Therapy is for everyone. One of the most common misconceptions about mental health is that only the most severe or complex experiences warrant professional support. Counseling is a space where all concerns are valid, whether you’re navigating a major life transition or simply feeling overwhelmed by the accumulation of everyday stress. There is no issue too big or too small for therapy. In fact, addressing challenges early can prevent them from growing into something more difficult to manage over time. At Amoskeag Health, our therapists often see patients who have been carrying stress, anxiety, or emotional burdens for longer than they realized. Day-to-day pressures like work demands, family responsibilities, financial concerns, or health issues can gradually build into a mental load that feels unmanageable. Because these stressors may not seem “serious enough,” many people delay seeking support. However, early intervention is one of the most effective ways to protect and improve your mental health. Our team of mental health clinicians has supported patients through a wide range of concerns, including stress, anxiety, depression, grief and loss, mood disorders, trauma, substance use, relationship challenges and life transitions. Everyone’s experience is unique, and we are committed to meeting you where you are. Beginning counseling can feel like a big step, and it’s natural to feel uncertain or nervous. We aim to make the process as smooth and welcoming as possible. Our clinicians are highly trained professionals who are also real people: compassionate, attentive, and dedicated to hearing your story without judgment. If you’ve been considering counseling, you might be wondering what comes next. Understanding the process can help reduce uncertainty and make it easier to take that first step. Step 1: Schedule Your First Appointment You may be referred by your primary care provider, or you can contact our office directly to schedule an appointment at one of our Manchester locations. Our administrative team will guide you through the process, gather basic information, and help you find a time that fits your schedule. Step 2: Attend Your Initial Assessment Your first session is an opportunity for you and your counselor to get to know each other. During this appointment, your counselor will ask about what brought you in, your personal and medical history, and what you hope to gain from therapy. This is also your time to ask questions, share concerns, and get a sense of whether the therapist feels like a good fit for you. It’s important to remember that counseling is collaborative. You are an active participant in your care, and feedback is encouraged. Open communication helps ensure that your therapy experience aligns with your needs and goals. Step 3: Develop a Personalized Treatment Plan After your initial assessment, you and your therapist will work together to create a treatment plan tailored specifically to you. This plan may include how often you meet, the goals you want to focus on, and the therapeutic approaches that may be most effective for your situation. Our clinicians are trained in a variety of evidence-based therapies. Some of the approaches we commonly use include: Cognitive Behavioral Therapy (CBT):  This approach focuses on identifying and changing unhelpful thought patterns and behaviors. CBT is used to treat anxiety, depression, and stress-related conditions, and it helps patients build practical coping strategies they can apply in everyday life. Dialectical Behavior Therapy (DBT):  DBT is a skills-based therapy designed to help individuals manage intense emotions, improve relationships, and develop techniques for mindfulness, distress tolerance, and emotional regulation. Eye Movement Desensitization and Reprocessing (EMDR):  EMDR is a structured therapy that helps individuals process and heal from traumatic experiences by using guided eye movements or other forms of bilateral stimulation. Solution-Focused Therapy:  This goal-oriented approach emphasizes strengths and progress rather than focusing primarily on problems. It helps individuals identify what is already working in their lives and build on those successes to create meaningful change. Motivational Interviewing:  This collaborative, person-centered approach supports individuals in exploring and strengthening their motivation for change. As therapy progresses, remember that change takes time. Building trust and learning new skills are gradual processes. Some sessions may feel more productive than others, and that’s completely normal. Consistency and openness are key components of progress. If you’ve read this far and feel that counseling might be right for you, we encourage you to take the next step. To schedule an appointment with one of our Behavioral Health Clinicians in Manchester, NH, please call 603-626-9500 or visit our Mental Health webpage for more information. We are happy to answer any questions you may have and help you get started.   If you are experiencing thoughts of self-harm or suicide, it is important to seek imme diate help. You can call or text 988 , the Suicide and Crisis Lifeline, for free, confidential support 24/7. If you are in immediate danger, please call 911  or go to your nearest emergency room. You are not alone, and help is always available.

