KEENE, New Hampshire — In the last week, Hillary Clinton has outlined her presidential campaign the same way at just about every event. She lists her "four big fights": rebuilding the economy, strengthening families, stripping dysfunction from government, and protecting the country from security threats.
From that framework, one issue not frequently discussed in presidential politics keeps coming to Clinton's attention: mental health and substance abuse.
She heard about it last week in Iowa in Council Bluffs, and in Davenport, she said. And on Monday, at a "roundtable" here in New Hampshire, Clinton discussed the issue a third time, promising to make it "a big part of [her] campaign."
"I think a lot of people are thinking, Well, that's somebody else's problem. That's not my problem. And indeed, it is all of our problem," Clinton said. "This is not something we can just brush under the rug and wish it would go away."
At the event — a panel-like discussion at Whitney Brothers, a small, family-owned business in Keene — several of the roundtable participants told Clinton they viewed mental health problems, including substance abuse, as a leading concern.
Pam Livengood, an assembler at Whitney Brothers, raised the issue. There is a "growing drug problem" in the area, said Livengood, citing a personal example — a struggling family member. "There are very limited resources here. And we'd like to see something in that respect. Do you have any further ideas?"
"Well, I do actually," Clinton said. "I am really concerned, because, Pam, what you just told me, I'm hearing from a lot of different people."
Clinton, who announced her campaign for president just over a week ago, said substance problems persist as an "increasing problem" but have become less visible. Treatment programs, Clinton added, have also seen "steady cutbacks."
"This is a quiet epidemic," said Clinton.
Later Monday, at a house party in Claremont, Clinton told a crowd of about 50 people how much Livengood's comment had resonated. "If I were just to read briefing books or I were just to engage in the political back-and-forth," she said, "would I have heard what a big problem mental health is in New Hampshire?"
The roundtables — the campaign's main event format during a period aides have called the "ramp-up" phase — may inform policies Clinton introduces later this year. She has said she hopes to "embed" voters' ideas directly into her agenda.
In Iowa, voters expressed unease in particular about shuttered in-patient facilities. "I literally heard from one end of the state, to Davenport to Council Bluffs, about this problem," she said. "There was nowhere for people to be sent."
The roundtable in Keene, attended by about a dozen local Democrats, was meant to concentrate on the first of Clinton's four "fights": the economy.
But after Livengood, a Keene resident, brought up mental health, Clinton spent a considerable chunk of time discussing the issue with several other panelists.
She praised the measure in the Affordable Care Act that requires most health insurance plans to cover mental health and substance services. But she said lawmakers have to "do more," and called for a "concerted policy" at the "national, state, local" levels, and across the public and private sectors.
Clinton also framed the problem as a particularly troubling one for local communities. New Hampshire, as well as other northeastern states, has notably faced an increase in heroin abuse in recent years.
State Sen. Molly Kelly, who supported Clinton in 2008 and was in the audience on Monday, said the issue was salient on a "local, state, and national" level.
And in Keene, said Kelly, "it's an issue that people really bring up."
Ruby Cramer is a political reporter for BuzzFeed News and is based in New York.
Contact Ruby Cramer at firstname.lastname@example.org.
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