I HAVE BIPOLAR DISORDER and have been working with people at 51���� Mental Health since I was six years old. I just turned 18 and will be graduating from high school in about a year. I soon am going to leave for Austria where I’ll be representing New Hampshire in the Special Olympics World Games in the snowshoeing event. I’ll be competing with kids from all over the world. I’m super excited!

Over the past year, I also have become strong and vocal supporter of the Change Direction NH campaign (See changedirection.org/nh.) It was almost a year ago when my mom and I agreed to have a picture taken in front of the State House in Concord and take the pledge with a bunch of other people to know the five signs of emotional suffering: personality change, poor self-care, being withdrawn, unusual anger or moodiness, and feelings of hopelessness.

It was kind of a big deal. Gov. Maggie Hassan and a lot of other important people came and spoke to the crowd. One of the most memorable moments for me was when John Broderick, the former chief justice of the New Hampshire Supreme Court, was speaking about his family’s experience. His son had mental illness, and he said that he wished he’d known the signs when his son was younger. He said that his son got the treatment he needed. He is now OK and has a job and is married and has a family. But what was most important was talking about it whenever and however you need to talk about it — and that mental illness isn’t something you should ever feel like you need to whisper about.

It’s an illness, just like when you break your arm, you go and get your arm fixed by a doctor. When you have mental illness, you go to a doctor too, and you get a different kind of treatment. And treatment works! It really does.

I’ve had some hard times over the years, and being able to talk about it all, openly and without being ashamed, is really, really important. There’s a lot of learning involved in managing any illness, and I have learned some great coping skills from my counselor at Riverbend that help me manage mine. Coping skills help me every single day.

Everybody has hard times sometimes, and what’s so important about the Change Direction NH campaign is that it helps people talk about it. That’s always the first step to getting better. Believe me, I know!

Ellie Coe lives in Hopkinton.

Twenty years ago, when someone seeking mental health treatment in New Hampshire went to get help, the person doing intake often asked whether they were self-medicating with drugs or alcohol.

If the answer was yes, “the intake person would say, ‘get yourself sober, then come back for treatment,’ ” Riverbank Community Mental Health CEO Peter Evers remembered.

The approach of treating addiction and mental health as different issues is fundamentally flawed, Evers told dozens of mental health clinicians and students on Wednesday night during a panel discussion co-sponsored by New England College and mental health awareness campaign Change Direction.

Sixty percent of people with substance use disorder also have co-occurring mental health challenges, according to the National Institute on Drug Abuse.

“If I feel psychological pain and I can get out of that for a minute, I’m going to do that,” Evers said, adding many use drugs and alcohol to escape disorders like schizophrenia, bipolar disorder and depression.

Evers was one of four panelists who addressed the link between mental health issues and substance use disorder – a pressing topic, given the state’s exploding drug crisis. All spoke about the need to boost prevention and awareness about mental health issues in addition to more treatment.

“Treating these things together is part of that, Evers said.

The room at New England College’s Concord office was packed – an encouraging sign, panelists said.

However, the talk also came at an uncertain time for mental health and substance use services, given the recent election of Donald Trump as president.

Trump has repeatedly pledged to “repeal and replace” the Affordable Care Act and has proposed giving states federal block grants to fund expanded Medicaid – a move that could ultimately reduce the amount of federal money each state receives. Trump has also said he wants to give states more authority in how they administer their programs.

New Future policy director Michele Merritt said the New Hampshire Medicaid Expansion program has been essential to connect people to treatment.

“These are individuals that are extremely, extremely low-income,” Merritt said. “This program is the only thing that’s able to connect them to treatment.”

Merritt also said the provision of the Affordable Care Act allowing children to stay on their parents’ insurance until age 26 is an important tool to make sure they get treatment for mental health and substance use disorder.

Trump has signaled he would be open to keeping that popular part of the law.

Merritt also talked about ongoing issues with insurance parity – insurance companies covering mental health and substance use disorder services the same way they would cover physical health issues.