“When I had very little money and very little insurance, Amoskeag Health really helped me by allowing me to come in for free," shares Liz, a patient who received financial assistance through Amoskeag Health's Sliding Fee Scale Program in 2025. Liz had come to Amoskeag Health for a routine checkup, just hoping to stay on top of her health, but her visit quickly became even more valuable than she expected. “My experience was a favorable one when I arrived there,” she said. “I was seen in a prompt manner, and the staff was friendly and courteous.” After living most of her life in New York City with limited access to quality health care services, she described the experience as “a welcome change.” For Liz, accessible care meant more than open appointment times and friendly staff. It meant she didn’t need to delay taking care of herself due to a financial barrier. When she expressed a need for financial assistance, Amoskeag Health connected Liz with a dedicated Case Manager, who helped her navigate the application process for the Sliding Fee Scale Program. Offering five levels of adjusted fees based on patient household size and income, this system grants a discount for use at all Manchester locations. "Being able to be seen by competent medical personnel means I can sleep at night, due to less anxiety,” Liz shared. That sense of ease drives Amoskeag Health’s mission of making high-quality health care available to everyone, regardless of their ability to pay. Liz was especially struck by how the team treated her at her first visit. “What stood out for me was the way staff made me feel welcome and respected, and the staff seemed to be well-informed about my medical issues.” Her experience speaks to the kind of compassionate, integrated care Amoskeag Health aims to provide for every person who comes through its doors. For patients facing similar financial burdens, case management services and low-cost prescription programs are also available. Liz hopes others in the community will be proactive in seeking care with Amoskeag Health. “I would want anyone else in the community who doesn't have much money or medical insurance to not hesitate to call or come in for treatment,” she said. “They will help set you up with an appointment, and it will be done with care and concern.” Click here to learn more about Amoskeag Health's financial assistance services, including the Sliding Fee Scale Program, Low-cost Prescription Program, health insurance navigation and coordination of government assistance benefits like TANF, WIC, food stamps, and Social Secruity.

Amoskeag Health Receives Grant From The Pearl Manor Fund April 1, 2026 L-R: Kelli Rafferty, Elliot Health System VP & Chief Philanthropy Officer; Nicole Clark, Amoskeag Health Manager of Social Services; Kat Sutton Amoskeag Health Older Adult Case Manager Amoskeag Health is excited to announce that it has received a major grant from the Pearl Manor Fund to support its work dedicated to older adults. “Within our Case Management Department, we have a dedicated Older Adult Case Manager (OACM) who works to help our patients navigate challenges and access services they need to enjoy healthy, independent lives, said Kris McCracken, President/CEO of Amoskeag Health, “This kind gift from the Pearl Manor Fund helps us strengthen our programs which focus on the specific needs of older adults.” Part of the Mary and John Elliot Foundation, the Pearl Manor Fund provides annual grants to local nonprofits for the specific purpose of providing assistance, comfort, care, and treatment for the elderly population of Manchester and surrounding communities. According to Kat Sutton, an Older Adult Case Manager at Amoskeag Health, the health center has seen a 33% increase in the number of older adults served since the pandemic. “In addition to chronic care needs, older adults are often impacted by social isolation which is a risk factor in and of itself,” she said. “Our dedicated team meets with patients and their families to evaluate and assess living conditions, transportation needs, and connections to social service programs, as well as the patient’s health needs.” Sutton added that this grant funding is critical in that many of the supportive services offered by Amoskeag are not covered by insurance but are vital in reducing cost of care. McCracken noted that over the past year, Amoskeag Health has cared for over 15,000 patients from infants to older adults and that more than half of those patients live at or below the federal poverty line. “Thanks to the support from the Pearl Manor Fund, we are able to continue to create and support healthier pathways for older adults,” she said.

