Uniting New Hampshire: The Case for a Whole-Person, Cross-Sectoral Response to Substance Use and Mental Health

Substance use and mental health are shaped by what happens in homes, schools, clinics, workplaces, and communities—and people often need support from more than one system at the same time. Whole-person care is an approach to health that acknowledges these intersecting factors, but implementing this approach requires that caregivers, health care workers, teachers, policymakers, and others work together to provide wraparound support.

As New Hampshire’s opioid deaths decrease, the state proves that progress against the opioid crisis is possible. Its experience reinforces the value of a whole-person approach to prevention and points to a practical lesson on how to deliver it: prevention works best when it is connected to early identification, treatment, and recovery support and when partners across sectors reinforce the same approach. This is what it looks like in practice and how JSI and state partners have helped build a more connected response system.

Transforming a Crisis Response to a Connected System

Since 1995, JSI has worked hand-in-hand with the New Hampshire Department of Health and Human Services, local foundations like the New Hampshire Charitable Foundation, and community partners to improve health outcomes across the state. In 2015, JSI worked with state partners to map the scale of the opioid epidemic and identify people at greatest risk of accidental overdose. That work helped shape a bipartisan commission that continues to convene state leaders, local organizations, and the public to advise the Governor and Legislature on effective statewide substance misuse prevention, treatment, and recovery services.

This long-standing partnership, and JSI’s work across sectors, reinforces a consistent lesson: results endure when systems work together. Whether addressing primary health care, infectious disease, or family health, the strongest approaches reflect how a person’s environment influences their health and well-being. To sustain momentum, New Hampshire uses strategies that strengthen coordination across sectors.

Preventing Substance Misuse with Whole-Person Care

We know the risk factors that too often lead to tragic outcomes: family history of substance use, childhood trauma, social isolation, and rejection of a young person’s identity. We also know what helps protect young people: mentorship, connection with trusted adults, coping skills, and strong school connectedness. These protective factors span sectors, reminding us that effective prevention requires coordination across clinical, education, and broader community settings. Through the Center for Excellence on Addiction at JSI, we support communities and practitioners working to reduce the misuse of alcohol and other substances through a variety of projects, including the Treating Addiction Together ECHO, which connects treatment professionals for shared learning and problem solving, or the Student Assistance Programs (SAP), which helps schools with behavioral health goals. Through Screen and Intervene, JSI supported primary care providers to screen earlier for unhealthy substance use, moving beyond reactive treatment. Combined with public messaging like the JSI-supported Anyone.Anytime.NH™ campaign, these efforts aim to shift the system from reacting to crisis to supporting well-being earlier – while also reducing stigma that can keep people from asking for help.

Building a Prevention Workforce Across Sectors

Prevention programming consistently provides the greatest return on investment (ROI) in reducing the enduring negative impacts on individuals, communities, and economies. A 2007 cost–⁠benefit analysis found that school-based prevention programs could save up to $18 per pupil for every $1 invested, and a 2024 analysis found that every $1 invested in tobacco prevention programs saved $20 in health care costs. Prevention succeeds when a wide range of adults who interact with young people have practical tools, shared language, and clear pathways for support. That includes educators, school counselors, clinicians, prevention specialists, youth-serving organizations, public health leaders, and partners in public safety and juvenile justice.

On May 12, 2025, nearly 250 professionals gathered in Concord for the statewide New Hampshire Prevention Conference. Convened by JSI through the Center for Excellence on Addiction, the event brought together partners from across the state involved in youth prevention, including the Partnership @drugfreeNH (1), NH Student Assistance Network, and Prevention Certification Board of NH. Participants included school staff, prevention specialists, health providers, public health leaders, juvenile justice partners, and other youth-serving professionals. Learning opportunities like these facilitate consistent statewide messaging about what works in youth prevention. The conference highlighted that prevention is not the sole responsibility of a single agency but a collective mission. Initiatives like these create a supportive network where every community member plays a specific, informed role in fostering healthy environments for New Hampshire’s youth, proving that collaboration is our strongest prevention tool.

Translating Insights to Policy

Progress depends on alignment between high-level policy and on-the-ground realities. The Governor’s Commission on Addiction, Treatment, and Prevention brings together state leaders, constituent organizations, and members of the public to coordinate priorities across prevention, treatment, and recovery. JSI supports the Commission to translate evidence and community experience into actionable recommendations. This partnership has been instrumental in transforming New Hampshire’s landscape from a collection of fragmented services into a cohesive system of care.

Through the “Strengthening Our Response Together” action plan, the Commission provides a blueprint for shared efforts to reduce alcohol and drug misuse. By encouraging coordination across member organizations, the plan helps ensure efforts reinforce one another, so communities experience a more connected, easier-to-navigate system of support and enables efficient use of the state’s resources by avoiding duplication and promoting strong return on investment.

Sustaining Progress in New Hampshire

New Hampshire’s progress in reducing opioid deaths shows what is possible when prevention is prioritized and partners coordinate across systems. However, maintaining this trajectory requires vigilance and a refusal to retreat into sectoral silos.

A whole-person, cross-sector approach is not a slogan, it is how people experience care that is easier to find, easier to navigate, and more consistent over time. By continuing to align schools, health care, public health, community organizations, and government, New Hampshire can sustain momentum for a resilient, responsive health system and build a healthier future for all.

1.  The Partnership @drugfreeNH is a public-private collaboration between the NH Charitable Foundation and the Center for Excellence on Addiction at JSI.