More than a decade on the front lines of the addiction and mental health crisis has taught me to be skeptical of good news. But the latest numbers are hard to argue with. For the first time since fentanyl flooded this country, fewer Americans are dying. Overdose deaths fell 27 percent in 2024, and CDC data shows they have now dropped for a third straight year, from a peak of more than 110,000 in 2023 to roughly 70,000. Those numbers are mothers, sons and neighbors who are alive today.

None of it happened by accident. It took years of relentless work by families, advocates and public health professionals. We put naloxone everywhere. We cut treatment waitlists. We expanded harm reduction. And most of it was possible because of federal programs that are finally paying off.

That is why June’s big announcement rang so hollow. Health and Human Services Secretary Robert F. Kennedy Jr. announced “over $700 million” in funding for addiction and mental illness. The money was not new. As STAT News reported, it was the long-delayed release of grants Congress had already authorized. The administration was claiming credit for progress built under President Biden.

Just as we are gaining ground, Washington is tearing up the foundation beneath us. The 2025 reconciliation law cuts more than $900 billion from Medicaid, the largest payer for mental health and addiction treatment in the country. An estimated 10 million people will lose coverage. In January, HHS abruptly canceled more than $2 billion in behavioral health grants, then reversed itself within 24 hours after public outcry. You cannot defund the ambulance and take credit for the rescue.

And this is the worst possible moment to pull back. Household budgets are already stretched, with inflation running above the Federal Reserve’s target and tariffs costing families an extra $900 to $1,500 a year. J.P. Morgan puts the odds of a recession before 2027 at 35 percent. More than a third of adults say they have delayed or skipped care because of cost. When money gets tight, mental health care is the first thing families give up and the last thing they get back.

We have seen this before. When manufacturing collapsed across the Midwest and Northeast, we lost more than jobs. We lost lives. Economists Anne Case and Angus Deaton called them “deaths of despair”: the overdoses, suicides and alcohol-related deaths that followed working-class job loss. When an auto plant closes in a small town, opioid deaths in that town rise. Economic pain becomes psychiatric pain, and ignoring the first guarantees we pay for the second. We are paying already.

Mental illness drains an estimated $282 billion from the economy every year. The opioid epidemic costs roughly $1.5 trillion a year in hospitalizations, incarceration, foster care and funerals, the wreckage of untreated illness rather than the treatment itself. Yet when Washington decides something matters, billions appear overnight. The Pentagon has committed an estimated $29 billion to the war with Iran so far, and independent estimates put the final bill above $200 billion. For a fraction of that, we could rebuild the entire behavioral health system and get more for every dollar.

We cannot keep patching a broken system. We need to rebuild it, the way the original New Deal built highways and electrified rural America. A New Deal for mental health and addiction starts with the workforce: pay therapists, counselors and peer specialists a living wage, speed up licensure and enforce the parity laws that require insurers to cover this care like any other. More than 137 million Americans live in areas without enough mental health providers. Many who have insurance run into “ghost networks,” directories full of providers who never return a call. Groups like Inseparable have already mapped the solutions. What is missing is the will to fund them.

It also means embracing technology. Telehealth knocked down the two biggest barriers to care almost overnight: distance and weeks-long waits. After sustained pressure from the National Alliance on Mental Illness and the recovery community, federal regulators finalized rules allowing providers to start treatment for opioid use disorder by video, including prescribing medications like Suboxone.

Bicycle Health, which calls itself the country’s largest telehealth provider focused on opioid use disorder, has treated more than 50,000 patients. None of this happens without voters demanding it. In a recent Change Research survey, 82 percent of Americans said politicians talk about mental health too little, and 63 percent, including 70 percent of women, said they are more likely to back a candidate who makes it a top-three priority, a view shared by 82 percent of Democrats and 72 percent of Republicans. Mental health is a kitchen-table issue hiding in plain sight, and the midterms are the moment to demand concrete plans before the next downturn hits.

We know what saves lives because we have watched it work. Now we need to elect leaders willing to finish the job with a New Deal for mental health and addiction.

Ryan Hampton is a nationally recognized recovery advocate and author who has organized for more than a decade on addiction and mental health policy. He is a 2026 TIME100 Health honoree.