Education and Culture Change


Improve the culture and quality of care within the Dartmouth Health system provided to vulnerable and marginalized persons with substance use disorders and mental health problems.


The access to and quality of care provided to vulnerable and marginalized persons with substance use disorders, mental health, or intellectual problems are often impacted by cultural bias and stigma.

As the work to improve and optimize Dartmouth Health's delivery systems and models of care for patients with mental health disorders and addiction continuously evolves, it is important to acknowledge the impact of culture and to work towards eliminating bias and stigma as a deterrent to care.

In order to positively impact the culture of our organization, this project seeks to raise awareness of the prevalence of behavioral health disorders and provides education and resources to providers and staff that will empower them in communications with and care of persons with behavioral health challenges. Making sure that care teams have access to the operating guidelines, are provided the evidence, and have the policies and procedures are critical to long-term success of practice transformation.

This project team is working to:

  • Identify, understand and quantify the impact for patients with substance use disorders and/or mental health issues receiving care within the Dartmouth Health system.
  • Develop and implement strategies that promote positive engagement for patients and care teams around patient care.
  • Provide education on behavioral health that empowers staff in communication and care of affected persons.
  • Build a foundation for sustained engagement throughout the Dartmouth Health system.

Patients/populations impacted

  • Persons with behavioral health needs especially in primary care and urgent care settings, and their clinical care teams.

Process/systems being improved

  • Sustainable avenues for dissemination of knowledge and information are being developed. These include:
    • Monthly webinars and bi-annual symposia on clinical topics of relevance to culture change.
    • Website that brings together resources to support care and dissemination of materials to facilitate support of persons with emotional distress.
  • Empowering persons who interact with persons with behavioral health issues reduces fear and stigma and increases support.

Provider teams involved

  • Primary care
  • Emergency departments

Economics of care

  • Persons with behavioral health issues often present to Emergency Departments and primary care physician (PCP) offices with somatic complaints that are secondary to underlying mental health or substance issues.
  • Evidence demonstrates that health care utilization is significantly reduced when behavioral health issues are optimally addressed.

Project team

  • Seddon Savage
  • Greg Norman

Learning and data

  • Attendance at education webinars, seminars and symposia are being tracked.
  • Changes in practice, knowledge and attitudes post learning activities are being queried.
  • Hits on SUMHI website are being tracked with revisions to content based on use.