When most people think about mental illness, they imagine sadness, anxiety, or troubling behaviors. As a psychiatrist, I often see something deeper and potentially more helpful: problems in how the brain experiencesÌęreward.

Our brains are designed to guide us toward what matters—relationships, purpose, pleasure, and hope. When that internal “reward system” is working well, it helps us learn from experience, stay motivated, and recover from stress. But when it’s disrupted, people can become stuck in states that look very different on the surface, yet share a common root.

Depression, for example, is not simply feeling sad. Many people with depression describe a loss of pleasure, motivation, or meaning. Things that once mattered no longer register. Mania can be the opposite problem: the brain’s reward system is turned up too high, attaching enormous importance to ideas or actions that others might see as risky or unrealistic. Psychosis can involve the brain assigning meaning or urgency where it doesn’t belong, making the world feel confusing or threatening.

Seen this way, mental illness is less about “weakness” and more about misfiring signals. The brain’s internal GPS is giving poor directions.

This perspective matters because it changes how we respond. Instead of asking, “Why won’t this person just try harder?” we ask, “What signals is their brain sending them right now?” That shift leads to compassion, patience, and better care.

At 51°”Íű Mental Health, our work is built around this understanding. Medications, therapy, structure, and human connection all help recalibrate the brain’s reward system over time. Progress is often gradual, and setbacks happen—but recovery is real.

For our community, this lens also reduces stigma. If mental illness is a disorder of brain signaling rather than character, then seeking help becomes an act of strength, not failure.

Your support—whether through donations, advocacy, or simple understanding—helps us provide care that is thoughtful, evidence-based, and deeply human. When we help someone rediscover meaning, motivation, and connection, we are not just treating illness. We are helping their brain find its way home.

Paul J. Brown, MD, is a board-certified psychiatrist and Chief Medical Officer of 51°”Íű Mental Health Center. He provides clinical and strategic leadership across outpatient, inpatient, and crisis services, with a focus on quality improvement, systems integration, and evidence-based psychiatric care. He also serves as Chair of the New Hampshire Suicide Fatality Review Committee and previously held a faculty appointment at the Geisel School of Medicine at Dartmouth.

– Riverbend’s 19^th Annual Awards Ceremony Honors Outstanding Leaders in Clinical Practice and Community Education –Ìę

From health clinics to the State House, Dr. Dominic Geffken and Susan Paschell are being honored for their significant efforts to support the mental health system in New Hampshire. The two will formally receive their awards at the upcoming Champions for Mental Health gala event October 7 in Concord, New Hampshire.

51°”Íű Mental Health provides comprehensive mental health care services to residents of 30 central New Hampshire communities. Through its annual awards ceremony, Riverbend recognizes individuals or organizations that advocate for greater access to mental health services; contribute extraordinary time, talent or treasure to improve the lives of people with mental illness; or publicly give voice to those with mental illness, helping eliminate the stigma and stereotypes that can surround the disease.

“As our industry and overall system of care continue to face rapid evolution and external challenges, our annual Champions event reminds the community each year of the value our services and staff provide in changing lives and improving our overall community health,” said Lisa K. Madden, President & CEO of 51°”Íű Mental Health.

“This year’s champions come from different worlds – clinical practice and public affairs – but each represent the types of essential skills and expertise we value as community partners and that our entire health system values in support of mental health education and advocacy,” Madden explained. “The work Dr. Dominic Geffken performs in service to the homeless population and to patients with opioid use disorders reinforces the importance of reaching out and helping people where they are, with what they need. In Susan Paschell, we have a champion who has educated not only our partners in community mental health, but other organizations as well as to how to best approach the legislative process, engage with lawmakers effectively and bring more voices into the public policy arena. It will be a distinct pleasure to honor both Dominic and Susan at our event and share our gratitude for their efforts.”

DOMINIC GEFFKEN, MD, MPH

Dominic Geffken is the Program Director of the NH Dartmouth Family Medicine Residency (NHDFMR), a community-based program at Concord Hospital that trains and educates future family physicians to provide primary care to patients in outpatient and inpatient settings. While teaching important skills, the program also seeks to provide health care to underserved populations needing essential primary care at the Concord Hospital Family Health Center (CHFHC).

More than a decade ago, Dr. Geffken partnered with the Concord Coalition to End 51°”Íűlessness to start a program that delivers primary care services specifically to the unhoused population in Concord, which includes clients with mental illness.

Called the ‘Downtown Clinic’, this program allows family medicine faculty and resident physicians, behavioral health clinicians, nurses and medical assistants to deliver physical and mental health care to clients at the 51°”Íűless Resource Center in Concord. Approximately 120 patients per year are seen at this outreach clinic and NHDFMR needs assessment data suggests that the majority of people struggling with chronic homelessness in Concord are patients of the Concord Hospital Family Health Center.

