Latest / The Mental Health Evolution / Ep 50: When Child Care Can't Wait for Nine to Five with Sara Bradley

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Ep 50: When Child Care Can't Wait for Nine to Five with Sara Bradley · The Mental Health Evolution

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(Transcribed by TurboScribe. Go Unlimited to remove this message.) This podcast is part of the Frederick podcast
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network.
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Learn more at listenfrederick.com.
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Welcome to Mental Health Evolution, a podcast about
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what's changing in mental health and why it
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matters.
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I'm your host, Rachel Harrison, inviting you into
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honest conversations with people from all perspectives in
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the field, clinicians, tech founders, investors, insurance companies,
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and all the folks in between.
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Let's explore what's working, what's not, and what's
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next.
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Welcome back everyone to the Mental Health Evolution
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podcast.
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I am Rachel Harrison, and today I'm speaking
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with someone who might not come to mind
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immediately when you think about the mental health
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workforce, but who is absolutely doing work every
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single day that supports the mental health of
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parents that keep our emergency responders, healthcare workers,
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and other essential workers on the front line
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where they are needed most.
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Sarah Bradley is the Executive Director of York
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Day Early Learning in York, Pennsylvania, an organization
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that has been serving working families in York
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County for more than 90, yes, 90 years.
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Under Sarah's leadership, York Day is doing something
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genuinely rare, offering reliable, high-quality early learning
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to families who work outside the traditional nine
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-to-five, including overnight shift workers, first responders,
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and families navigating recovery from substance use disorder.
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But Sarah's vision goes beyond the families York
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Day serves today.
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She is working to build a model for
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non-standard child care that other organizations can
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replicate so that what York Day does in
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York County can eventually exist in communities across
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the country.
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We are going to go dig into all
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of that today.
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Sarah has spent nearly two decades in non
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-profit early childhood education and joined York Day
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as a parent before eventually becoming its leader.
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I'm really glad she's here and can't wait
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to dig into that conversation.
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As you know, we always start with some
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articles first to kind of set a baseline
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for our conversation today.
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And so the first article that I want
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to talk about is called The 74 Million.
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When work isn't nine-to-five, child care
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can't be either.
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And this piece looks at a problem many
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people don't think about.
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The child care system in the United States
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was built around a standard workday.
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And for the millions of parents who work
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nights, weekends, irregular hours, shift work, that simply
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doesn't work.
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The article explores what non-standard child care
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actually looks like, who needs it, and why
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so few providers are equipped to offer it.
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It's a useful frame for understanding why what
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York Day does is genuinely rare.
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The second article from the University of Michigan
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School of Public Health is titled How Inaccessible
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Child Care Affects Families and Early Childhood Educators.
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So when child care is inaccessible, the consequences
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go well beyond logistics.
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Parents experience chronic stress, anxiety, and depression when
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they cannot find or afford reliable care.
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And for the mental health clinicians listening, these
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patients you are already seeing.
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This piece connects the child crisis directly to
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measurable mental health outcomes for parents, children, and
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the early childhood educators trying to serve them.
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And lastly, we have an article from JAMA
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Pediatrics, that's the Journal of American Medical Association,
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called U.S. Children Living with a Parent
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with Substance Use Disorder.
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And this 2025 study found that more than
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six million children in the United States live
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with at least one parent with a co
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-occurring substance use disorder and mental illness.
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For people working with these families, reliable child
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care is not a peripheral issue.
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It's often a direct factor in whether a
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parent can sustain recovery.
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York Day's work with family and substance abuse
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disorder recovery puts them at the intersection of
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early childhood education and behavioral health in a
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way that most child care providers never attempt.
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So with that, Sarah, I'm excited to dive
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into a conversation with you.
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Tell me a little bit more about York
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Day.
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Your organization has been around for a long
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time.
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I'm curious, what are you seeing as the
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most urgent unmet need for families that you're
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already serving?
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So yes, York Day is very old.
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It was here long before I was here
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in this community.
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It really is a York County supported program,
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and it will continue to be here long
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after.
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And so I am just a blip in
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its existence, but it really does serve as
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the village for so many generations of families
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here in York County.
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So there were a few urgent needs.
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And so one thing I think is important
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to do is kind of set the stage
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that all high quality early learning programs have
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significant waiting lists.
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And so as a parent who is trying
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to find care in organizations such as ours,
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we have over 600 children on a waiting
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list today.
