This article is the latest in the Health Affairs Forefront featured topic, “Health Policy at a Crossroads,” produced with the support of the Commonwealth Fund and the Robert Wood Johnson Foundation.

del Vecchio is former SAMHSA executive officer. At the age of 23, after years of mental health problems, addictions, and trauma, I found myself on a Philadelphia subway platform ready to end my life.

The country's main mental health agency, the Substance Abuse and Mental Health Administration, commonly known as SAMHSA, is in the process of being dissolved. It has lost more than a third of its ...