Hotlines that have fielded millions of calls from people — including new mothers — looking for mental health support or to quit smoking are in limbo after federal officials fired the workers who oversaw them.
Employees were cut from offices that fund prevention work on the local, state, and tribal level. Those include hotlines like the Maternal Mental Health Hotline run by the Health Resources and Services Administration, and another to help smokers quit using tobacco.
The workers who oversee these hotlines make up a small sliver of the overall cuts to chronic disease work in the Department of Health and Human Services. But their responsibilities directly touch people in need of help: Those facing mental health crises, including new parents, and people who want to quit smoking. The hotlines, which are free and available 24/7, are readily accessible tools in a landscape where mental health and substance use treatment is often costly and difficult to come by.
It’s unclear what will happen to the national network of quit lines for smokers, since the CDC’s Office on Smoking and Health was gutted. HHS officials fired the people who oversaw contracts with states and ran quit lines in various languages, including Spanish, Korean, and Cantonese. Studies have shown the quit lines are effective at helping smokers stop using tobacco.
In a team meeting on the morning of the reduction-in-force, employees asked division heads about the fate of grant projects like the quit line. Their managers didn’t know. The remaining employees in the CDC’s chronic disease prevention branch could take on the hotline work, but it is not known if plans for such a transition exist.
“What is the effect on people’s health going to be when they try to call a number and it’s not funded?” said a former employee in the CDC’s population health division who asked to remain anonymous for fear of retribution.
At HRSA, multiple teams within the Maternal and Child Health Bureau were cut Tuesday. Some of those workers oversaw the Maternal Mental Health Hotline, which since 2022 has offered free professional counseling to pregnant and postpartum people. From October to December, the hotline received 7,500 calls and texts, according to HRSA data — a majority of those were from postpartum parents, many reporting depression, anxiety, or feeling overwhelmed.
The future of the hotline is up in the air. “It is very concerning,” former HRSA administrator Carole Johnson told STAT. A slimmer version of HRSA will be folded into the new Administration for a Healthy America, or AHA, according to HHS. STAT reached out to HHS for comment.
The 988 hotline for people in a mental health or substance use crisis is run through the Substance Abuse and Mental Health Services Administration, in partnership with states. It also connects to the Veterans Crisis Line. While many SAMHSA workers assigned to the hotline appear to have been spared from cuts that slashed 10% of the agency’s workforce, some advocates worry crisis response will backslide.
Suicide is a leading cause of death in the U.S., particularly among young people. Since the hotline launched mid-2022, 988 has received over 10 million calls, texts, and chats, according to a KFF analysis.
The mental health agency has given hundreds of grants to states, territories, and tribes to fund the program since 2022. Mental health and crisis response networks have also used other funds, such as Covid relief grants or Medicaid dollars, to pay for 988. Those streams could also be imperiled as the new administration makes sudden, sweeping changes. (Already, HHS is trying to claw back billions in Covid grants to state health departments.)
“If you start eliminating those funding streams, you’re gonna see a lot of challenges across the states in terms of crisis response and ability to support 988,” said Nev Jones, an associate professor at the University of Pittsburgh and a mental health services researcher.
Even before the cuts at HHS, a recent study found that the national rollout of 988 failed to make crisis services like mobile response units and emergency psychiatric walk-in services more available.
Shifts at the top — like folding the agency into AHA, as is the plan — could have other trickle-down effects. The new administration could push SAMHSA grant recipients away from a focus on equity (which the Biden administration championed), for example, or decide to reduce its scope of harm reduction work, experts told STAT. Leaders of 988 also stepped down or retired in recent weeks, leaving openings for people favored by Kennedy and his allies.
“What values, what principles, what kind of understanding of evidence-supported practice is going to guide how that money is spent?” Jones said.
Theresa Gaffney and O. Rose Broderick contributed reporting.
To reach the 988 Suicide & Crisis Lifeline, call or text 988 or chat 988lifeline.org. For TTY users: Use your preferred relay service or dial 711 then 988.
The Maternal Mental Health Hotline can be reached by phone or text at 1-833-TLC-MAMA (1-833-852-6262).
The national quit line can be reached at 1-800-QUIT-NOW (1-800-784-8669).
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.