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And so one of the needs immediately that
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we know is additional slots, right?
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And so sometimes we can't accept siblings coming
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into a program.
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We have to be really careful how we
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weigh that to make sure we can continue
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to serve families the way they need to
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be served so they're not taking kids to
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multiple places.
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A big one was resource and referral services
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for behavior supports.
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And so we are kind of talking about,
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I mean, it's different from when you and
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I were young and there was a lot
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of outdoor time.
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And so with further implementation of technology, medicine
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is finally trying to understand and catch up
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with how that influx of technology has affected
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young brains and those behavior outcomes that are
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associated with that infiltration of technology.
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And so we see, and we are not
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alone in this, a lot of, I will
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say, explosive or undesirable behaviors from young children
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that are coming earlier and earlier and earlier.
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And so parents are frequently seeking help for
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those behaviors.
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So that type of resource and referral.
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The other thing that we noticed is the
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amount of families that needed traditional, non-traditional
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hours.
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And so I know we're going to talk
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about that a little bit more, but even
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those that work in what we would consider
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a traditional daytime hours, you know, working, that
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could be 6.30 to 2.30, that
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could be 8 to 5.30. When most
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of our standard programs are only operating between
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6.30 or 7.30 to 5.30
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or 6.00. And so that puts a
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lot of strain on the family.
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And so when I came in, we were
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looking at all of these solutions for all
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of these areas.
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The first thing we did was get our
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resource and referral in line for behavior supports.
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And that included bringing people in, that included
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education components for parents, and building a sense
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of community amongst themselves.
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And the second thing we did, which is
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what we're talking about today, is looking at
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those extended hours.
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Wow.
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So what have you been able to bring
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in, in terms of behavior support?
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So a lot of it is just knowing
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where to find those in the county that
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you are.
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And so our state puts a significant amount
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of money into support systems to help families
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through our Lincoln Intermediate Units here in Pennsylvania.
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But one thing that the Office of Child
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Development and Early Learning did here is they
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created rapid response teams, which is a group
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of professionals that can come in quickly and
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provide emergency supports for kids who are struggling
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to adapt to care.
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They help our teachers one-on-one, they
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give them recommendations and suggestions, they work with
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the family, they put a plan in place.
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Because the goal is for families to be
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able to work and for kids to be
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able to adapt to these types of settings.
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And so having those additional supports to be
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able to bring those rapid response team in
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have been life-changing for some of our
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families here.
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Yeah.
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Yeah, that makes a lot of sense.
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And what kind of parent supports are you
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referring to?
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So we bring in speakers to talk to
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our parents if there's a particular topic, whether
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that's academic, whether that's behavioral, whether that is
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even outside of kid care.
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So that could be bringing in a bank
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to talk about budgeting and finances and how
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to get a mortgage.
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And so we really do work with the
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needs of our families to make sure we're
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providing that level of support where it fits
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our current families at that time.
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Yeah, that's awesome.
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And so this also kind of round-the
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-clock supporting shift work sort of care, how
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is that working?
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And are some of the logistics challenging?
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Like I'm very curious about those pieces.
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So this is a topic that has been
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talked about county and statewide because I've worked
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at both levels for over 20 years.
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Can we do this?
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What does it look like?
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What is the need?
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And so coming into this role with the
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needs that we knew existed, and just so
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everyone knows what that framework looks like here
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in New York County, the New York County
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Economic Alliance gave us data that it's anywhere
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between 15% to 20% of our
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workforce here in New York County works some
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type of nontraditional hours.
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And you already hit on those are our
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customer service individuals, those are healthcare workers, emergency
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responders, any number.
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I mean, some we have contract work.
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There's a lot of commercial industry that happens
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here in New York.
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We are known for that.
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And so that also reflects the national data
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about what's happening across the country.
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And so it's not just here, it's everywhere.
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Yeah.
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When we initially tried to put this into
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place with that data, we put together a
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program that one was staffed appropriately, because we
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thought staffing was going to be our biggest
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barrier.
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It ended up not being which was surprising
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to us.
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And we piloted in the month of January
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of this year.
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And so we have only been open for
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six months for nontraditional care.
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We've had to pivot multiple times already in
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this pilot, one being what we envisioned was
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going to be based on surveys from parents
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and businesses that they had need a very
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particular start and a very particular stop sign.
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So we had the idea that we were
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going to stop our daytime program at 530,
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have an hour reset, open the building back
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up and this new wave of kids was
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going to come into the building in this
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very perfect linear fashion.
