When Sarah Manlupig’s phone started ringing shortly after she opened her therapy practice in Gresham, a pattern quickly emerged. Families were searching for help for their young children, but finding support was not easy.

In the Portland metro area, more than 32,000 children are under the age of five. Many families need support with their child's emotional, social or behavioral health at some point during those early years. Finding that support, however, isn't always easy. Families often struggle to find the right help because of long wait times, too few providers trained to support young children's mental health and uncertainty about where to turn for services.

To help make that journey easier, CareOregon launched the Early Childhood Mental Health Pilot in August 2025. Pilot funding helped participating providers make operational shifts that increased timely access to assessments and treatment, including creating dedicated intake slots and early-childhood-focused caseloads. The pilot also supported provider training and stronger coordination between organizations serving young children and their caregivers.

The pilot includes eight organizations serving families across the region: Eastside Child and Family Therapy, Family Roots, Kinship House, LifeWorks NW, Morrison Child and Family Services, Restore Therapy, Willamette Health and Wellness and Youth Contact. Together, these organizations are helping build a stronger network of support in Portland for young children and their families.

Why early support matters

The first few years of a child's life are some of the most important. During this time, children are learning how to express emotions, build relationships and make sense of the world around them. When families can get support early, children are more likely to build the skills they need to succeed at home, in school and throughout their lives.

“Without early support, emotional, social and behavioral challenges can become more difficult to address over time,” said Amy Shea Reyes, CareOregon Behavioral Health Program Manager for Children, Youth and Families.

“Children who struggle with regulating emotions, building relationships or coping with stress may face challenges at home, in childcare settings and later in school. Early intervention can help families address concerns before they grow into larger barriers to learning, development and overall well-being.”

Meeting families where they are

Sarah had spent years working with children and families and understood that young kids communicate differently than adults. While adults may talk through their feelings, children often express themselves in other ways, such as through play. That understanding became the foundation of Eastside Child and Family Therapy.

What began as a one-person practice grew steadily. Schools started reaching out, asking Sarah to provide services on campus. One school became two, then three. Eventually, Eastside Child and Family Therapy expanded into a team serving children and families throughout the Gresham area.

As the practice grew, Sarah encountered another challenge — there weren't enough clinicians trained to work with very young children.

Many therapists want to support children but have limited opportunities for specialized training. CareOregon’s Early Childhood Mental Health Pilot helped Eastside Child and Family Therapy respond to that need by supporting staff training and helping the practice build more capacity for young children.

With that support, clinicians were able to attend trainings and expand expertise in areas that directly support young children, parents and caregivers.

Helping children feel safe and supported

For Sarah, the fundamental goal is to help children feel safe enough to learn, grow and express themselves.

Many families seek support because a child is having emotional outbursts, struggling with big feelings or having difficulties at home or school. Through play-based approaches, children are given space to express feelings they may not yet have the words to describe. Parents also learn tools that can help them support their child at home.

Sarah believes children do best when they feel safe and understood.

In therapy, children are encouraged to be themselves, without worrying about making mistakes or getting in trouble. Over time, they build confidence, learn new ways to communicate and develop skills that can support them throughout their lives.

It’s amazing to see what children can do when they feel safe and supported. They often find their own path forward.

Sarah Manlupig

Building a stronger system of care

Sarah's experience reflects what CareOregon is seeing across the pilot.

The pilot helped providers create more intentional pathways into care by supporting dedicated intake slots, early-childhood-focused caseloads and closer coordination among mental health providers, primary care clinics, schools, early learning programs and community organizations.

The impact is encouraging. Approximately 233 children and families received services through pilot providers. About 56% of children received an assessment within 10 days of referral, offering faster access than the weeks- or months-long waits often reported for children's behavioral health and developmental services.

Families also continued moving through the care process. Three out of four children referred for services attended an assessment appointment and nearly two-thirds moved on to treatment.

Together, those results show how the pilot supported more than access alone. It helped young children receive assessments sooner, supported families in taking the next step into treatment and gave providers more ways to coordinate with one another around shared community needs.

Providers say the pilot has also strengthened collaboration across the community. Organizations are working more closely with schools, pediatric clinics, preschools, childcare programs and other partners to help families find support more easily. Regular meetings give providers opportunities to share ideas, learn from one another and improve services.

Looking ahead

As the pilot comes to a close, the work continues. For Sarah, the pilot helped create a growing network of professionals committed to supporting young children and families. Each clinician who gains new skills and each partnership that grows stronger makes it easier for families to find support closer to home, when it can make the biggest difference.

“Moving forward, we will continue to build a stronger network of early childhood mental health providers, creating more opportunities to learn from one another and work together on behalf of young children and their families,” Amy Shea Reyes said.

Every child deserves the opportunity to succeed. Learn more about early childhood mental health resources, including providers who work closely with CareOregon, or search our Provider Directory to find care near you.