Having the right people at the table and the right voices heard – that’s the key to making systems work.

Cheshire County has been awarded a $4 million federal grant to implement a comprehensive regional plan to create a more integrated system of care of children and youth with behavioral and mental health issues.

The grant is the largest grant in Cheshire County in the last 10 years, said grant writer Suzanne Bansley. “Everyone was behind [the grant],” she said. “Everyone involved is passionate about this cause.”

And with the planning done in conjunction with youth and family of those with mental and behavioral health issues, the hope is that the result will provide solutions to what isn’t working in the current system of care.

“There is little support for families who have children with mental illnesses,” said Michele Nuttle of Jaffrey, whose 11-year-old son has mental health issues. Nuttle served as a family representative with the Monadnock Region System of Care planning grant. “The problem that we really had is that the doctors don’t talk to each other. The doctor that provides [my son’s] medication doesn’t talk to his primary care physician. The school nurses don’t talk to either of them.”

Nuttle’s son has a right parietal lobe deficiency that results in a delay in his emotional development, and causes him to have trouble decoding facial expressions and interpreting figurative speech.  Nuttle said that in her ideal world, her son would have a family doctor and psychiatrist who would share information about his care with family and school and community supports. And, she said, her family would be able to easily access support resources in the various areas of their life – school, community and home.

These are all issues that Cheshire County hopes to address through the Monadnock Region System of Care, which it will put in place over the next four years with the funds from the grant.

“I think that it is widely known that 20 or so years ago, New Hampshire was said to have one of the best mental health systems in the country, said Dennis Calcutt, the project manager of the grant. “But as time has moved on, services, especially those for children and youth with significant issues has continued to decline.”

The model will include creating a governance baoard that will involve families and youth dealing with mental health issues at the policy and system level and in the planning and delivery of services to make sure that the system works for them. 

“It puts the family at the center of this and lets them guide this care,” said Calcutt.

The plan also addresses the other issue that was high on Nuttle’s wish list – supports.

There will be a regional coordinator that will be able to assist the public with coordinating care and resources, hired by the county, said Calcutt, and the county will also be hiring dedicated coordinators for two school systems – one of which is ConVal Regional School District.

The objectives of the System of Care will be to create partnerships between providers and related initiatives, creating peer supports, and broadening the array of available survices. 

And those important voices – those affected by these decisions – will remain involved throughout the implementation of this project. At least one family member and one youth representative will be on each committee in the implementation phase. 

“Its main focus is that it is family-driven and youth-guided,” said Nuttle. “As long as those people who experience these issues have a seat at the table and a voice, yes, I think this will work.” 

“This is a big step,” said Calcutt. “But it’s not going to be the last step. Our focus will be on providing better training and reinforcing some of the services that are already here, as well as developing sustainable models so that when the grant is done, we’ll be able to continue moving forward.”

Cheshire County will provide fiscal sponsorship and oversight of the project. To become involved, contact Dennis Calcutt at 357-1738.