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That would then before we started again in
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the morning, we'd have a reset time, it
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would be like a whole second shift that
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came in.
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But once we opened registration, what we found
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is that although some of our families fit
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within that, many of them were asking for
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an exception.
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I need to come in an hour early,
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I start work at this time.
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I need to come in a little late,
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we start work at this time.
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We only need these days a week.
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And so we as the administrative team, we
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really started having the conversation if we are
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making exceptions for every family, we're providing the
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wrong program.
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And so we really had to take a
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step back and look at what are the
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hours that are actually needed.
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And so at that point, we no longer
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had our is considered overnight, but we are
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now a 24 hour a day program.
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So throughout the afternoon, when you see daytime
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kids leaving, we see kids coming in to
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take their place depending on when their parent's
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start time is.
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And so there is no definitive stop and
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start because the community doesn't need that.
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So trying to force a program that wasn't
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going to work wasn't helping our families and
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wasn't helping the model.
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Yeah, I think that sort of more fluid
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ability to have kids starting and stopping in
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a way that makes sense for their families.
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That's pretty awesome that you've been able to
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design that.
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Thank you.
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Yeah.
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And we will have to pivot again.
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So we were able to raise enough dollars
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through the philanthropic community and through the Commonwealth
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to be able to support this program for
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18 months operationally to build and test and
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pivot to really see what model will work.
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So when we start telling the story of
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non-traditional care, we will be able to
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talk about our failures, our successes, words of
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wisdom, barriers we faced, things to consider.
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There's lots of things we didn't consider in
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this process.
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And so one of those being, do these
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kids sleep?
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Because if they're parents, typically we anticipated we'd
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have kids sleeping through the night.
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But what we found is we in a
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lot of cases need to create some kind
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of educational opportunity for them overnight because they
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sleep at home with their parents during the
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day.
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Okay.
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Yeah.
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And so we've been working with families to
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kind of shift their child's sleep schedule, which
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is a very different environment than what we
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initially anticipated.
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Right.
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Wow.
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Yeah.
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And I just see so many connections to
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being able to support the wellness of parents,
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but also the wellness of kids in this
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piece.
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I think the University of Michigan piece about
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connecting childcare and accessibility directly to anxiety, depression,
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and burnout, not just for parents, but for
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early educators too, is very interesting.
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Does that match what you see on the
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ground?
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Every day.
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Every day.
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Yeah.
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Every day.
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We probably get 30 to 35 people on
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our waiting list every single day.
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We have people that call with tears.
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We are not the only community that suffers
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from this.
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This is a national epidemic.
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There are, there's not enough spots to support
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families for needed care for both, if they
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even have two parents in the household to
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be able to work and find care.
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I know one of the recommended, someone asked
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me recently what piece of advice I would
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give to parents who find out they're recently
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expecting in terms of finding childcare.
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And so the recommendation is not to wait
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till the baby is born, which is when
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a lot of parents think they're like, okay,
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now I need to find care.
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I have six to 12 weeks if they're
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fortunate to being able to find care to
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go back to work.
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And so, you know, my advice in those
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is at the point of conception, you need
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to start looking to see what your options
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are in your community.
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Because I mean, even in New York County,
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there are a lot of what I would
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consider childcare deserts where it's not even available.
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That creates a tremendous stress on couples.
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It creates a tremendous stress on household income,
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on siblings, if they're in two different places.
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And so, I mean, just some really good
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things to consider when you're thinking about having
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children.
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Definitely.
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You've talked about wanting to train other organizations
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to replicate this model.
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I'm curious, what does that look like?
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And what are some of the biggest barriers
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for a childcare provider who wants to start
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serving non-standard hours families or families in
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recovery?
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So again, we are only six months in.
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Yeah.
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And so the end goal at the end
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of 18 months is to be able to
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create a blueprint that can be replicated so
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we can support other organizations through this journey.
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Here are the surveys that we used.
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Here is, you know, examples of paperwork that
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we used.
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Here is barriers that we faced, frequently asked
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questions, you know, work with your local chamber
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of commerce to really connect with businesses.
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And so something like that would be really
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helpful.
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And I know we have companies around here
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who are waiting for that to see what
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happens with our model to be able to
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pick up that work.
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Does it work?
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Does it not work?
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Is it a need?
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And so we know based on the research
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with 20% of our population working non
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-traditional hours, it is.
