(Opinion) A proven path forward for New Hampshire’s mental health crisis

Certified community behavioral health clinics offer a clear, evidence-based path forward for Granite Staters

 HEALTH CARE

By: Patricia Carty, Dr. Cynthia Whitaker and Lori Shibinette

Mental health and substance use challenges have reached crisis levels across New Hampshire. Emergency departments are overwhelmed, families struggle to find timely care, and too many Granite Staters fall through the cracks because services are fragmented, understaffed or unavailable — especially in rural communities.

There is, however, a proven solution that offers New Hampshire a real opportunity to strengthen its behavioral health while improving access, quality and outcomes: certified community behavioral health clinics (CCBHCs).

CCBHCs are not a pilot idea or an untested reform. They are a nationally recognized model of care that delivers comprehensive, coordinated mental health and substance use services 24 hours a day, seven days a week, regardless of a person’s ability to pay. At their core, CCBHCs are designed to meet people where they are — during a mental health crisis, while managing substance use recovery or when navigating cooccurring conditions that too often go untreated.

Since the model launched in 2017 through a federal demonstration, CCBHCs have expanded rapidly across the country. The National Council on Mental Wellbeing reports more than 500 certified community behavioral health clinics and CCBHC grantees are operating in 46 states, plus Washington, D.C. and Puerto Rico.

Research consistently shows that CCBHCs expand services, grow the workforce, reduce wait times and serve more people with complex needs while improving care coordination with hospitals, primary care providers, law enforcement, schools and social service agencies.

For New Hampshire, the potential impact is especially significant.

Our state faces longstanding workforce shortages in mental health and substance use treatment. The CCBHC model directly addresses this challenge by supporting sustainable staffing levels through a Medicaid payment structure that reflects the true cost of providing care. That stability allows providers to recruit and retain clinicians, peer support specialists and crisis workers — building a workforce that communities can rely on.

CCBHCs also strengthen crisis response.

Instead of relying on emergency rooms or law enforcement as the default entry point into care, CCBHCs provide round-the-clock crisis services, mobile response and follow-up care that keeps people connected to treatment. That means fewer psychiatric boarding cases in hospitals, less strain on first responders, and better outcomes for individuals and families.

Equally important, CCBHCs break down silos. The model requires strong partnerships across the health care system and beyond — connecting mental health and substance use treatment with primary care, housing supports, child welfare, veterans’ services and criminal justice programs. For a state like New Hampshire, where collaboration is essential to serving rural and underserved areas, this integrated approach is critical.

The CCBHC framework is guided by rigorous federal standards developed by the Substance Abuse and Mental Health Services Administration, with oversight and payment guidance from the Centers for Medicare & Medicaid Services. These standards ensure accountability, data-driven outcomes and a consistent level of quality, while still allowing services to be tailored to local community needs.

New Hampshire does not need to reinvent its behavioral health system. We need to build on what works. New Hampshire has not sat idle on this opportunity to modernize its system of care. Currently, three of New Hampshire’s 10 community mental health centers — the Mental Health Center of Greater Manchester, Greater Nashua Mental Health Center and West Central Behavioral Health — have voluntarily and seamlessly transitioned to a CCBHC model. Other centers are building on that success and expertise, and with new opportunities through the Rural Health Transformation initiative awarded to New Hampshire, centers will also capitalize on the benefits of a CCBHC model.

By advancing the CCBHC model, our state can expand access to care, stabilize the workforce, improve crisis response and create a more coordinated and effective system for people living with mental health and substance use challenges. This is not about bureaucracy or buzzwords; it is about ensuring that, when someone in New Hampshire needs help, the door to care is open, no matter who they are or where they live.

At a time when the need has never been greater, CCBHCs offer a clear, evidence-based path forward. New Hampshire should seize this opportunity to strengthen its behavioral health system — for today, and for generations to come.

Patricia Carty is CEO of the Mental Health Center of Greater Manchester. Dr. Cynthia Whitaker is CEO of Greater Nashua Mental Health Center. Lori Shibinette is the CEO of West Central Behavioral Health Center.