grief and powerlessness as men, women, and heartbreaking numbers of children die there. Students and people in all walks of life continue to take to the streets in protest, including the one of us who is a citizen.
Indeed, in such a devastating moment, in all corners of American society, people are in ever greater need of mental health services, just as funding for them is being slashed. May is Mental Health Awareness Month and so a ripe moment to take stock of the damage being done and to report that there appears to be surprising agreement among people with divergent political beliefs that it’s time to expand services for those who are struggling.
In late January, the Trump White House issued a vague memo that put a temporary freeze on the disbursement of federal financial assistance. By early February, NBC News had reported that some health clinics were closing their doors. Then, in March, the Trump administration announced the cancellation of more than $11 billion in funding to deal with addiction, mental health, and related issues. A federal judge subsequently halted that cancellation of funds, saying such a sudden termination caused “direct and irreparable harm to public health.” The Trump administration requested a stay of the order, with plans to appeal.
By mid-April, around the same time that Elon Musk’s DOGE took over responsibility for posting federal grant opportunities for the public, Reuters published an extensive investigation on the subject. It drew on interviews with dozens of experts to conclude that funding cuts and associated layoffs were “dismantling the carefully constructed health infrastructure that drove the number of overdose deaths down by tens of thousands last year.”
In Philadelphia, where one of the authors of this article resides, the Inquirerreported that a forensic research lab that tests the nation’s illicit drug supply for new and harmful substances hadn’t received crucial funds from the federal government. That, in turn, meant the furloughing of staff and a growing backlog of untested samples. If you’ve followed news about the evolving nature of illicit and counterfeit drugs, you know that novel and dangerous molecules are continually turning up in unexpected places, whether the veterinary sedative xylazine or the more potent medetomidine found in batches of fentanyl, or as deadly levels of nitazenes in seemingly innocuous pills. Slowing or halting drug-testing is a dangerous proposition.
Meanwhile, a Philadelphia outreach program run by Unity Recovery was recently forced to shut down, while its workers who had offered services in addiction, nutrition, and other kinds of healthcare suddenly lost their jobs. At the time of this writing, the organization’s website features a red warning symbol and the message: “Due to federal funding cuts enacted on March 24, 2025, Unity Recovery has lost critical access to resources to provide peer support services.” It also notes that “information is changing rapidly”—a nod to the fact that a judge halted the cancellation of funds and no one now knows exactly how the pending cuts will (or won’t) unfold.
And while there is supposedly stark disagreement between the Trumpist and non-Trumpist halves of this country about whether such cuts should be taking place at all, extensive data from the purple state of Pennsylvania suggests there is far more agreement than anyone might have guessed.
Over the past year, the two of us have worked on a research project that collected perspectives from thousands of Pennsylvanians about mental health, substance use, and the state’s criminal justice system. We also collected hundreds of surveys from Pennsylvanians who work in law enforcement and criminal justice. We guessed that such anonymous surveys would capture punitive viewpoints and a belief that people who use drugs should be put behind bars. And, yes, there was a bit of that, but to our surprise, on the whole, we found something quite different.
More than a quarter of Pennsylvanians said that, in recent years, they had become more sympathetic toward people who struggle with drugs or alcohol. A majority of the respondents identified stress and traumatic life events as a primary cause of problematic substance use. And most surprising of all, we found broad agreement on policy priorities across—yes, across—the political spectrum.
It’s notable that, in this purple state where the current president won more than 50% of the vote, there is majority support across the political spectrum for providing genuine assistance to people who need it.
Eighty-three percent of Pennsylvanians agreed that “addressing social problems such as homelessness, mental health, and substance use disorder” was a greater priority than “strengthening social order through more policing and greater enforcement of the laws.” That view was shared across political affiliations: 71% of respondents identifying as conservative agreed with it, as did 88% of those identifying as liberal.
Asked whether they agreed or disagreed with the statement, “It is in all our interests to give help and support to people who struggle with drugs and/or alcohol,” 68% of respondents identifying as conservative or very conservative agreed, as did 77% of liberal or very liberal respondents. Notably, there was majority support (61%) for increasing government spending for this cause. Even 54% of conservatives said they supported increasing spending to improve treatment and services for substance-use disorder.
We assumed that Americans who work in law enforcement and criminal justice would have more hardline views. Again, we were wrong. Compared with Pennsylvanians overall, over the past five years, those who work in the criminal justice system were—yes!—more likely to report feeling greater sympathy toward people who struggle with drugs or alcohol, and an overwhelming 70% of them believed that this society was obliged to provide them with treatment. Asked what services they believed could help prevent people struggling with substance use from becoming involved in the justice system, 71% said “more access to mental health treatment providers or services.”
