When Child Care Can't Wait for Nine to Five with Sara Bradley

welcome to Mental Health Evolution, a podcast about what's changing in mental health and why it matters. I'm your host, Rachel Harrison, inviting you into honest conversations with people from all perspectives in the field. Clinicians, tech founders, investors, insurance companies, and all the folks in between. Let's explore what's working, what's not, and what's next.

Welcome back everyone to the Mental Health Evolution Podcast. I am Rachel Harrison and today I'm speaking with someone who might not come to mind immediately when you think about the mental health workforce, but who is absolutely doing work every single day that supports the mental health of parents and that keep our emergency responders, healthcare workers and other essential workers on the front line where they are needed most. Sarah Bradley is the Executive Director of York Day Early Learning in York, Pennsylvania, an organization that has been serving working families in York county for more than 90 yes, 90 years. Under Sarah's leadership, York Day is doing something genuinely rare, offering reliable, high quality early learning to families who work outside the traditional nine to five, including overnight shift workers, first responders, and families navigating recovery from substance use disorder. But Sarah's vision goes beyond the families York Day serves today. She is working to build a model for non standard child care that other organizations can replicate so that what York Day does in York county can eventually exist in communities across the country. We are going to go dig into all of that today. Sarah has spent nearly two decades in nonprofit early childhood education and joined York Day as a parent before eventually becoming its leader. I'm really glad she's here and can't wait to dig into that conversation. As you know, we always start with some articles first to kind of set a baseline for our conversation today. And so the first article that I want to talk about is called the 74 million. When work isn't 9 to 5, child care can't be either. And this piece looks at a problem many people don't think about. The child care system in the United States was built around a standard workday. And for the millions of parents who work nights, weekends, irregular hours, shift work that simply doesn't work, the article explores what non standard child care actually looks like, who needs it, and why so few providers are equipped to offer it. It's a useful frame for understanding why what York Day does is genuinely rare. The second article from the University of Michigan School of Public Health is titled How Inaccessible Child Care Affects Families and Early Childhood Educators. So when child care is inaccessible, the Consequences go well beyond logistics. Parents experience chronic stress, anxiety and depression when they cannot find or afford reliable care. And for the mental health clinicians listening these patients you are already seeing, this piece connects the child care crisis directly to measurable mental health outcomes for parents, children, and the early childhood educators trying to serve them. Lastly, we have an article from JAMA Pediatrics that's the Journal of American Medical association called US Children Living with a Parent with Substance Use disorder. And this 2025 study found that more than 6 million children in the United States live with at least one parent with a co occurring substance use disorder and mental illness. For people working with these families, reliable child care is not a peripheral issue, and it's often a direct factor in whether a parent can sustain recovery. York Day's work with family and substance abuse disorder recovery puts them at the intersection of early childhood education and behavioral health in a way that most child care providers never attempt. So with that, Sarah, I'm excited to dive into a conversation with you. Tell me a little bit more about York Day. Your organization has been around for a long time. I'm curious, what are you seeing as the most urgent unmet need for families that you're already serving?

