Election 2020: Where Trump and Biden Stand on Mental Health and Substance Use Issues

Amid the coronavirus pandemic, half of Americans report that their mental health has been negatively impacted due to related stress and worry. Many are, or will be, struggling with mental health challenges due to anxiety, social isolation, loss of loved ones, and job losses – potentially leading to increased mental health care needs over the long term.

A new issue brief examines where President Trump and Democratic presidential nominee Joe Biden stand on key aspects of the nation’s mental health and substance use challenges. Key points include:

• Opioid epidemic. President Trump declared a national public health emergency in 2017 and has renewed it repeatedly since then. His proposed 2021 budget would decrease total funding to the Substance Abuse and Mental Health Services Administration and to Medicaid, the nation’s largest payer for mental health services and main contributor for substance use disorder services. Vice President Biden’s campaign website features a five-point plan to address the opioid crisis that would increase access to services, curb unnecessary opioid prescriptions, and hold pharmaceutical companies accountable for their role in the crisis.
• Suicide prevention. Both candidates’ suicide prevention plans focus on veterans, with President Trump creating a task force to tackle the issue and proposing to boost the Veterans Administration (VA) budget for suicide prevention. Vice President Biden proposes to expand and strengthen veterans’ mental health programs inside and outside the VA, as well as strengthen programs aimed at reducing suicide among LGBTQ teenagers.
• Mental health parity. Vice President Biden’s campaign vows to redouble efforts to enforce existing mental health parity laws and expand funding for mental health, but has not offered specific plans. President Trump’s campaign website does not address mental health parity. His administration is seeking to overturn the Affordable Care Act, which would substantially limit the scope of parity rules.
• Mental health workforce. Neither candidate specifically addresses mental health workforce shortages on their campaign websites. However, President Trump’s 2021 budget proposal includes a 24% increase for behavior health workforce development programs, and Vice President Biden’s education plan would double the number of psychologists, counselors and other mental health professionals in schools.

The brief draws on each candidates’ campaign website, news coverage, public statements and budget proposals. It is part of KFF’s ongoing efforts to provide useful information related to the health policy issues relevant for the 2020 elections, including policy analysis, polling, and journalism. Find more on our Election 2020 resource page.

KFF also has compiled state-specific data on mental health and substance use on more than 20 indicators, with mental health state fact sheets available profiling each state, as well as an updated look at how the COVID-19 pandemic is affecting Americans’ mental health.