The current administration’s cuts to mental health funding are serious business, not only because so many of its other actions are causing mental anguish for countless Americans, but also because mental health investment works: Early intervention can prevent a psychological struggle from developing into a full-blown crisis. As Robert Kuttner of The American Prospect put it recently, “Trump’s Republicans are not only promoting lunatic policies. They are literally promoting mental illness.”
In the midst of the current situation, the American Psychiatric Association Foundation remains relatively unscathed. The APA Foundation is the philanthropic arm of the American Psychiatric Association (APA), the nearly 40,000-member organization of the nation’s physician psychiatrists. The APA Foundation aims to promote the mental health and wellbeing of individuals and communities.
Founded in 1991, it runs a handful of public-facing programs, working in schools and faith communities, at the workplace, alongside the justice system, and with athletes and the entertainment industry. It also funds 200 bi-annual fellowships for psychiatric residents, supported in part through its $60 million endowment, and raises an additional $2.5 to $3.5 million each year for its other grantmaking programs. These include MOORE Equity Grants, which provide up to $10,000 to community organizations running mental health awareness and/or service programs for young people of color, and $5,000 “Helping Hands” grants for mental health projects at medical schools, particularly in underserved communities. It also offers numerous awards to individuals and community organizations.
The APA Foundation held its annual fundraising gala at the tail end of the APA’s Annual Meeting this past May. The Annual Meeting is a massive, multiday affair, held at the Los Angeles Convention Center this year. (This year’s theme, “Lifestyle for Positive Mental and Physical Health,” seemed particularly appropriate for Los Angeles, where wellness is a way of life for many.)
Only a small part of the foundation’s funding comes from the federal government, making it resilient in this moment of crisis. This is good news for the field of psychiatry and communities the foundation reaches.
Some grantee partners, though, are being squeezed, including one that helps train judges and psychiatrists who work together on cases with a mental health component. “That program had a cut in its funding,” said Amy Porfiri, APA Foundation’s managing director, “but we can keep them fully funded to do this particular program. We are not directly impacted to a large extent.”
Supporting new psychiatrists and those who (maybe) need to see them
The foundation’s flagship fellowship program began in 1974 under the APA, prior to the foundation’s actual inception, to develop the pipeline of future leaders in the field. Fellows sit on APA councils of experts in specific topics, work with mentors and attend meetings, including the big annual meeting.
For nonpsychiatrists, the main interface with the foundation is likely through one of its public-facing programs, such as “Notice. Talk. Act,” which helps train school administrators, workplace leaders and others to notice when someone may be struggling and intervene in an appropriate way. “It’s the ‘stop, drop and roll’ of mental health,” said APA Foundation Executive Director Rawle Andrews Jr. “You learn to notice signs of distress in people who are off their usual behavior and to ask about it. It makes you a better observer and listener. Then ‘act’ means knowing culturally sensitive tools and resources to get someone to a clinician, if they need that. Maybe they don’t. Maybe just talking is enough.”
The workplace version, “Notice. Talk. Act at Work,” reached 150,000 employees in 2024, according to the foundation. It has been so successful that the program is now being offered in 10 languages. This is a fee-based service, meaning that it brings in revenue for the foundation, rather than tapping its resources. The foundation reports an impressive 99% reduction in major mental health events recorded by pilot schools trained in “Notice. Talk. Act. at School.”
Other programs involve partnerships with public agencies and public-adjacent organizations, including the Washington, D.C., office of the attorney general and the Council of State Governments. The foundation also has mental health initiatives with The Defensive Line, Hope Center Harlem and Athletes for Hope, which Mia Hamm cofounded in 2007 with Muhammad Ali, Cal Ripken Jr. and Andre Agassi, as my colleague Ade Adeniji has reported.
Helping faith communities expand their mental wellness toolkit
In some religious congregations, stigma around mental health issues remains. The foundation aims to address this. “We were seeing some communities of faith where it was taboo to talk about mental health. The idea was that maybe if you were more devout, if you prayed more, you wouldn’t feel as badly as you do,” Andrews said.
This attitude started to change somewhat during the pandemic. To step into what seemed like a new opening, the APA Foundation created an updated version of its 2014 faith guide. The guide also deals with pastoral fatigue and compassion fatigue and encourages medical doctors to consider the role of faith as one part of a patient’s healing journey. “We recognize that nearly 75% of folk in the U.S. believe faith is a material component of their healing journey,” Andrews said.
The pandemic “created a watershed moment, where many people became more aware of and more open to these moments,” Andrews went on. “People stopped saying what we used to hear in faith communities, ‘I’m too blessed to be stressed.’ You’re looking at them, and you’re like, ‘You seem pretty stressed.’ We’re really seeing a lot of progress being made.”
Porfiri, who has worked in the mental health space for more than 20 years, agrees that the conversation has shifted. “Twenty years ago, you wouldn’t be open with your colleague or supervisor about your personal mental health. Now, especially with COVID and post-COVID, it’s more part of the normal conversation. I’ve seen that improve so much,” she said.
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Support for those facing the lingering impacts of crises
The APA Foundation funds mental illness prevention in other ways, too — such as by staying connected to those who have faced natural disasters, even after the news media has moved on. During this year’s APA Annual Meeting in L.A., for example, the foundation presented a $10,000 check to the Los Angeles County Fire Department Peer Support Program, which supports behavioral health awareness, resilience and critical incident stress management for firefighters and firefighter paramedics who have had a traumatic call.
“The long-term mental health effects of natural disasters are often overlooked. Our role isn’t to go in right away, but to wait and see where the mental health support is needed,” Andrews said.
The long-term logistical impacts of disasters can also impede progress on mental health. “In North Carolina and L.A., our members are reaching out to us, saying things like, ‘We’re OK, but we lost our computers. We lost Wi-Fi and can’t treat our patients,’” Andrews said. The APA Foundation helps with these sorts of issues, too.
The future of mental health in a nation on orange alert
We’ve been covering ways that philanthropy has begun stepping up, at least somewhat, to address the nation’s mental health crisis. We’ve reported on commitments to youth mental health, for example, including efforts to hold the tech sector accountable. But modest increases in funder support will only go so far, as advocacy organizations like Mindful Philanthropy have pointed out, calling for “greater collaboration and bigger and bolder bets” through the year 2035 and beyond. Organizations like the APA Foundation will likely see more demand for their services, requiring a lot more funder support and creative collaboration.
The Trump administration’s attack on mental health programs is an evolving crisis, one that makes mental health support more important than ever. As Andrews put it, “Five years ago, we were asking, ‘how did we get here and how do we get out of here?’ Now, we’re asking the same question. We’re looking for avenues and portals to get relief. Wars that can’t end. A new administration creating unpredictability around employment. Will I have a job next week? Graduation is coming; people are afraid to go to graduation; will they be mistaken for someone they’re not? These kinds of drivers create anxiety and depression.”
Porfiri said the field should respond creatively, especially given the fact that there was already a lack of providers in certain communities, including rural ones. “We talk about the mental health crisis, but it’s also an opportunity for the field to train more providers, create collaborations with primary care providers, and practice in a way that opens up more access for people. The national conversation around mental health is helping. There are more and more places where mental health is being addressed.”