In addition, beginning in 2015, Dr. Geffken was the first family medicine clinician at the Concord Hospital Family Health Center to provide medication treatment for opioid use disorder (OUD). The model he created, in collaboration with a team of behavioral health clinicians and nurses, grew throughout the residency program and now, future family physicians and behavioral health clinicians learn this interdisciplinary model of care as part of their training. Beyond his workplace, Dr. Geffken, a Concord resident, shares his medical expertise with the community through volunteering his personal time at local shelters and vaccine clinics.

“As a family physician, my goal is to provide whole person care, delivering health care that treats both the body and the mind,” said Geffken. “I also believe that primary health care delivery should not be confined to the walls of a traditional clinic. Meeting and treating people physically and emotionally allows us, as healthcare workers, to manage medical issues in their initial stages and prevent them from escalating into a devastating and costly crisis. I am honored to accept this award, and I accept it on behalf of all members of the NH Dartmouth Family Medicine Residency, Concord Hospital Family Health Center and Concord Hospital who have supported this work over the years.”

SUSAN PASCHELL

For more than 40 years, Susan Paschell’s work in the public policy arena has helped individuals and groups navigate the legislative system and advance community-focused causes and missions. Spanning both New Hampshire and Maine, Susan has worked in partnership with numerous business and non-profit clients to help them share their stories, advocate effectively with legislators, and illuminate issues of importance.

Paschell’s career includes work as a lobbyist and legislative specialist with the government affairs division of a multi-disciplinary law firm, and – since 2007 – as a senior associate for the Concord, New Hampshire-based Dupont Group. Through the latter, Susan collaborates with the ten community mental health centers in New Hampshire to highlight issues of importance for mental health clients, the mental health workforce and system sustainability. Educating lawmakers on issues relating to protecting Medicaid, the importance of residential housing for the mentally ill, and preserving access to services are some recent efforts. Susan’s work involves everything from prepping ordinary citizens on how to prepare for State House testimony, to crafting speeches, opinion pieces and other written communications to share data and real-life stories around key issues before the State Legislature. In concert with her colleagues, Susan works with everyone from top executives to citizens who have never approached a lawmaker, to educate people on how state government works and how to best advocate for their own or community interests.

A Bow resident with a master’s degree from Harvard University’s Graduate School of Education, Susan began her career as a public-school teacher, coordinating special education services and teaching children with disabilities in the Henniker school system. She also spent nearly a decade as a senior researcher in the non-partisan Committee Research Office of the NH House of Representatives, where she prepared analyses of legislation and drafted amendments, testimony and reports for key House committees.

“In a democratic society, understanding how state government works and how to support our citizens is a passion and responsibility I take seriously,” said Paschell. “Whether in Concord or in Augusta, to help people navigate the rules and customs of state government and get their voices heard has propelled me every day of my working life for decades. I am honored to accept this award, an award I share with my wonderful colleagues from The Dupont Group who I collaborate with every day on topics and issues important to our state.”

Riverbend will honor Geffken and Paschell at its upcoming Champions for Mental Health event on Tuesday, October 7 at the Bank of NH Stage in Concord. The annual ceremony shines a light on the importance of mental health and broadens community engagement around supporting Riverbend and the entire community mental health system in New Hampshire.

EVENT DETAILS:

CHAMPIONS FOR MENTAL HEALTH

Where: Bank of NH Stage
16 S. Main Street

Concord, NHÌę 03301

When: Tuesday, October 7, 2025

5:30 – 6 p.m. – Reception

6 – 7 p.m. – Ceremony & Awards Presentation

Tickets & Registration

Sponsorship Information:

To support Riverbend or be part of the event, contact Riverbend’s Community Affairs Office at: development@riverbendcmhc.org.

Ìę

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Celebrating 60 years of hope and healing, 51°”Íű Mental Health is a private non-profit and one of the largest providers of specialized behavioral health services for children, adults, and their families in central New Hampshire. Close to 6,000 children, families and adults are served annually. Core services include 24/7 emergency services; counseling services; comprehensive community and school-based services for children; addiction recovery services; community support, vocational services, and residential programs for adults and seniors. For more information, visit , or follow @RiverbendCMHC on Facebook, Twitter, or LinkedIn.

Each year, 51°”Íű Mental Health recognizes individuals or organizations in central New Hampshire who advocate for greater access to mental health services; contribute extraordinary time, talent or treasure to improve the lives of people with mental illness; or publicly give voice to those with mental illness, helping eliminate the stigma and stereotypes that can surround the disease.

For this year’s ceremony, Riverbend is honoring Dr. Dominic Geffken and Ms. Susan Paschell.