March is Colorectal Cancer (CRC) Awareness Month, an opportunity to shine a light on the risks associated with this increasingly common disease. Kristin Schmidt, Certified Physician Associate at Amoskeag Health, shares more insight into what we can do to prevent, catch and treat colorectal cancer. Research on colorectal cancer is constantly evolving. What recent findings are most relevant for the general public? The most striking finding in 2026 is the "two-speed" trend in the United States. While rates continue to decline among adults 65+, they are rising in people under 65, particularly those in their 40s. Recent data shows that 75% of colorectal cancers in adults under 50 are being diagnosed at an advanced stage. However, the 5-year survival rate for local-stage disease is 95%, highlighting that "late discovery" is the primary hurdle, not the disease's treatability. What are the common symptoms of colorectal cancer? Many people with CRC have no symptoms in the early stages. When they do appear, they often include: Changes in bowel habits: diarrhea, constipation, or narrowing of the stool that lasts more than a few days Rectal bleeding: bright red blood or very dark/tarry stools Abdominal discomfort: persistent cramping, gas, or pain Incomplete emptying: lack of relief and continued urge to have a bowel movement after using the bathroom Unexplained weight loss and fatigue: feeling weak or losing weight without trying What steps can people take to reduce their risk of colorectal cancer? The most effective "prevention" step is for getting screened CRC because it allows doctors to find and remove polyps before they ever become cancerous. Beyond screenings, over 50% of colorectal cancers are linked to modifiable lifestyle choices : Diet: limit red meats (beef, pork, lamb) and processed meats (hot dogs, lunch meats). Focus on fiber-rich fruits, vegetables, and whole grains. Weight and activity: maintain a healthy weight and aim for at least 150 minutes of moderate activity per week. Limit alcohol and tobacco: avoiding smoking and limiting alcohol intake significantly lowers risk. Who is most at risk for developing colorectal cancer? CRC can affect anyone but those in the following categories are at higher risk: people age 45 and older; Black Americans ; and people with a personal or family history of certain genetic or colorectal conditions . Black Americans have the highest incidence and mortality rates of colorectal cancer of any racial group in the United States and should receive routine preventative screenings. H ereditary conditions like Lynch Syndrome or Familial Adenomatous Polyposis (FAP), as well as a f amily history of polyps, CRC or inflammatory bowel diseases (like Ulcerative Colitis or Crohn’s) indicate a need to get screened earlier. Data shows colorectal cancer rates are rising among people ages 45–49. What might be driving this trend? Because the recommended screening age was lowered to 45 in 2021, more people in this group are finally getting tested, leading to increased detection and a "catch-up" in diagnosed cases. Additionally, research suggests that changes in the gut microbiome (due to ultra-processed foods, antibiotic use early in life, and sedentary lifestyles) are causing a genuine biological increase in rectal and distal colon cancers in younger generations. What colorectal cancer screening options does Amoskeag Health offer? Are there additional services—either through Amoskeag Health or other resources—that you recommend for prevention or treatment? Right now there are two methods that we generally recommend to patients who are due for screening. The screening method used depends on a person’s risk factors. Stool-Based Tests (Non-Invasive) : These tests look for signs of cancer in your stool. They are more convenient as they can be done at home, but they are required more frequently. FIT (fecal immunochemical test ): looks for blood in the stool that could be an earlier indicator of cancer; repeated annually if negative Cologuard test : looks for blood in the stool and for DNA mutations that could suggest cancer; repeated every three years if negative Colonoscopy: This procedure is performed by a gastroenterologist at a local facility. After doing a colon cleaning preparation at home and fasting, a camera is used to examine the entire colon using a flexible tube while you are sedated, looking for any findings that could suggest risk for colon cancer. If negative, this test is repeated every ten years. There are newer screening methods involving blood samples that require more research. As we learn more about these options, we may expand our screening recommendations to include additional screening methods. What is the most important message you want people to remember about colorectal cancer? The benefits that result from being screened early greatly outweigh the discomfort of the screening tests. While a colonoscopy is not necessarily the most pleasant experience, early detection of CRC leads to a higher probability of successful treatment outcomes . Last year, one of my patients elected to take one of the non-invasive stool-based screenings, which came back positive for signs of cancer. We then referred her for a colonoscopy, which detected stage 1 colon cancer. She received surgery to remove the cancer, and one year later she is doing great and living a cancer free life. Colorectal cancer is preventable and treatable, but without early detection through routine screenings, options for treatment become more limited. If you would like to discuss your options for colorectal screening, or to schedule an appointment with an Amoskeag Health provider, please call 603-626-9500.