Parity is federally mandated, but a recent study from the National Alliance on Mental Illness showed there are still a lot of gaps. In addition to a nationwide shortage of mental health providers, many are not in insurance networks due to low reimbursement rates.

Lack of insurance means many patients must pay out of pocket, or forgo mental health services, the report found.

On Wednesday, Merritt reminded clinicians to help patients figure out insurance in addition to treating them.

“You have a responsibility to your clients to help them navigate insurance,” she said.

Panelists also encouraged audience members to start talking openly about mental health and addiction, and share stories with New Hampshire policy makers.

“People like me, we can only say so much,” Merritt said. “But if you have someone that comes out and shares their stories, that’s what changes people’s minds.”

(Ella Nilsen can be reached at 369-3322, enilsen@cmonitor.com or on Twitter @ella_nilsen.)

Published NH Business Review 6/10/2016

Barbara Van Dahlen is the founder of two powerful national initiatives to address mental health-related issues. In 2005, the Washington, D.C.-based clinical psychologist founded Give an Hour, a national network of over 7,000 mental health professionals who provide free services to U.S. troops, veterans and their families.

More recently, she founded the Campaign to Change Direction, an effort to raise awareness about and change the culture of mental health in America. The goal of the campaign is to teach people to be aware of the five signs of emotional suffering – withdrawal, agitation, hopelessness, decline in personal care and change in personality.

On May 23, Van Dahlen visited Representatives Hall at the New Hampshire State House to launch the campaign’s first statewide initiative, which is being led by former NH Supreme Court Chief Justice John Broderick and Peter Evers, CEO of 51���� Mental Health Inc.

Q. When you spoke to the hundreds of people in Representatives Hall and asked them to raise their hand if they were not affected by mental illness, no one raised their hand. What does that say to you?

A. I know the answer before I ask the question. The way we talk about this, the five signs are about emotional suffering. Who among us has not experienced emotional suffering? We all have it, every day.

Today I’m having a great day, mental health-wise, but if something happened to me tomorrow – if something happened to one of my daughters, either physically or emotionally, or my husband, or someone I care about, I would most likely struggle. I would be hurting. We all go through that continuum of life.

Q. Why did you choose New Hampshire as the place to launch the first statewide initiative?

A. New Hampshire is the perfect size to be able to really say we can do this in an entire state. At our first steering committee meeting were the head of HHS, the head of Corrections, representatives of both senators, and we met with Annie Kuster that morning. So it is a state that allows people to really know each other. That’s what we need in order to create a model at the state level and then give it to all the other states.

Q. In terms of people reaching out. How does that work? Let’s say you know the five signs, someone talks to somebody about it. How do they get there?

A. That’s why we’re starting with “know these five signs,” because then we create a common language. Then if I see if someone’s hurting – if you have been withdrawn or more agitated and you and I are friends, I can say, “I care about you. I noticed this and this.”

It’s the same thing that humans do when they open the door. They start sharing. They start talking. They provide the support. They say, “It’s OK, you really should tell your wife that you’re hurting. Or you really should talk to your son that he’s drinking too much.” That’s the cultural shift we’re after.

Q. We’ve seen in New Hampshire that businesses are now talking about opioids in the workplace. Is discussing mental health the next step?

A. When I was building Change Direction, I reached out to a friend of mine who’s a very high-level executive of a corporation. I told her what we’re doing and asked her if they wanted to be involved. She said, “Absolutely.” I said, ”Great.” She said, “Thank you.” I said, “OK.” “No,” she said, “Thank you. I’m OCD. Every day I come to work and have to hide it. I manage 200 people in our company, and I have to pretend that this is not part of me. I manage it, I function, I deal with it. I know what to do, at times I struggle, but I have to hide it. What you’re doing is going to change everything.”

That’s the story in every company in this country. There are people throughout who have these challenges. They’re functional, they’re great employees, so why should they be walking around feeling like they can’t talk about it, the way they would if something is going on with their chemo treatment or anything else?