Dr. Dominic Geffken, MD, MPH, is the Program Director of the NH Dartmouth Family Medicine Residency, a community-based program at Concord Hospital that trains and educates future family physicians. Dr. Geffken partnered with the Concord Coalition to End 51°”Íűlessness to start a program that delivers primary care services specifically to the unhoused population in Concord, which includes clients with mental illness. In addition, Dr. Geffken was the first family medicine clinician at the Concord Hospital Family Health Center to provide medication treatment for opioid use disorder (OUD).

Susan Paschell helps individuals and groups navigate the legislative system and advance community-focused causes and missions. For more than 40 years, her work as a lobbyist and legislative specialist includes educating lawmakers on key issues impacting the community mental health system. In concert with her colleagues at The Dupont Group, Susan works with everyone from top executives to citizens who have never approached a lawmaker, to educate people on how state government works and how to best advocate for their own or community interests.

Community members, mental health advocates, local businesses, neighbors and friends will gather together at this year’s event ceremony to honor these two talented leaders in clinical practice and public policy.

Champions have expanded training opportunities, provided essential clinical services, worked with legislative or community partners to change policy, and shared stories that grew recognition of the importance of mental health.

For Riverbend, a Champion for Mental HealthÌęis an individual who:
‱ Advocates for greater access to mental health services;
‱ Contributes extraordinary time, talent or treasure to improving the lives of people with mental illness; and/or
‱ Publicly gives voice to those with mental illness, helping eliminate the stigma and stereotypes that surround the disease.

Honor those making a difference in the mental health of our local communities – alleviating hardships, serving as an ally, educating or raising awareness, or helping those with addictions or mental illnesses. Winners are honored each fall at Riverbend’s Champions for Mental Health awards ceremony, where members of the public, business leaders, public officials and other interested community members come together in an evening of celebration. This year’s event will be held Tuesday, October 7 at the Bank of NH Stage in Concord.Ìę

Previous winners include:

‱ John Barthelmes, former Colonel, New Hampshire State Police
‱ The Hon. John Broderick, Jr., former Chief Justice of the New Hampshire Supreme Court
‱ John and David Constant, Constantly Pizza (Concord)
‱ Gretchen Grappone, LICSW, training consultant and clinician
‱ Lucy C. Hodder, Professor of Law
‱ Congresswoman Ann McLane Kuster
‱ Brielle Paquette, advocate for children’s mental health
‱ Robert L. Quinn, Commissioner of Safety

And many more!

Make your nomination today.
The deadline for nominations is Friday, June 6, 2025.Ìę
(NOTE: Current Riverbend Employees and Board members are not eligible for the award. Champions must live or have spent significant time working on the issue of mental health in Merrimack County or in Riverbend’s 30-community catchment area).

Questions? Contact: development@riverbendcmhc.org

Join with Riverbend this May for programs and events celebrating Mental Health Awareness Month!

COMMUNITY WORKOUT/WALK – Monday, May 12 (5:30 – 7:00 p.m.)
Riverbend’s InSHAPE fitness team will lead a free mini-session combining education, a community walk and a bonus fitness activity. Take a walk, and take a listen about the important connection between physical and mental health.

Sign up for this free community workout .

EVERYONE HAS MENTAL HEALTH. Riverbend serves the mental health needs of 30 communities in central New Hampshire. We are Riverbend, and it is our privilege to continue to shine a light on the importance of mental health.

Community Workout/Walk
When: Monday, May 12, 2025

Click here for further information and registration for all of our Mental Health Awareness Month programming.

Riverbend continues to work with partners at the Community Behavioral Health Association to raise awareness of State and Federal legislative activity that may impact the system of mental health care in New Hampshire.

Through CBHA, the ten community mental health centers serving New Hampshire compiled a memo highlighting the budget cuts and detailing some of the projected losses to programming and personnel that are at risk via the proposed State budget – starting with the House. Click to read the memo in full.

The budget passed the House Thursday, April 10, and is now in the hands of the Senate.

The memo lays out our unified position and discusses in more depth the potential ramifications of what our system of care will have to absorb. Mental health is community health; having a system of care that ensures people of all income levels get the appropriate services they need is essential to our overall quality of life and the wellbeing of our state.

If you have a story to share about your mental health journey and how community mental health centers like Riverbend made a difference, please consider the following action steps:
‱ Write, call or question your legislator
‱ Make a donation
‱ Share information with your networks
‱ Identify and refer potential supporters

All of these are ways to help, and all are appreciated.

As we address the current situation today, we continue to work collaboratively to position Riverbend and the wider community mental health system the best we can to address future challenges. Our team remains focused and committed to providing the care that so many in our community need at this moment.

Wednesday, April 16, 2025

In honor of Mental Health Awareness Month, 51°”Íű Mental Health will host community events and training, connecting with community members and reiterating the need for mental health awareness and vigilance.