February 4, 2026 L-R- Ken Darby, General Manager, Revo Casino and Social House in Manchester, Darlene Estevez-Community Outreach and Engagement Manager-Amoskeag Health, and Chris Dugan-Director of Donor Relations-Amoskeag Health. Amoskeag Health is excited to announce that it has received over $95,000 in charitable gaming proceeds following its run at Revo Casino and Social House in Manchester. “This wonderful donation directly supports our mission of providing quality, compassionate care to every patient who walks through our doors, regardless of their ability to pay, “said Kris McCracken, President/CEO of Amoskeag. “It also helps reduce barriers to care by providing transportation, translation services, or care management programs to those in need.” McCracken noted that over the past year, Amoskeag Health has cared for over 15,000 patients from infants to older adults and that more than half of those patients live at or below the federal poverty line. During 2025, Revo contributed over $15,000,000 to more than 350 NH non-profits in support of their work. Revo’s “Rebel With A Cause” program is committed to making a difference by helping local non-profits care for some of the state’s most vulnerable populations that depend on their services. “Thanks to Revo’s kind contribution, our communities are stronger and healthier,” added McCracken.

“She saved my life!” That is how Adriana describes the moment she sat down with Cecilia, our Patient Access Manager. Adriana has been a patient at Amoskeag Health for 25 years. A friend first sent her our way because she did not have health insurance and needed a doctor she could count on. Earlier this year, Adriana experienced a sudden health issue that landed her in the emergency room of a local hospital. She got the care she needed, but when the bills arrived, she was hit with around $13,000 in charges, an amount that would be overwhelming for anyone. She had no idea how she could ever manage it. While discussing the bill with the hospital, a representative realized Adriana is an Amoskeag Health patient and referred her to Cecilia. During their meeting, Cecilia reviewed her household information and explained that she qualified for Amoskeag Health’s sliding fee scale. Upon approval, Adriana received a Medical Discount Card which discounts her rate at Amoskeag Health and is accepted by many local doctors. Most importantly, she found out the program was able to retro-actively cover her emergency room visit, removing the debt that had been causing so much stress. Today, Adriana continues her care with Amoskeag Health. She is grateful to have a place where she can get the care she needs and the support to manage the costs that once felt out of reach. Our sliding fee program currently helps over 3,400 patients stay healthy without being overwhelmed by medical bills. With support like this, those patients can focus on their health instead of medical debt.

Winter in New Hampshire is beautiful, but ice and snow create hazardous conditions that can impact your safety and lead to slips and falls. Falls can cause injuries and may lead to urgent care or emergency room visits. A few simple steps can help you stay safe and healthy this winter.   Places to Be Extra Careful Some environments are especially hazardous in the winter. To prevent injury, you should remain extra alert in these areas: Parking lots and sidewalks, where ice and snow can build up Building entrances, after snow and water get tracked inside Outdoor stairs, especially during and after wet weather conditions   4 Tips to Stay Safe This Winter Wear the right shoes : Shoes with good grip help you stay steady when navigating ice, snow and sleet. Avoid smooth-soled shoes and high heels on icy days, instead opting for boots or shoes with non-slip soles to create traction while in motion. If you have ice cleats, use them. If your footwear gets wet, change into dry shoes once you’re inside to avoid making indoor surfaces even more slippery. Walk slowly and carefully:  Walk like a penguin! Take short, slow steps when walking outside, keeping your hands out of your pockets so you can maintain balance. Try not rush, even if you are in a hurry. Watch out for black ice:  Black ice is a thin layer of "invisible" ice that forms during extremely cold conditions. While very difficult to see, there are a few signs you can look out for on a cold day: the ground will likely look dark, wet, or shiny. Take extra precautions in especially shady areas and near bridges or gutters, common breeding grounds for black ice. Use handrails and take your time:  Stabilize yourself on railings when walking up or down stairs. When getting in or out of a vehicle, move slowly and keep three points of contact, like planting two feet on the ground with one hand on the car, or steadying yourself with two hands on the car as you place your leading foot onto the ground. Acting slowly gives you time to notice dangerous spots and make safe, intentional movements with your feet. Preventing a slip or fall this winter can be simple. Small changes, like taking your time and walking carefully, can help keep you safe and injury-free!