So, yes, York Day is very old. It was here long before I was here in this community. It really is a York county supported program and it will continue to be here long after. And so I am just a blip. And it is and its existence, but it really does service the village for so many generations of families here in York County. So there were a few urgent needs. And so one thing I think is important to do is kind of set the stage that all high quality early learning programs have significant waiting lists. And so as a parent who is trying to find care, an organization such as ours, we have over 600 children on a waiting list today. And so one of the needs immediately that we know is additional slots. Right. And so sometimes we can't accept siblings coming into the program. We have to be really careful how we weigh that to make sure we can continue to serve families the way they need to be served so they're not taking kids to multiple places. A big one was resource and referral services for behavior supports. And so we are kind of talking about, I mean, it's different from when you and I were young and there was a lot of outdoor time. And so with further implementation, technology medicine is finally trying to understand and catch up with how that influx of technology has affected young brains and those behavior outcomes that are associated with that infiltration of Technology. And so we see, and we are not alone in this, a lot of, I will say, explosive or undesirable behaviors from young children that are coming earlier and earlier and earlier. And so parents are frequently seeking help for those behaviors. So that type of resource and referral, the other thing that we noticed is the amount of families that needed traditional, non traditional hours. And so I know we're going to talk about that a little bit more. But even those that work in what we would consider a traditional daytime hours, you know, working that could be 6, 30 to 2 30, that could be 8 to 5 30, when most of our standard programs are only operating between 6 30, 30 or 730 to 5, 530 or 6. And so that puts a lot of strain on the family. And so when I came in, we were looking at all of these solutions for all of these areas. The first thing we did was get our resource and referral in line for behavior supports. And that included bringing people in, that included education components for parents and building a sense of community amongst themselves. And the second thing we did, which is what we're talking about today, is looking at those extended hours.

Wow. So what have you been able to bring in in terms of behavior support?

So a lot of it is just knowing where to find those in the county that you are. And so our state puts a significant amount of money into support systems to help families through our Lincoln Intermediate Units here in Pennsylvania. But one thing that the Office of Child Development and Early Learning did here is they created rapid response teams, which is a group of professionals that can come in quickly and provide emergency supports for kids who are struggling to adapt to care. They help our teachers one on one, they give them recommendations and suggestions. They work with the family, they put a plan in place because the goal is for families to be able to work and for kids to be able to adapt to these types of settings. And so having those additional supports to be able to bring those rapid response team in have been life changing for some of our families here.

Yeah, yeah, that makes a lot of sense. And what kind of parent supports are you referring to?

So we bring in speakers to talk to our parents if there's a particular topic, whether that's academic, whether that's behavioral, whether that is even outside of kidcare. So that could be bringing in a bank to talk about budgeting and finances and how to get a mortgage. And so we really do work with the needs of our families to make sure we're providing that level of support where it fits our current families at that time.

Yeah, that's awesome. And so this also kind of round the clock supporting shift work, sort of care how is that working and are some of the logistics challenging? Like I'm very curious about those pieces.

So this is a topic that has been talked about county and statewide because I've worked at both levels for over 20 years. Can we do this? What does it look like? What is the need? And so coming into this role with the needs that we knew existed and just so everyone knows what that framework looks like here in York county, the York County Economic alliance gave us data that it's anywhere between 15 to 20% of our workforce here in York county works some type of non traditional hours. And you already hit on those are our customer service individuals, those are healthcare workers, emergency responders, any number. I mean some we have contract work. There's a lot of commercial industry that happens here in York. We are known for that. And so that also reflects the national data about what's happening across the country. And so it's not just here, it's everywhere.

Yeah.

When we initially tried to put this into place with that data, we put together a program that one was staffed appropriately because we thought staffing was going to be our biggest barrier and ended up not being which was surprising to us. And we piloted in the month of January of this year. And so we have only been open for six months for non traditional care. We've had to pivot multiple times already in this pilot. One being what we envisioned was going to be based on surveys from parents and businesses that they had need a very particular start and a very particular stop sign. So we had the idea that we were going to stop our daytime program at 5:30, have an hour reset, open the building back up. And this new wave of kids was going to come into the building in this very perfect linear fashion that would then before we started again in the morning, we'd have a reset time. It would be like a whole second shift that came in. But once we opened registration, what we found is that although some of our families fit within that, many of them were asking for an exception. I need to come in an hour early. I start work at this time. Time. I need to come in a little late. We start work at this time. We only need these days a week. And so we as the administrative team, we really started having the conversation if we are making exceptions for every family, we're providing the wrong program. And so we really had to take a step back and look at what are the hours that are actually needed. And so at that point we no longer had. Our twilight is considered overnight, but we are now a 24 hour a day program.

Okay.

