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Lived experience informs a N.H. mental health worker's expertise at a reopened Manchester program

A room inside the Manchester Step Up Step Down building. The program houses three residents at a time, who can stay for up to 90 days.
Samantha Captain
A room inside the Manchester Step Up Step Down building. The program houses three Granite Staters at a time, who can stay for up to 90 days.

Two small, state-funded mental health programs, one in Manchester and the other in Northwood, re-opened their doors a month ago, after both programs were closed due to staffing shortages.

Step Up Step Down is a transitional program staffed 24/7 by people who use their lived experience of mental health challenges to support their clients. Short-term residents can “step up” into the program while managing mental health challenges, or “step down” from an intensive care setting like a psychiatric hospital. It’s a part of the state’s push to improve mental health care, and reduce the acuity of the crisis in emergency rooms across New Hampshire.

The program in Manchester has found five new staff members for its team of nine, and the Northwood program is still hiring for several part-time positions. These locations are two of four in New Hampshire.

Jesse is one of the new hires in Manchester. NHPR isn’t using his last name to protect his privacy. Like the majority of the program’s new staff, it’s the Concord resident’s first time working in the mental health field.

Jesse said he found out about the program through his therapist.

“She wanted me to try something different, where I get to use my experience in mental health struggle with other people,” he said.

Step Up Step Down the type of program Jesse wishes had been around for him.

“It’s so easy, sometimes, to be rushed to the hospital instead of having a place where you can calm down and get your mind right with people that understand you,” he said. “I wish when I had my breakdown that they had a program like this.”

But demand for the program is significantly higher than the state’s four programs can take on. The programs are receiving referrals from hospitals, mental health centers and local residents referring themselves. There are only 12 slots in the entire state. The shortages means the four programs need to make difficult decisions about who to serve.

“There are only so many slots and it’s stressful,” said Kali Moulton, who oversees the Northwood Step Up Step Down.

The weight of the decision-making has led her to revise the process. More staff members now actively participate in the interview process in the hopes that diversity of staff experiences and backgrounds may make the process fairer for prospective participants.

Now, a fifth program is trying to open in Rochester, but they’ve run into zoning challenges.

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