Cheshire Medical Center’s hub for addiction services — The Doorway — will move to downtown Keene this fall, allowing for easier access for clients.
The center, which opened in January at 640 Marlboro Road (Route 101), is part of a statewide effort to create a “hub and spoke” system to screen, assess and refer people to treatment and support services in the community.
Funded by a two-year, multimillion dollar federal grant announced in October, the hubs aim to link people to resources and follow up with them as they advance through recovery services provided by the spokes — rehabilitation centers, sober homes, peer support agencies and other organizations.
The model doesn’t disrupt existing paths to recovery, but creates a network with more obvious connections for people in recovery to move seamlessly through services, according to Shawn LaFrance, who oversees the Keene program.
With the help of advertisements, publicity and word of mouth, he said, the local Doorway had 343 clients as of August, with 160 completing clinical evaluations — the first step in finding substance use treatment.
Most commonly, data provided by LaFrance show, the program treats people addicted to opioids and alcohol. Clients also reported use of cocaine and methamphetamine, and he noted substance use often overlaps.
LaFrance, who is vice president of population health and health system integration at the hospital, said if people seeking recovery don’t know where to begin, they can call the statewide 211 hotline or walk into the hub, where staff will ideally connect them to resources in fewer than two days.
But, as with many new programs, the Keene center had a difficult time getting off its feet. By the end of its first month, The Doorway had only 32 clients, according to LaFrance.
“We basically had November and December to find a place and find staff. Eight weeks is a pretty tight time frame for that,” he said. “We also had significant difficulties finding a location because landlords didn’t want to rent to us.”
Though The Doorway is run through Cheshire Medical Center, an affiliate of the Dartmouth-Hitchcock Health System, LaFrance said renting space there wasn’t an option.
“We didn’t want people to just go to the emergency room. We want them to go somewhere where they are in the right environment and can get the help they need,” he said.
This led them to The Doorway’s less-than-ideal location on Route 101, LaFrance noted, which is more difficult to find and farther from many other local services.
Recruiting qualified staff was also an issue, he added.
With all nine Doorway locations in New Hampshire opening at once, the limited pool of mental health providers was being spread across the state.
Due to this workforce shortage, only 45 percent of New Hampshire’s mental health needs were being met as of December, according to a report from the Henry J. Kaiser Family Foundation.
Originally slated to have eight employees, the Keene program has three — one clinician, one peer recovery support worker and a director, who splits his time between clinical and administrative work. LaFrance said two available positions — one clinician and one administrative assistant — have been posted as well, as the case load has steadily increased since January.
As for the other three envisioned positions, LaFrance said there is no plan to fill them given the number of clients the hub has now.
With a new location on the horizon in downtown Keene, at 24 Railroad St., LaFrance said he’s optimistic.
“It [will] improve access for people who don’t have their own car or vehicle, and because of the way things are set up here. The Community Kitchen, [Hundred Nights] and other services are all right there,” he said.
The building, across the street from the former Scores Sports Bar & Grille, is under renovation, and LaFrance said an official move-in date isn’t set yet.
“I really do think location matters,” he said. “It’ll be good to be downtown.”
The Doorway at Cheshire Medical Center is at 640 Marlboro Road in Keene (the Curran Building on Route 101) and is open Monday through Friday from 8 a.m. to 5 p.m. Support through the state’s 24/7 hotline is available at 211.