Mental Health Awareness Month, first established in 1949, takes place each year in May to recognize the importance of mental health, raise awareness of wellness in the lives of Americans, and celebrate those who have recovered from mental illness. Riverbend will mark this important commemoration through events reaching the public, key stakeholders, and staff.

“Riverbend is proud of our 60+ year history of providing mental health support to thousands of people in our 30-community service area,” said Lisa K. Madden, president & CEO of 51°”Íű Mental Health. “Mental Health Awareness Month may come once a year, but finding best practices to develop and safeguard your own mental health is a positive action to take every day. Taking stock of one’s own mental health and being observant about the needs of your family, friends, neighbors and colleagues is so important to our overall wellbeing.”

Riverbend’s Mental Health Awareness Month activities will include:

COMMUNITY WORKOUT/WALK
Riverbend staff and the public will explore the important connection between physical fitness and mental health at Riverbend’s Community Workout/Walk, taking place Monday, May 12.

A team from Riverbend’s InSHAPE program will offer a free mini session combining education, a community walk and a bonus fitness activity, starting and ending at Riverbend with a stop in White Park as part of the program. Through one-on-one coaching and conversations with clients, InSHAPE specialists may discuss topics such as mindfulness, listening to your body, or the importance of sleep, hydration and healthy nutrition. Join us for a fun and energetic event and learn some of the healthy tips they typically share with clients. Click for more details and registration.

COMMUNITY-CENTERED CRISIS RESPONSE TRAINING
Join Riverbend for a free, community-focused training session. IEA, or Involuntary Emergency Admission, refers to the court process by which someone is admitted on an involuntary basis to a Designated Receiving Facility for treatment.

This training will focus on understanding the presentation of a mental health or substance use disorder crisis. Participants will learn trauma-informed skills to support individuals experiencing a mental health or substance use disorder (SUD) crisis, plus gain understanding of community resources and psychiatric levels of care in New Hampshire.

Staff and volunteers from community service agencies that have regular interaction with people who experience mental health concerns will benefit from this training. Domestic violence coalitions, police departments, first responders, human service nonprofits, and Probation and Parole Officers (PPO) are welcome, but this training is also open to all interested members of our community. Educators, coaches and members of faith-based organizations may benefit as well. Click for more details and registration.

Riverbend clinical staff will lead the training:
‱ Sheila C. Mullen, LICSW – Community Support Program (CSP) Director
‱ Melissa Stephens, LCMHC – Director of Psychiatric Emergency Services
‱ Kelsey Belanger, LCMHC – Assistant Director, Community Support Program

In addition, Riverbend will mark Mental Health Awareness Month through staff speaking opportunities, a donor appreciation event, sponsorships and digital content. Learn more about Mental Health Awareness Month nationally by visiting the Mental Health America .

RIVERBEND – EVENTS’ DETAILS:
Community Workout/Walk
When: Monday, May 12, 2025
5:30 – 7:00 p.m.
Where: Start at Riverbend Administrative Offices
29 School Street
Concord, NH 03301
Registration: To participate in this community workout, register .

Crisis Response Training
When: Thursday, May 15, 2025
1:00 – 4:00 p.m.
Where: Riverbend Administrative Offices
29 School Street
Concord, NH 03301
Registration: To participate in this community training, register .

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51°”Íű Mental Health is a private non-profit and one of the largest providers of specialized behavioral health services for children, adults, and their families in central New Hampshire. Nearly 6,000 children, families and adults are served annually. Core services include 24/7 emergency services; counseling services; comprehensive community and school-based services for children; addiction recovery services; and community support, vocational services, and residential programs for adults and seniors. For more information, visit www.riverbendcmhc.org, or follow @RiverbendCMHC on Facebook, X (formerly known as Twitter), or LinkedIn.

As part of Riverbend’s continuing commitment to serving people in need, walk-in intakes for mental health services are now expanding, through our Community Support Program (CSP).

Intakes for adults 18 years and older are now available daily (Monday-Friday) from 8:30 a.m. to 1:30 p.m.

“The clinicians and staff at CSP are excited to offer these expanded walk-in intake hours to better serve our community,” said Sheila Mullen, director of Riverbend’s Community Support Program. “By having daily walk-in intakes now five days a week, we hope to reduce barriers for those seeking needed mental health treatments.ÌęThe response to prior walk-in intakes has been positive and has reinforced the need for accessible options for treatment.”

A wide range of services are available, including:

• Case management
• Functional Support
• Therapy
• Medication Management
• Dialectical Behavior Therapy (DBT)
• InShape – fitness program
• Illness Management & Recovery (IMR)
• Supported Employment
• Housing Supports

All intakes are at Riverbend’s CSP offices at 10 West Street in Concord. For more information, call (603) 225-0123. ]]> 12561