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But how can we get that word out?
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A marketing plan?
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People to consider in that way.
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The biggest barrier, and we have been very
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fortunate on this so far, is going to
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be consistent staffing.
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We heard from employers in our surveys that
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their non-traditional hours are really non-consistent
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with maintaining employees.
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Yeah.
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We have seen that with children here.
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And so when families enroll their child, we
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have seen that rollercoaster of enrollment.
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When they come in and three weeks later,
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their parent has offered a daytime shift.
16:45
Oh, wow.
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And our daytime is full.
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And so we have seen that here as
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well.
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Okay.
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And so it continues to transition like that.
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And the toll of working non-traditional hours
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in your own family life from an employment
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standpoint, again, we have been very fortunate, but
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that burnout is very real.
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So taking really careful consideration on who you're
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bringing in, how you're taking care of those
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employees, what their hours of work look like,
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and creating some wellness areas for them to
17:14
be able to maintain that non-traditional employment
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under stressful conditions.
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Any child care is a stressful condition to
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be able to maintain that workflow overnight.
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Otherwise it can't exist.
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Yeah.
17:27
That seems like a pretty enormous challenge, actually.
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Yes.
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Maybe with some creative solutions, but definitely love
17:36
your approach to taking the 18 months, seeing
17:39
where you need to pivot and being able
17:42
to make those changes and those pivots.
17:45
What do you think that just people in
17:49
general, maybe people in the mental health industry,
17:51
maybe just people who are looking for childcare,
17:54
what do people most need to understand about
17:57
the needs, the challenges, the barriers?
18:00
What message would you want to get out
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there about what you're doing?
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About Twilight in particular, about just early learning
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in general.
18:08
Whatever you want.
18:10
Yeah.
18:11
Whatever we want to talk about.
18:12
Yeah.
18:13
So I think it's really important for people
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to know that there is no one traditional
18:20
way to care for your child.
18:23
It is all hard.
18:25
There are lots of options.
18:27
Some people prefer at-home providers, some people
18:29
for group homes, some people prefer centers.
18:32
And if one of those options isn't working
18:33
for you, even if it's overnight during the
18:37
day, if you need weekend care, whatever that
18:39
looks like, that it's okay.
18:41
Care is best.
18:42
Community is best.
18:44
The village is best.
18:45
And so whatever that looks like for your
18:46
family, you will need to feel good about
18:50
it.
18:50
It will need to be the best situation
18:52
for you with your hours, with what you
18:55
can afford, because the other part we haven't
18:57
talked about is the enormous cost of early
19:00
learning for families, which can also create mental
19:03
health issues.
19:05
But to know that you need to find
19:07
something that works for you and to start
19:09
that process as early as possible.
19:12
Yeah.
19:12
Yeah.
19:13
I love that piece of advice to get
19:15
on it quickly, get on a waiting list
19:17
or get on a few quickly.
19:19
That's awesome.
19:20
Well, I want to thank you, Sarah.
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I feel like what you're doing does support
19:25
mental health of our communities, wellness of our
19:28
children, wellness of parents, wellness of families, and
19:32
especially those workers that do jobs that are
19:37
challenging and different shifts, right?
19:39
We want those people to be doing that
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work.
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It's a service to our community to have
19:45
people in those organizations and being able to
19:47
do what they do.
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So I appreciate how you are supporting wellness
19:52
in your community.
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So thanks for being here.
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Thanks for sharing what you're doing.
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And I'm just glad to have had this
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conversation.
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Yep.
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No problem.
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I sincerely appreciate it.
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Thank you very much for having me.
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And yeah, thank you.
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So for our listeners, we will have all
20:11
of the in the show notes, we will
20:13
have links to everything that Sarah and her
20:16
team are doing and to the articles as
20:19
well.
20:20
If this is something of interest and something
20:21
that you want to dig into a little
20:23
bit more.
20:24
And we will be back next time to
20:27
talk about everything on how the landscape in
20:31
the mental health industry is changing.
20:33
I'm Rachel Harrison.
20:35
This is Mental Health Evolution, and we'll see
20:37
you next time.
20:39
Thanks for listening to the Mental Health Evolution
20:42
podcast.
20:43
Join the conversation, find us on socials, send
20:46
us your thoughts and tell us what you're
20:47
seeing in your corner of the mental health
20:49
world.
20:50
Until next time, stay curious and keep evolving.