Project Upstream: Prevention and Community Navigation
A Prevention-First, Relationship-Driven Model for Resilient Communities
Makin' It Happen built a regional prevention model that connects eight urban, suburban, and rural communities across Greater Manchester to existing state and local services, serving as a trusted navigator who helps residents learn what help is available and how to reach it before a crisis arises.
The Challenge They Were Addressing
Outlying communities around Manchester had a recurring experience: residents who needed help were directed into the city, which strained an already busy system and left smaller towns feeling that they had no local support. Suburban and rural residents told the coalition that they either could not access services or did not understand how to do so, and many felt the regional and state systems were not built with their towns in mind.
New Hampshire has spent years building strong statewide resources, and most of them are free. The state built a regional public health network, a Doorway hub-and-spoke system for people seeking help with substance use, the 988 line, a rapid-response mobile crisis system, the Recovery Friendly Workplace initiative, and the Strong as Granite anti-stigma campaign. The gap was not a missing service. The gap was awareness. As the coalition put it, the people who set up these systems all know about them, but most of the residents they aim to serve do not.
The need built up in layers rather than from a single event. New Hampshire was already in an overdose crisis in 2018 and 2019. The pandemic followed, mental health concerns rose as communities came out of it, and more recent shifts in national funding left local programs uncertain about what would continue. Prevention had long been treated as part of the work, funded only if money was left over. Project Upstream was built on the opposite premise: that helping families and communities know their resources before a crisis is the steady, year-round work that keeps the whole system from being overwhelmed.
What They Built
Makin' It Happen operates as a connector agency, similar to the hub in a hub-and-spoke model. National, state, and local service providers are the spokes; the coalition is the connector that links residents to them. The team describes itself as navigators. They get to know each community by attending its meetings and events or by being invited to deliver a training or workshop, and then grow the relationship from there. In partnership with the Manchester Health Department, Makin' It Happen is the lead prevention agency for the Greater Manchester Regional Public Health Network.
The work does not follow a single script. The coalition learned this early. Its first instinct was to hold listening and learning sessions and tell each community about all the state resources it might not know about. The first session in a suburban community was too much: a lot of the coalition talking to people who did not yet know who the coalition was. The team backtracked and changed its approach, showing up repeatedly at community events, learning each town, and letting residents see them more than once before asking anything of them.
Because the region spans urban, suburban, and rural towns with different needs and different capacities, the model is built to flex. What happens in Manchester looks different from what happens in Auburn. In Auburn, the coalition trained school district staff in suicide prevention, which led to work with the police department on a neighborhood event, which in turn led to scheduling sessions with the school nurse and police on additional strategies. Each community starts where it is ready.
Marketing and communications carry the model as much as in-person outreach. Many families in the region work second and third shifts. They may not be able to attend a school or library event, so the coalition uses social media, a resource hub website, and a podcast series to reach them on their own time. The team also built a resource connection map of services across the area, including mental health, food assistance, homelessness, and treatment and recovery supports, which was distributed to outreach workers, urgent care sites, and schools.
Key Program Components
Who You Need at the Table
What made a willing partner essential vs. optional?
The partner that makes this model possible is a community willing to be in a real relationship rather than a transactional one. The six core sectors and the regional providers are required because they supply the local trust and the actual services residents are connected to. Without them, a navigator has nowhere to navigate. The coalition found that some partnerships it first labeled helpful, such as libraries, community centers, and civic groups, turned out to be essential, because those are the places where residents already gather and feel safe.
Some relationships take patience to build. Rural, private, and charter schools often start by sending us some information; we will call you. Some for-profit employers are slow to engage. The coalition has found openings through existing statewide doors, drawing on the Recovery Friendly Workplace initiative to reach businesses it could not reach directly. The pattern holds across sectors: a partner becomes essential the moment it is willing to let the coalition show up more than once and learn the community together.
Budget Breakdown
What is the minimum viable budget to replicate this?
A smaller county could start with two full-time staff plus committed partner and volunteer time, braiding a modest grant with free state resources and donated community capacity. The coalition is clear that $75,000 alone would need to be combined with other funding or social capital, such as partnering with volunteers, to work. With limited dollars, the advice is to run an asset and gap analysis first, identify the strengths that already exist in a community, and match those strengths to stated needs rather than building new programs from scratch. What cannot be cut is the core function: identifying support resources and connecting residents to them.
What Worked and Why
Specific decisions or design features that drove success
Slowing down and building trust before delivering content was the decision that turned the model around. The first listening-and-learning session showed limited engagement because the coalition arrived as strangers, talking to residents. Showing up at town events, handing out water, joining National Night Out and DEA Take Back days, and letting people see the same faces repeatedly eventually led communities to start calling the coalition on their own.
Using the language of resilience rather than addiction made the work approachable. When the team leads with “we do drug prevention”, doors close. When it leads with “what we want is to help build resilient youth, families, and communities”, people lean in and ask to hear more. It is the same work described in a way that invites the community in rather than putting it on the defensive.
Investing in marketing and communications reached the families that in-person events miss. Many households in the region work two or three jobs across second and third shifts and will never make it to a school or library meeting, but they will see a positive, health-focused message online while winding down from a shift. Social media also lets the coalition send timely alerts about emerging risks to parents, schools, and providers simultaneously.
Staffing the team with at least one person who has lived experience gave the outreach empathy and credibility. That staff member can speak openly about what helped her family and what she wished she had known earlier, which lands differently than information delivered by someone who learned it from a binder.
Anchoring the project in the coalition's existing mission and staying fluid, flexible, and willing to adapt is what the team identifies as the single most important factor. Because community building was already the organization's purpose, Project Upstream extended what Makin' It Happen does rather than asking it to become something new.
Early outcomes and data
Steady year-over-year growth in requests for training, workshops, and support materials from the eight communities.
Rising social media engagement as the coalition shares what services exist and how to reach them.
Positive pre-survey and post-survey results from trainings and workshops.
Local reports of eased pressure on emergency rooms and shelters as residents learn alternatives such as calling 988 or visiting a Doorway.
Rural police departments equipped with Narcan kits, medicine disposal bags, and 988 information are now carried in cruisers.
An anti-stigma training, delivered with a national policy partner, that shifted how partner agencies think about their work.
A mobile My Recovery Gallery of community recovery stories, hosted at roughly a half dozen sites and expanding into billboards.
Lessons Learned
Build trust before you build programs. The first listening session showed that residents may not engage with an organization they do not know. Showing up repeatedly, learning each town, and letting people see the same faces is the foundation on which everything else rests.
Run the asset and gaps analysis earlier. The team would map its community continuum-of-care partners sooner. Knowing each town's strengths and needs from the start would have focused the work faster.
Bring community partners into the work sooner. Rural and suburban towns want to meet the people behind the agencies. Involving partner organizations earlier would have built relationships ahead of need rather than during it.
Speak the community's language. Framing the work as building resilience rather than fighting addiction opens doors that clinical language closes, even when the underlying work is identical.
Plan and advocate for sustainable funding. Short-term grants create turnover and disrupt the people being served. Prevention deserves stable, long-term support, and replicators should plan to braid funding and advocate for it from day one.