Published Foster’s Daily Democrat 5/12/2016

Nearly one in every five people, or 42.5 million Americans, has a diagnosable mental health condition. Yet, they or those closest to them may not recognize the symptoms that could lead to help.

“Mental illness remains in the shadows and away from the public square,” said John Broderick, a former chief justice of the New Hampshire Supreme Court.

Broderick is co-chairing a new initiative called Change Direction New Hampshire with Peter Evers, the executive director of 51���� Mental Health, which has several locations around and north of Concord.

The initiative highlights a simple pledge that anyone can do. That is to learn the five signs of emotional suffering so someone can recognize them in him or her self or help a loved one who may be in emotional pain.

They are a change in personality, agitation, withdrawal, decline in personal care and hopelessness.

“People are so uncomfortable talking about mental illness,” he said. “Going back to 1957, people would not talk openly about breast cancer, and now there are signature events to raise awareness with the signature pink color.”

Change Direction New Hampshire is the brainchild of Dr. Barbara Van Dahlen, a child psychologist based in Maryland. Van Dahlen made Time Magazine’s 100 List in 2012 for her work in establishing Give an Hour.

That program asked psychologists and psychiatrists from across the country to donate at least an hour of their time to assist a veteran or a veteran’s family member with mental health issues. It has enjoyed much success and is in full operation.

“I was asked to speak to Barbara last fall by Bill Gunn, who is head of behavioral health at Concord Hospital and a good friend of Barbara’s husband,” Broderick said. “Barbara told me of her commitment to Change Direction and her interest in expanding it nationwide.”

Van Dahlen wanted New Hampshire to be the first statewide effort. The Change Direction campaign is non-political. Its goal is simple, practical, achievable and powerful — to make the five most common signs of mental illness/ emotional suffering as wide and well-known as the signs of a heart attack or stroke.

“Knowing the five signs is particularly important when you consider that half of all mental illness arises by age 14 and two-thirds by age 24,” Broderick said. “Most often those suffering with a mental illness are the last to know.”

Parents, teachers, siblings, friends, coaches, relatives, employers, co-workers and others need to know the signs in order to help and, in many cases, the mentally ill might find themselves in the signs.

The Change Direction New Hampshire campaign is an effort to improve public awareness and understanding with a goal of helping get people to effective treatment. Early diagnosis and early treatment often improve outcomes.

Change Direction New Hampshire will be asking the public and private sectors to partner with it “to get the word out.” Literature (including posters) and information should be widely and readily available.

“We will be doing public service announcement with N.H. voices and faces,” Broderick said.

Change Direction will be hosting five to six mental health forums throughout the state during the next year.

“We want to attract the medical and behavioral health community, but we will be reaching for a cross-section of the lay community,” Broderick said. “Part of our effort will be geared to changing the culture surrounding mental health in New Hampshire. We need to remove the needless shame and stigma from mental health and emotional suffering that so often causes the afflicted and their families to avoid treatment.”

Sponsors to date include Dartmouth-Hitchcock Medical Center, Elliot Hospital, 51���� Mental Health Center, Catholic Medical Center, Southern N.H. Medical Center, Lakes Region General Hospital, Concord Hospital, Wentworth-Douglass Hospital, Northeast Delta Dental and former Gov. Craig Benson. Media partners are NH1( Binnie Media) WMUR-TV and WGIR radio.

The Change Direction New Hampshire campaign will be launched in Representatives Hall at the Statehouse at 10 a.m. Monday, May 23. The speaker of the House will open the proceedings.

“We will be joined by Gov. Maggie Hassan and the entire N.H. congressional delegation hopes to be with us along with our distinguished steering committee,” Broderick said.

A VIP reception will follow. The launch is open to the public at no cost.

Broderick will also be speaking about Change Direction during the Portsmouth City Council meeting at 7 p.m. Monday, May 16, at City Hall.

Visit to learn about the campaign.