Because much drug use in this country is criminalized, those who work in criminal justice are on the frontlines of our mental health crisis. These new findings suggest that, at least in Pennsylvania, justice system workers feel a responsibility to offer genuine help and see bolstering mental health services as the best way forward.
Of course, the opposite is happening. Yet it’s notable that, in this purple state where the current president won more than 50% of the vote, there is majority support across the political spectrum for providing genuine assistance to people who need it.
The ongoing axing of services will likely prove devastating. It leaves many feeling like there is nothing they can do. Yet, as individuals, count on one thing: We are not powerless (as we so often believe).
When life feels scary and uncertain, as it increasingly does in the Trump era, many people respond by thinking a lot about what might happen in their world and trying to anticipate the future in order to make plans and gain at least some minimal sense of control. Both authors of this article—one of us a doctor, the other a writer—struggle with our ruminations on the state and direction of this country, which can lead us deeper into anxiety and isolation.
And while we probably can’t escape those fearful feelings (and probably shouldn’t try to), we can at least stay in touch with others instead of giving in to the common urge to withdraw. That isn’t easy, of course. Both of us find ourselves struggling to pick up the phone. But this is a time when picking up that phone couldn’t be more important. A time when so much of our world is endangered is distinctly a moment to put special effort into looking out for one another and regularly experiencing the energy that comes from human connection.
We also understand that many Americans are living on the edge. We often don’t know who among our neighbors and loved ones is wrestling with the question of whether life is worth living. (Suicide rates remain high for Americans generally and especially for those with drug and alcohol use disorders.) Right now, there is a dire need for better services, but even if every person had access to quality mental healthcare, our actions as community members would still matter. It’s sometimes possible to save the life of someone you care about just by telling them you care.
Each of us, including you, has a role to play in keeping all of us alive and safe as best we can in ever more difficult times.
No one yet knows exactly how the Trump administration’s potentially staggering cuts to community healthcare and social services will unfold. But amid the chaos, people across this nation continue to do meaningful, lifesaving work.
The Drug Policy Alliance, a nonprofit outfit that seeks to prevent harms associated with drug use and drug criminalization, recently published a report entitled “From Crisis to Care.” It presents an intelligent roadmap for improving mental health and addressing substance use and homelessness, including investing in treatment options that are evidence-based and voluntary, as well as housing programs and community-based crisis response systems. These are anything but radical ideas. They’re grounded in research and can serve as a model for the future. Of course, funding and some political power will be necessary to accomplish such things, and that might sound farfetched in our current situation. But simple actions in the present make it more likely that such services will be launched in the future.
We can save a life by reaching out to friends and neighbors, and it’s no less important to recognize when we ourselves are struggling. Sometimes we worry about others without acknowledging that we, too, are on the edge. With that in mind, we’re writing the following words for you and every other reader but also for ourselves: When you’re struggling, contact someone you trust for support. By doing so, you’re also implicitly giving them permission to ask for help from you when they need it, and by giving and receiving help, you create a new pattern of reciprocity.
Such reciprocity has political significance. It fosters social cohesion, a precursor for coordinated action on a far larger sale.
The Trump and Musk hollowing out of the civilian government, while keeping the Pentagon budget at enormously high levels of funding, means the United States is well on its way to becoming the very “garrison state” that Eisenhower warned against.
Under the guise of efficiency, the Trump administration is taking a sledgehammer to essential programs and agencies that are the backbone of America’s civilian government. The virtual elimination of the U.S. Agency for International Development, or USAID, and plans to shut down the Department of Education are just the most visible examples of a campaign that includes layoffs of budget experts, public health officials, scientists, and other critical personnel whose work undergirds the daily operations of government and provides the basic services needed by businesses, families, and individuals alike. Many of those services can make the difference between solvency and poverty, health and illness, or even, in some cases, life and death for vulnerable populations.
The speed with which civilian programs and agencies are being slashed in the second Trump era gives away the true purpose of the Department of Government Efficiency (DOGE). In the context of the Musk-Trump regime, “efficiency” is a cover story for a greed-driven ideological campaign to radically reduce the size of government without regard for the human consequences.
The first two months of the Trump-Musk administration undoubtedly represent the most blatant power grab by the executive branch in the history of this republic.