By: Laura Fry, MD January is Cervical Cancer Awareness Month! Many of you know me as the “queen of everything cervical,” so with that title, let’s dive into some information that might help all of us work together to prevent and treat this disease. Why Does Cervical Cancer Awareness Matter? Cervical cancer is a type of cancer that begins in the cells of the cervix, which is the lower part of the uterus that connects to the vagina. On a global scale, cervical cancer is the fourth most common cancer in women , with 604,000 new cases leading to 342,000 deaths annually. However, c ervical cancer affects people around the world very differently. In 2020, almost 90% of the deaths occurred in countries with lower incomes due to delays in getting vaccines, screenings, and treatment. In the United States, there are about 11,500 new cervical cancer cases per year and 4,000 deaths  linked to this cancer. Cervical cancer usually develops slowly over many years. Early signs of cervical cancer include abnormal changes in the cells of the cervix, which is not noticeable from the outside. However, these changes can be detected through tests at your doctor’s office. If abnormal cells are left untreated, they can progress to become cancerous. So, it’s important to be seen regularly by someone like me! What Causes Cervical Cancer? Nearly 100% of cervical cancer cases  are caused by the Human Papilloma Virus (HPV), mostly through sexual intercourse. HPV has many subtypes, and over 11 of them are considered “high risk” types. Globally, about 40% of women were unaware that HPV causes most cervical cancers. Can Cervical Cancer Be Prevented? YES!  Primary prevention (preventing a disease before it occurs) can be done through HPV vaccines. These vaccines are given in the US to girls and boys preferably before the age of 15. Two doses are recommended. Secondary Prevention (identifying disease at its earlies stages) is done through a pap test and HPV testing. Testing should start at age 21 and be done every three years, with HPV added at age 30 and repeated every 5 years for women who do not test positive. Paps and HPV testing can detect pre-cancerous conditions, which can often be treated easily and can prevent progression to invasive cervical cancer. WHO’s Global Efforts to Reduce Cervical Cancer There is a global campaign from the World Health Organization (WHO) called “90-70-90” by the year 2030. This campaign has three goals: 90% of girls worldwide will be vaccinated against HPV by age 15. 70% of women will have been screened by a high-quality screening method at age 35 and 45. 90% of women with invasive or pre-invasive disease will receive treatment.   Now, What Can You Do to Protect Yourself and Your Family from Cervical Cancer? If you have not been vaccinated and are below the age of 24 – GET IT DONE! There are some situations in which you can be vaccinated later than age 24. Talk to your provider at your next appointment about your options. Make sure your children are vaccinated. There are lots of parents who don’t think it’s needed, or they think that giving the vaccine will give their children permission to start having sex younger. This has been proven NOT to be the case!   Get screening done for yourself if you’re assigned female at birth. Talk to any of the providers or nurses here at Amoskeag Health if you have questions. Spread the news and help us dispel myths and misinformation about vaccines, screenings, and treatment.   Think about it this way: we have a cancer that is very effectively prevented through a vaccine! How cool is that?           Let’s eliminate cancer one cervix at a time! If you’re interested in the HPV vaccine or are overdue for a screening, we can help! To schedule an appointment with an Amoskeag Health provider, please call 603-626-9500.

