“Nobody’s turned away.”

That’s how Peter Evers, president and CEO of Riverbend Community Mental Health, described the new “hub” that will manage and coordinate substance use disorder(SUD) treatment in the greater Concord region.

The first of nine public forums to unveil “The Doorway-NH,” the state’s ambitious new “hub and spoke” system for SUD treatment drew a standing-room-only crowd of about 150 people Monday at Concord Hospital, one of nine designated regional centers. The hub location is just down the road from the hospital campus, at 40 Pleasant St.

Jeffrey Meyers, commissioner of the state Department of Health and Human Services, told the crowd that the new system is up and running, with a helpline (2-1-1) staffed by Dartmouth-Hitchcock clinicians already taking calling and making referrals.

When New Hampshire was awarded nearly $46 million in federal funding to combat the opioid crisis, DHHS officials decided to create a community-based system of care based on Vermont’s successful hub-and-spoke model. The hubs are tasked with coordinating care “to ensure people are getting the right services in the right location at the right time,” Meyers said.

Evers, who is also vice president for behavioral health at Concord Hospital, said when his two organizations heard about plans to create regional hubs that would serve as access points and refer clients to “spokes” in their local areas for treatment services, “We were all in.”

Here’s how it works in Concord: When someone is ready to seek treatment, he or she can either call 2-1-1 or walk into the hub facility at 40 Pleasant St. There, clinicians will do an initial assessment to decide what services are most appropriate. The hub will then refer clients to providers in their local communities — the “spokes” of the new system.

Sarah Gagnon, vice president of clinical operations for Riverbend, said providers know that taking that first step — asking for help — is the most difficult. That’s why it’s important to create a welcoming environment at the hub, she said.

Referrals will be based on the clients’ choice, Gagnon said. For instance, if someone comes to the Concord hub for help but it’s more convenient for them to seek spoke services in Manchester, that’s what will happen, she said.

Evers said it’s also important to make sure clients are educated about what services are available in different areas. If there’s a six-week waiting list for a nearby facility, for instance, it may make more sense to go somewhere a bit farther away where there’s an immediate opening, he said.

“This is about making sure if somebody comes to you, you have a solution that they’re interested in,” Evers said.

“We also know the longer you wait when you’re in the throes of this disease, the less likely the pathway to recovery is going to be smooth,” he said.

What’s unique about the new approach is that the hub will provide case management throughout a client’s treatment and recovery, however long that takes, Gagnon said. “We’re hanging onto them until they get through their care,” she said.

Shanna Large, director of the Choices addiction recovery program at Riverbend, said as a provider, she welcomes that case management, knowing that clients will have had full assessments done before they come to her agency and will have access to other services such as housing support.

The mood in the room was upbeat. Many of those attending were providers who will become the “spokes” that care for those referred by the hubs.

When it came time for questions, many had practical concerns.

What about the uninsured, someone wanted to know. “We’re insurance-blind at the hubs,” Evers said. “We will meet you where you are in terms of this disease.”

The hub team will work with clients and their providers to get them insured, he said, “but it is not a question we will be asking the first time somebody walks into the hub services.”

Someone else asked what happens if it’s Sunday at 2 a.m. when someone decides to call 2-1-1. Gagnon said the clinicians will screen the individual to decide what services they may need right away; the next morning, that information is relayed to the Concord hub, which will contact the individual directly.

Someone asked if Concord was considering adopting the Safe Station program that both Nashua and Manchester have, in which the cities’ fire stations serve as contact points for those seeking help. Evers said the hub at 40 Pleasant St. will offer the same service: “A warm, inviting environment that has peer support specialists and the ability to keep people safe.”

Peer support from someone who has had similar experiences can play a key role in helping clients through treatment and recovery, Evers said. “Oftentimes, a person’s view of recovery in those early days is pretty dim,” he said. “To actually be able to support that person and say it gets better is enormously important.”

Evers noted the presence in the room of many first responders, “who have been involved in providing services selflessly for years.”

It shows, he said, “that there is a massive interest in turning this around, in terms of making better pathways for treatment.” It’s also “a testament to the fact that we as a community know that treatment works, and once we can help people, they can be masters of their own destiny in terms of getting into recovery,” he said. “We just have to get it right for them.”

Upcoming forums will be held in Berlin, Dover, Keene, Laconia, Lebanon, Littleton, Manchester and Nashua.

For more information: www.dhhs.nh.gov.

Beyond the Stigma, a series exploring solutions to the state’s addiction and mental health challenges, is sponsored by the New Hampshire Solutions Journalism Lab at the Nackey S. Loeb School of Communications and funded by the New Hampshire Charitable Foundation, Dartmouth-Hitchcock Medical Center, NAMI New Hampshire, and private individuals. Contact reporter Shawne K. Wickham at swickham@unionleader.com. To read previous stories in this series, visit: unionleader.com/stigma.

Monday, July 20, 2020
Sunday, June 14, 2020
Saturday, March 21, 2020
Monday, March 09, 2020