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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 and in the moment coaching of relationship skills, groups, as well as medication management. 

Usually provided during school hours, day treatment programs offer education services in collaboration with the mental health treatment providers.

Research shows that children and families are best served with treatment options to meet their mental and behavioral needs in their communities. Sometimes, when the challenges of a youth’s mental health needs are unable to be safely managed in community-based programs, a 24-hour care out-of-home treatment option is needed.

These treatment environments are used to accurately understand the mental health needs of the youth and family, and to 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 whose illnesses are less acute but who still require a residential environment to assess, treat and prepare the youth and families for responsiveness to community-based programs.

Youth receive care in 24-hour facilities where they live while receiving treatment. Active psychiatric treatment includes medication management, group therapy, and individual and family therapy to assist the youth in reintegrating back to their community at the earliest appropriate time.

Providers in Oregon are:

​Similar to residential treatment services, this service is designed to be a short-term psychiatric assessment and stabilization service, with 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 with specialized units 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 and 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 to these 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 may 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

A growing number of 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 serves to come available.

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

CATS providers:

  • Work in close partnership with local emergency rooms and crisis centers to offer an array of clinical and family support services to children and their families to reduce the amount of time spent in the emergency room.
  • 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 services in the home or community that include 24-hour crisis response, interim clinical services and family support and care coordination 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 that results in a unique set of community services and supports individualized for a youth and family to achieve a positive set of 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 to create a plan of care, a crisis and safety plan that supports youth and family members moving 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)

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


Nat Jacobs
System of Care and Wraparound Coordinator



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 Care Based Coordinator ​


Summer Hunker
Complex Clinical Care Coordinator


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