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Intensive Services


Oregon’s Children’s System strives to offer a comprehensive continuum of care. We work with communities to build and support trauma-informed treatment programs that can serve mental health needs close to home.

Because day and residential treatment options are an essential part of a holistic continuum of care, Oregon’s Children’s System includes providers across the state that operate evidence based and trauma informed residential treatment programs for children and youth with mental health conditions that cannot be safely treated in their home, school and community based programs.

Throughout Oregon, private agencies operate intensive psychiatric services at a variety of levels of care. Depending on the agency, youth with commercial insurance and/or Oregon Health Plan receive appropriate levels of care. 

Psychiatric Treatment Services

Sometimes referred to as “partial hospitalization,” ​this level of care offers:

  • Individualized therapeutic services, 
  • Social environment supervision,  
  • In the moment coaching of relationship skills, 
  • Groups, and
  • Medication management. 

Day treatment programs are usually provided during school hours. They offer education services in collaboration with the mental health treatment providers.

Research shows that to best meet children's mental and behavioral needs, children and families should have treatment options in their communities. But sometimes community-based programs cannot safely manage the challenges of a youth’s mental health needs. When this happens, families may need an care out-of-home treatment option that provides 24-hour care.

These treatment environments are used to:

  • Accurately understand the mental health needs of the youth and family, and 
  • Keep the person safe.

​In Oregon, non-hospital treatment settings are known as psychiatric residential treatment services. These programs are generally less restrictive than a hospital setting. 

Residential programs treat children and adolescents who:

  • Have less acute illnesses, but 
  • Still require a residential environment for assessment and treatment. 

Youth receive care in 24-hour facilities where they live while receiving treatment. Active psychiatric treatment includes:

  • Medication management
  • Group therapy
  • Individual and family therapy

This helps the youth reintegrate with their community at the earliest appropriate time. This also prepares the youth and families for responsiveness to community-based programs.​

Providers in Oregon are:

​Similar to residential treatment services, this service is designed to be a short-term psychiatric assessment and stabilization service. It has more frequent access to child psychiatry and nursing.  

Oregon subacute providers are:

​If a youth’s mental health crisis requires hospital-based treatment, there are two Oregon hospitals to serve these needs. 

​Sometimes, children and youth who have a mental health crisis end up in an emergency room for evaluation.

The Acute Care Call Center and Bed Registry operates 24/7. It helps emergency department personnel find appropriate treatment for youth with intensive Behavioral Health needs.

OHA contracts with Lines for Life to complete this work.

Mental health providers and emergency department personnel may call the Acute Care Line at 503-255-4257.

OHA approves and funds referrals for secure inpatient psychiatric treatment. This type of treatment offers long-term psychiatric services for children and adolescents.

These non-hospital based, secure residential treatment programs are available to all Oregon youth who:

  • Have not been able to benefit from any of the lower levels of care and
  • Need to be treated in a secure setting for an average length of stay of six to nine months.

Oregon's secure inpatient treatment provider:

​The SAGE Residential program provides long-term stabilization for survivors of Commercial Sexual Exploitation of Children (CSEC) ages 11 to 17.

SAGE stands for: Support, Achieve their goals, Grow, and become Empowered.

CSEC survivors have very complex histories and have experienced multiple traumas. Referrals are usually made through the juvenile justice or Child Welfare systems. But referrals may also come from schools, hospitals, or a youth’s parent.

SAGE offers CSEC survivors treatment instead of punishment. Services are designed to teach participants pro-social alternatives that will help create long-term wellness.

Oregon's provider:

Program contact:
Shannon Karsten
Intensive Services Coordinator


Community Services and Supports

A community-based alternative for children and youth in crisis

Children and youth experiencing a mental health crisis are presenting in emergency rooms across the nation at an alarming rate. It is reported that at times children and youth are left waiting in their local emergency rooms for hours, days and even weeks for inpatient or outpatient services to come available.

  • In 2014 Oregon launched a community-based alternative, Crisis and Acute Transition Services (CATS). CATS originally served 4 counties. 
  • Since 2018, CATS has served 1300 children and youth. It has expanded to 9 counties across the state. 78% of these children were able to discharge from the emergency room within 24 hours.

To reduce the amount of time spent in the emergency room, CATS providers:

  • Work in close partnership with local emergency rooms and crisis centers.
  • Work with the youth and family to assess the clinical and safety needs to develop a plan to safely transition the child back home from the emergency room.
  • Offer an array of clinical and family support services to children and their families, in the home or community. Services include 24-hour crisis response, interim clinical services and family support and care coordination. CATS offers these services for up to 45 days or until the family is connected to the appropriate community resources to meet their needs.

Fidelity Wraparound is a voluntary and intensive care coordination model. It offers a unique set of community services and supports individualized for a youth and family to achieve positive outcomes. Fidelity Wraparound is available in every county in Oregon. 

Youth and families will work with a team of individuals trained to support youth and their families. Together they will create a plan of care. This is a crisis and safety plan that helps youth and family members move toward their goals and vision for the future.


Wraparound is for children and youth ages 0-17 who:

  • Experience complex mental health issues and
  • Are involved in mental health and one other system (e.g., foster care, special education, juvenile justice, intellectual/developmental disability programs)
  • Are currently receiving OHP.

Once eligible for wraparound, children and youth may receive services through age 25.


Nat Jacobs
System of Care and Wraparound Coordinator



Local Wraparound Programs (A-Z)

  1. Adapt Integrated Health Care (Douglas and Curry Counties)
  2. Benton County Health Department
  3. Best Care Treatment Services - Crook County
  4. Best Care Treatment Services - Jefferson County
  5. Center for Human Development (Union County)
  6. Clackamas County Health Housing & Human Service
  7. Clatsop Behavioral Healthcare
  8. Columbia County Mental Health
  9. Community Counseling Services (Gilliam, Grant, Morrow, Wheeler Counties)
  10. Deschutes County Health Services
  11. Direction Service (Lane County)
  12. Jackson County Health & Human Services
  13. Kairos NW (Coos and Jackson Counties)
  14. Lake District Wellness Center
  15. Lifeways, Inc. - Malheur County
  16. Lifeways, Inc. - Umatilla County
  17. Lincoln County Health and Human Services
  18. Linn County Mental Health
  19. Lutheran Community Services NW (Klamath County)
  20. Marion County Health Department
  21. Mid-Columbia Center for Living (Hood River, Sherman, and Wasco Counties)
  22. Multnomah County Behavioral Health Division
  23. New Directions NW, Inc. (Baker County)
  24. Options for Southern Oregon, Inc. (Jackson and Josephine Counties)
  25. Polk County Addiction and Mental Health Services
  26. Symmetry Care, Inc. (Harney County)
  27. Tillamook Family Counseling
  28. Wallowa Valley Center for Wellness
  29. Washington County Health & Human Services
  30. Yamhill County Health & Human Services



Change to mental health assessment timeline for Wraparound referrals, effective Dec. 1, 2021
The Wraparound Approach in Systems of Care


Assessment Tool for Expanding Systems of Care
Peer Roles Matrix
Roles and Responsibilities for Families and Youth
Roles and Responsibilities for Wraparound Partners
Children's Seclusion and Restraint Report, 2018-2020
Wraparound Glossary
Wraparound Guidance Document for CCOs (2016)


Children's Seclusion and Restraint Report, 2018-2020


Page Info

Shannon Karsten
Intensive Services Coordinator


​Nat Jacobs
System of Care and Wraparound Program Coordinator


Beth Holliman
Intensive Community-Based Services Coordinator


Summer Hunker
Complex Clinical Care Coordinator