New Hampshire has developed a statewide, values-driven children’s system of care under the leadership of its New Hampshire Department of Health and Human Services and Department of Education, grounded in principles of being child- and family-driven, community-based, trauma-informed and culturally competent.
Starting from a 2010 collaborative of over 50 organizations and bolstered by a 2012 federal SAMHSA grant and subsequent 2016 legislation, the system includes intensive care coordination (via the FAST Forward initiative), mobile crisis response, and a high-fidelity wraparound model for children with complex behavioral health needs.
Early evaluations show that the system has increased spending on community-based services, reduced psychiatric hospitalization and emergency department use, and achieved a 28% decrease in expenditures per enrollee from 2012 to 2016.
3 Key Takeaways #
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Cross-Agency Infrastructure Enables Sustainability
Governance is shared between Health and Human Services and Education, ensuring system-wide accountability and stability beyond grant cycles. -
High-Fidelity Wraparound Improves Access and Outcomes
The FAST Forward initiative delivers intensive care coordination and peer support, linking families to community-based care instead of institutional placement. -
Data-Driven Refinement Strengthens Investment
Evaluation data showed decreased hospitalizations, emergency-department use, and a 28% reduction in per-enrollee costs, supporting long-term funding and policy alignment.
Relevance for the National Center:
New Hampshire demonstrates how cross-system governance, fidelity-based wraparound models, and strong evaluation can sustain statewide transformation—key elements for states and Tribal Nations advancing adoption-competent, family-centered mental health systems.