So far, the only agency that seems to have escaped the ire of the DOGE is—don’t be shocked!—the Pentagon. After misleading headlines suggested that its topline would be cut by as much as 8% annually for the next five years as part of that supposed efficiency campaign, the real plan was revealed—finding savings in some parts of the Pentagon only to invest whatever money might be saved in—yes!—other military programs without any actual reductions in the department’s overall budget. Then, during a White House meeting with Israeli Prime Minister Benjamin Netanyahu on April 7, President Donald Trump announced that “we’re going to be approving a budget, and I’m proud to say, actually, the biggest one we’ve ever done for the military... $1 trillion. Nobody has seen anything like it.”
So far, cuts to make room for new kinds of military investments have been limited to the firing of civilian Pentagon employees and the dismantling of a number of internal strategy and research departments. Activities that funnel revenue to weapons contractors have barely been touched—hardly surprising given that Elon Musk himself presides over a significant Pentagon contractor, SpaceX.
The legitimacy of his role should, of course, be subject to question. After all, he’s an unelected billionaire with major government contracts who, in recent months, seemed to have garnered more power than the entire cabinet combined. But cabinet members are subject to Senate confirmation, as well as financial disclosure and conflict-of-interest rules. Not Musk, though. Not only hasn’t he been vetted by Congress, but he’s been allowed to maintain his role in SpaceX.
The Trump and Musk hollowing out of the civilian government, while keeping the Pentagon budget at enormously high levels of funding, means the United States is well on its way to becoming the very “garrison state” that President Dwight D. Eisenhower warned against in the early years of the Cold War. And mind you, all of that’s true before Republican hawks in Congress like Senate Armed Services Committee Chairman Roger Wicker (R-Miss.), who is seeking $100 billion more in Pentagon spending than its officials have asked for, even act.
What’s at stake, however, goes well beyond how the government spends its money. After all, such decisions are being accompanied by an assault on basic constitutional rights like freedom of speech and a campaign of mass deportations that already includes people with the legal right to remain in the United States. And that’s not to mention the bullying and financial blackmailing of universities, law firms, and major media outlets in an attempt to force them to bow down to the administration’s political preferences.
In fact, the first two months of the Trump-Musk administration undoubtedly represent the most blatant power grab by the executive branch in the history of this republic, a move that undermines our ability to preserve, no less expand, the fundamental rights that are supposed to be the guiding lights of American democracy. Those rights have, of course, been violated to one degree or another throughout this country’s history, but never like this. The current crackdown threatens to erase the hard-won victories of the civil rights, women’s rights, labor rights, immigrant rights, and LGBTQ rights movements that had brought this country closer to living up to its professed commitments to freedom, tolerance, and equality.
Back in 2019, right-wing populist and Trump buddy Steve Bannon told PBS “Frontline” that the key to a future victory was to increase the “muzzle velocity” of extremist policy changes, so that opponents of the MAGA movement wouldn’t even know what hit them. “All we have to do,” he said then, “is flood the zone. Every day we hit them with three things. They’ll bite on one, and we’ll get all of our stuff done. Bang, bang, bang. These guys will never—will never be able to recover. But we’ve got to start with muzzle velocity.”
The Trump/Musk administration is now implementing just such a strategy in a staggering fashion.
Despite a certain amount of noise about DOGE-driven efficiencies at the Pentagon, the department has indeed been spared the fate of civilian outfits like the Agency for International Development and the Department of Education, which have been either decimated or are slated for elimination altogether.
A proposal to lay off 60,000 civilian employees at the Pentagon will have harsh consequences for those expecting to lose their jobs, but it is only 5% of the department’s workforce of 700,000 government employees and another more than half a million individuals under contract. By contrast, the workforce of USAID, which offered a peaceful helping hand to countries around the world, was rapidly reduced from 10,000 to less than 300.
The goal is to Make America Unequal Again with an expansive program that could leave current levels of inequality, which already exceed those reached during the “Gilded Age” of the late 19th and early 20th century, in the proverbial dust.
In addition, the layoffs of research scientists and public health experts may prove to have disastrous consequences down the road by reducing the government’s ability to prevent or respond to infectious diseases and possible pandemics like new variants of Covid-19 or the bird flu. To compound the problem, the administration has ordered the firing of 1 in 5 employees at the Centers for Disease Control and Prevention (CDC), and is now pressing that agency to terminate more than one-third of its outside contracts.
In addition, the almost instant firing of independent government inspectors general, who were charged with overseeing government waste, fraud, and abuse, at the start of Trump’s second term in office bodes anything but well for policing an administration already awash in conflicts of interest. Worse yet, the freezing of actions by the civil rights division of the Justice Department will allow racial injustice to flourish without the slightest meaningful legal pushback.