October 13, 2025 Chris Dugan has joined Amoskeag Health as the organization’s Director of Donor Relations.  In this newly created role, Chris will lead development and execution of a comprehensive fundraising plan focused on individual, corporate, and legacy giving. A New Hampshire native, Chris brings extensive non-profit experience to this role, including leadership positions at Optima Health, Elliot Hospital, St. Joseph Hospital, Monadnock Community Hospital, and the American Lung Association of NH (now Breathe NH). He also served as Regional Director of Corporate Communications at Anthem Blue Cross and Blue Shield in NH and Maine for several years. As a non-profit consultant, Chris has supported the Granite YMCA, the NH Senior Games, The Way Home, Safe Sports, Riverwoods, and Meals on Wheels of Hillsborough County. Chris is member of the Queen City Rotary Club and chairs the Marketing and Communications Committee.  He also serves on the Board for Meals and is a member of the agency’s development committee.  He holds a Bachelor of Arts Degree in Journalism from Northeastern University in Boston, MA. Chris is long-time resident of Hooksett, NH.

November 17, 2025 Maria (name changed for privacy) had been using fentanyl and taking methadone when she decided she was ready for a change. She wanted to stop using both and start Suboxone, a medication that can help people manage opioid use disorder. But switching to Suboxone isn’t easy. Before starting, Maria needed to stop taking any opioids for at least 48 to 72 hours, which can be extremely uncomfortable and even unsafe for someone in active use. She tried to start the process on her own and had stopped taking methadone, but she wasn’t able to make it to her induction appointments. Eventually, she reconnected with our Medication Assisted Treatment (MAT) case manager. By then, Maria was in crisis. She was distressed, still using, and at very high risk for overdose. Our case manager quickly stepped in and coordinated with our MAT providers to make sure Maria could be seen that same day. They helped arrange transportation and helped build a plan she felt she could follow. During her appointment, more barriers came up. Her medications had been stolen, and she couldn’t get to her usual pharmacy because she needed to walk everywhere. The case manager switched her prescription to a more accessible location, called the pharmacy to report stolen medications, advocated for a replacement prescription, and worked to make sure she could get everything filled that same day. After the appointment, the case manager checked in again. Maria had made it home safely and picked up her medications. She’s now started microinductions for Suboxone, putting her on a much safer path and dramatically lowering her risk of overdose. The case manager helped Maria move past the barriers by offering steady, nonjudgmental support. This kind of support gives our MAT patients the space they need to show up as they are and work toward better outcomes.

October 13, 2025 Talking to your kids about substance use can be a difficult conversation. It can be even more challenging when you’re in recovery yourself. Amoskeag Health is working as part of the Manchester Youth Wellness and Prevention Collaborative to help parents approach these conversations with confidence. The Collaborative, which includes Makin’ It Happen, the YMCA of Greater Manchester, and the Boys and Girls Club of Greater Manchester, focuses on supporting families and preventing youth substance use. One part of this work is a parenting program that helps parents in recovery build resiliency, strengthen their relationship with their children, and lay the groundwork for prevention at home. These parents show up every week and work together to talk about parenting styles, skill building, and communication as a group. Many have experienced substance use disorder themselves and are using this space to heal, address difficult topics, and create stronger family bonds. By learning how to communicate openly and support their children’s emotional health, these parents are also reducing risk factors and helping their kids make healthy choices. For the staff leading the program, it is inspiring to see parents show up week after week and put in the work. As one facilitator shared, “Recovery is a robust process, and these parents are shining examples of what it means to do things differently.” Through this program, parents are helping break the cycle of substance use and setting their children, and the Manchester community, on a healthier path.

September 15, 2025 Amoskeag Health is pleased to welcome Dr. Christopher Diamond as a physician at our Elm Street office! Christopher brings over 40 years of medical experience, bolstered by a long family history of dedicated healthcare service. Medicine runs in Christopher's family. His father is a neurologist and his mother was a visiting nurse, and he has carried that passion for caring for the whole person throughout his career. Christopher previously cared for students at the University of New Hampshire, helping them get back on track and supporting their success when health issues affected their studies. He is excited to bring that focus of patient-centered care to Amoskeag Health, working closely with patients to guide and collaborate while making sure they remain in control of their health. Valuing our integrated care model, Christopher is looking forward to working with our providers, behavioral health clinicians, and case managers to support patients as a team. He loves the variety family medicine offers, caring for a week-old patient at one appointment and an older adult in the next. and is now seeing patients at the Elm Street office.