The origins of SAMHSA (the Substance Abuse and Mental Health Services Administration) date to 1977 and 1981. In 1977, congressional hearings had made clear that the Community Mental Health Centers (CMHC) program under NIMH was failing badly to provide care for patients being discharged from state mental hospitals. To correct this, NIMH started the Community Support Program (CSP) with $3.5 million. The money was to be given to the states specifically to help coordinate services “for one particularly vulnerable population—adult psychiatric patients whose disabilities are severe and persistent.” By 1987, the CSP program had grown to $15 million. In its initial years, the CSP program did a reasonably good job.

In 1981, after Ronald Reagan became president, his administration terminated the federal CMHC program altogether. The federal funds that had been going to CMHCs were then block granted to the states by the 1981 Omnibus Budget Reconciliation Act. The CSP program and mental health block grant both remained as part of NIMH until 1992, at which time a decision was made to return NIMH, along with NIDA and NIAAA, to NIH, where they once had resided. Because NIH consists of purely research institutes, the parts of NIMH, NIDA and NIAAA that supported services did not belong there. Therefore, the NIMH CSP program and mental health block grant as well as the services parts of NIDA and NIAAA (including their block grant) were all put together into a new DHHS agency: the Substance Abuse and Mental Health Services Administration.

SAMHSA was thus born.