Then there are the plans of both the Trump administration and House Republicans to slash programs from Medicaid to Social Security to the Supplemental Nutrition Assistance Program that serve tens of millions of Americans. In addition, there have already been staff cuts at the Social Security Administration, as well as steps taken to make it harder to apply for benefits there, and that’s undoubtedly just the beginning. In the future, there could be devastating direct benefit cuts to a program that serves more than 70 million Americans. And such crucial programs may, in their own fashion, end up on the chopping block, in part to make way for a planned multi-trillion-dollar tax cut geared mainly—you undoubtedly won’t be surprised to learn—to helping individuals at the high end of the income scale.
In short, the goal is to Make America Unequal Again with an expansive program that could leave current levels of inequality, which already exceed those reached during the “Gilded Age” of the late 19th and early 20th century, in the proverbial dust.
While most government agencies are either under siege or fear that they will be so in relatively short order, one agency has largely escaped the budget cutter’s knife: the Pentagon. In 2024, that agency (including nuclear warhead work done at the Department of Energy) already received an astonishing $915 billion, accounting for more than half of the federal government’s discretionary budget that year.
Meanwhile, as a New York Times analysis recently showed, the revenues of major weapons contractors have barely been touched. So far, General Dynamics (with a loss of less than 1%) and Leidos (with a loss of 7%) are the only firms among the top 10 weapons contractors to experience any kind of reduction in revenues from DOGE’s efforts.
One possible tradeoff within the Pentagon could be a move away from big platforms like aircraft carriers and piloted combat aircraft toward faster, nimbler, more easily produced systems based on applications of artificial intelligence, including swarms of drones. Elon Musk is already a longtime critic of Lockheed Martin’s F-35 fighter jet, which he’s slammed as “the worst military value for money” in the history of Pentagon procurement. His solution, however, is ever more advanced drones, presumably produced by his Silicon Valley allies.
But there is another possibility: The Pentagon might further boost its budget so that it can fund systems large and small, simultaneously feeding both the big contractors and the emerging military tech firms. After all, despite Musk’s critique, the president only recently announced that Boeing will produce a new plane, the F-47 (that “47” being—you guessed it!—in honor of America’s 47th president).
If there is a move toward tradeoffs between existing systems and new tech, both sides will have ample lobbying clout at their disposal. After all, the Silicon Valley crowd is literally embedded in the Trump administration from Musk to Vice President JD Vance, a protégé of Peter Thiel, the founder of the military-tech firm Palantir. Shortly after graduating from Yale Law School, Vance took a job at Mithril, a venture capital firm owned by Thiel. When Vance left that firm in 2019 to run for the Senate in Ohio, he did so with $15 million in backing from Thiel.
And Thiel is just one of the tech moguls backing Vance. An analysis by CBS Newsfound that:
Vance, a relative newcomer to national politics, has assiduously courted billionaires and Silicon Valley titans to bankroll his unlikely rise from bestselling memoirist of despair, drugs, and generational poverty in Appalachia to a ticket that could seat him a heartbeat away from the presidency.
The conservative New York Post summarized the state of play in an article headline in July 2024: “Silicon Valley Cheers Vance Pick as More Tech Billionaires Back Trump.” And keep in mind that Musk and Vance are not the only advocates for the military-tech sector embedded in the Trump administration. Stephen Feinberg, second-in-charge at the Pentagon, worked for Cerberus Capital, an investment firm that has a history of investing in the handgun and defense industries. And Michael Obadal, a senior director at Anduril, has been selected to serve as the deputy secretary of the Army. A recent analysis by Bloomberg, in fact, found that “more than a dozen people with ties to Thiel—including current and former employees of his companies, as well as people who have helped manage his fortune or benefited from his investments and charitable giving—have been folded into the Trump administration.”
For their part, the Big Five arms contractors, led by Lockheed Martin, still have a firm foothold in Congress, having made millions in campaign contributions, employed hundreds of lobbyists serving on commissions that influence military spending and strategy, and placed their facilities in a majority of the states and districts in the country. Even if some in the Pentagon tried to phase out the F-35, Congress might well add funds to that institution’s budget request to save the program.
Recent procurement decisions suggest that there may be a desire in both Congress and the Trump administration to finance traditional contractors and emerging tech firms alike. The two largest recent program announcements—Boeing’s selection as the prime contractor for that F-47 next generation combat aircraft and President Trump’s commitment to a “Golden Dome” defense system supposedly geared to protecting the entire United States from incoming missiles—will offer ample opportunities to both traditional arms firms and emerging military tech companies. The procurement phase of the F-47 program could cost up to $20 billion, but as Dan Grazier of the Stimson Center has noted, that $20 billion will be “just seed money. The total costs coming down the road will be hundreds of billions of dollars.” Meanwhile, General Atomics and Anduril are competing to build drone “wingmen” that would work in coordination with those future F-47s in battle situations.
