As we recognized the 2nd anniversary of enacting statewide Medicaid expansion, which provides coverage to 3,000 people in Cheshire County, it is important also to recognize that we still have important health and mental health care issues needing attention. Keene Sentinel articles have informed us of people falling through our health care, mental health and human services systems.  Additional perspectives come from Cheshire County professionals about how we can improve mental health and human services in NH.  

We currently spend a lot of money putting band aids on symptoms without dealing with the root causes of income, home, and food insecurities.  Frequently, these symptoms are connected to a substance use disorders, mental illness, abusive relationships, learning disabilities and disrupted education and often they co-exist.  We need to go beyond patching the symptoms and to a more systematic approach to helping people overcome the pain from root causes; it’s not a dash to the finish line it’s about restoring belief in oneself and that change is possible.


As the problem of substance use disorders increases it becomes more evident there is a shortage of people trained to work on these issues. Staffing levels are affected by:

  • low earnings,
  • high burn-out rates from unrealistic workloads, and
  • a lack of certification and degree programs to fill current openings.

Area mental health, healthcare, corrections and human service professionals provide some valuable ideas for us to consider:


1) Review NH's licensing requirements for healthcare and substance use disorder counselors, and accept reciprocity of licensure/certification from other states. Professionals in the field believe NH takes too long, and newly qualified personnel are going elsewhere for work.


2)  Create more in-state educational opportunities for certificate and degree programs that provide health-care, mental health and human services personnel.  

3) Expand model programs, like Southwestern Community Services’ Coordinated Access Provider Program (CAPP), a 24/7 hotline providing Trained Recovery Coaches within one hour of emergency responders coming to assist users.


4) Begin Substance Use Education at earlier ages and reach out to family’s of youngsters who experience the stress of a household in need of help.


5) Offer alternatives to incarceration, such as drug court programs, transitions to work and more health-trained professionals to prescribe treatment for substance use disorders.


6) Increase screening of 0-5 year-old children for learning, physical, and behavioral disabilities and expand treatment options.


7) Integrate information systems and services.  So often people who need housing assistance also need food, education, employment experience, energy assistance, or child care, and each service request is treated like a first (or separate) occurrence.  We make it difficult to for people applying for services that are co-related but separated by  funding silos.


8) Provide better information technology to state employees.  State and non-profit caseworkers are overloaded and need better technology to do their work.


We are spending a lot of volunteer and salaried resources on stand-alone programs and can strengthen the safety net in NH and the nation by coordinating needs and services.  Most of the ideas above are inexpensive and within our ability to implement quickly.  Cheshire County professionals, coaches, families and individuals dealing with recovery have much to offer to policy makers.  The responsibility of area legislators is to ensure that local ideas drive policy and funding, not just follow.


Jay Kahn