At this point, President Trump’s Golden Dome isn’t a fully fleshed out concept, but count on one thing: Attempting to meet his goal of a comprehensive, leakproof defense against missiles would require building large numbers of interceptors and new military satellites woven together with advanced communications and targeting systems, at a potential cost over time of hundreds of billions of dollars. And while the big weapons firms may have an inside track on building the hardware for the Golden Dome, emerging tech firms are better positioned to produce the software, targeting, surveillance, and communications components of the system.
Golden Dome is poised to go forward despite the fact that, as Laura Grego of the Union of Concerned Scientists has asserted, “It has been long understood that defending against a sophisticated nuclear arsenal is technically and economically unfeasible.” But that reality won’t stem the flow of massive quantities of tax dollars into the project, no matter how unrealistic it may be, since profits from producing it will be all too realistic.
There are signs of growing resistance to the Musk-Trump agenda from lawsuits, to rallies against the oligarchy led by Sen. Bernie Sanders (I-Vt.) and Rep. Alexandria Ocasio-Cortez (D-N.Y.), to a boycott of Musk’s Tesla automobiles. Such efforts will need to be supplemented by the involvement of millions more people, including Trump supporters hurt by his cuts to essential programs that had helped them stay above water financially. The outcome of all this may be uncertain, but the stakes simply couldn’t be higher.
The Pentagon’s deep over-reliance on private corporations not only wastes billions of taxpayer dollars, but also feeds conflicts and contributes to weapons proliferation.
With an annual budget rapidly approaching $1 trillion, the Pentagon already gets more discretionary tax dollars than any other agency.
Now congressional Republicans are proposing to hike that figure by anywhere from $100 billion to $150 billion—while slashing funding for programs like Medicaid, SNAP, and other programs that help keep Americans on their feet.
Lawmakers have it backwards: We need to invest more in those programs and less in the Pentagon, which simply can’t account for how it’s spending our money.
We have to curb our endless spending on the military—and put that money back into our real needs, like creating jobs, educating students, protecting our planet, and much more.
Late last year, the Pentagon failed its mandatory audit—yet again.
This isn’t the first time this has happened, either—in fact, the Pentagon has failed every audit it’s ever undergone. According to the Project on Government Oversight, the Defense Department is the only department to have achieved consistent failure over nearly 35 years of government audits. Quite the achievement.
While the Pentagon may not know where its money goes, we do know that about half of its budget each year goes to private, for-profit military contractors. The Pentagon’s deep over-reliance on these corporations not only wastes billions of taxpayer dollars, but also feeds conflicts and contributes to weapons proliferation. Ultimately, this creates a fundamentally less secure world.
Much of the Pentagon’s operations and personnel have been outsourced to “private military contractors,” or PMCs. The use of PMCs exploded during the Iraq and Afghanistan Wars—by 2019, there were 1.5 times as many contractors on the ground in the Middle East as U.S. troops.
These corporations have turned our tax dollars into their private slush fund with rampant waste, fraud, and abuse.
Take for instance the time in 2020 when the Pentagon paid over $52,000 for a trashcan. Or when a Pentagon contractor made a 9,400% profit margin off of a half-inch metal pin. Last year, reports emerged that Pentagon contractor Boeing made almost $1 million in profit just from overcharging for spare parts on C-17 cargo planes, such as soap dispensers.
There are countless examples of Pentagon contractors defrauding American taxpayers like this, and yet we keep writing them bigger and bigger checks. And the wealthier these companies and their executives get, the easier it is for them to throw their weight around in government.
Look at Elon Musk, President Trump’s chief billionaire backer and the one he charged with rooting out “waste” from the government.
Musk, the wealthiest oligarch on the planet, has many glaring conflicts of interest as he meddles in the U.S. government. Not the least of which: He’s a Pentagon contractor CEO himself, through his company SpaceX.
Contractor fraud isn’t going away—in fact, it will only get worse with the most recent Pentagon budget’s loosened restrictions on how these companies can spend taxpayer dollars. Despite this, there is little political will to crack down on the companies that are bleeding taxpayers dry.
Our politicians can’t just allow the Pentagon to fail audit after audit forever. We have to curb our endless spending on the military—and put that money back into our real needs, like creating jobs, educating students, protecting our planet, and much more.
Targeting companies that make billions ripping off taxpayers is a perfect place to start.