So throughout the afternoon, when you see day, daytime kids leaving, we see kids coming in to take their place depending on when their parents start time is. And so there is no definitive stop and start because the community doesn't need that. So trying to force a program that wasn't going to work wasn't helping our families and wasn't helping the model.

Yeah. I think that that sort of more fluid ability to have kids starting and stopping in a way that makes sense for their families, that's part of. Pretty awesome that you've been able to design that.

Thank you.

Yeah.

We will have to pivot again. So we were able to raise enough dollars through the philanthropic community and through the commonwealth to be able to support this program for 18 months operationally to build and test and pivot to really see what model will work. So when we start telling the story of non traditional care, we will actually, we will be able to talk about our failures, our successes, words of wisdom, barriers we faced, things to consider. There's lots of things we didn't consider in this process. And so one of those being, do these kids sleep? Because if they're parents, typically we anticipated we'd have kids sleeping through the night. But what we found is we in a lot of cases need to create some kind of educational opportunity for them overnight because they sleep at home with their parents during the day.

Okay. Yeah.

And so we've been working with families to kind of shift their child's sleep schedule, which is a very different environment than what we initially anticipated. Right.

Wow.

Yeah.

And I just see so many connections to being able to support the wellness of parents, but also the wellness of kids in this piece. I think the University of Michigan piece about connecting childcare inaccessibility directly to anxiety, depression and burnout, not just for parents, but for early educators too, is very interesting. Does that match what you see on the ground every day? Every day? Yeah.

Every day we probably get 30 to 35 people on our waiting list. Every single day. We have people that call with tears. We are not the only community that suffers from this. This is a national academic. There are. There is not enough spots to support families for needed care for both if they even have two parents in the household to be able to work and find care. I know one of the recommended. Someone asked me recently what piece of advice I would give to parents who find out they're recently expecting in terms of finding childcare. And so the recommendation is not to wait till the baby is born, which is when a lot of parents think they're like, okay, now I need to find care. I have six to 12 weeks, if they're fortunate to being able to find care, to go back to work. And so, you know, my advice on those is at the point of conception, you need to start looking to see what your options are in your community. Because, I mean, even in New York county, there are a lot of what I would consider childcare deserts where it's not even available. That creates a tremendous stress on couples, it treats a tremendous stress, stress on household income, on siblings if they're in two different places. And so, I mean, just some really good things to consider when you're thinking about having children.

Definitely you've talked about wanting to train, organize other organizations to replicate this model. I'm curious, what does that look like? And what are some of the biggest barriers for a childcare provider who wants to start serving non standard hours, families or families in recovery?

So again, we are only six months in. Yeah. And so the end goal at the end of 18 months is to be able to create a blueprint that can be replicated so we can support other organizations through this journey. Here are the surveys that we used. Here is, you know, examples of paperwork that we used. Here is barriers that we faced, frequently asked questions, you know, work with your local chamber of commerce to really connect with businesses. And so something like that would be really helpful. And I know we have companies around here who are waiting for that to see what happens with our model to be able to pick up that work. Does it work? Does it not work? Is it a need? And so we know based on the research, with 20% of our population working non traditional hours, it is. But how can we get that word out? A marketing plan, people to consider in that way, the biggest barrier, and we have been very fortunate on this so far, is going to be consistent staffing.

Hmm.

We heard from employers in our surveys that their non traditional hours are really non consistent with maintaining employees. Yeah, we have seen that with children here. And so when families enroll their child, we have seen that roller coaster of enrollment when they come in and three weeks later their parent is offered a daytime shift. Oh, wow. And our daytime is full. And so we have seen that here as well.

Okay.

And so it continues to transition like that. And the toll of working non traditional hours in your own family life, from an employment standpoint, again, we have been very fortunate, but that burnout is very real. So taking really careful consideration on who you're bringing in, how you're taking care of those employees, what their hours of work look like and creating some wellness areas for them to be able to maintain that non traditional employment under stressful conditions. Any childcare is a stressful condition. To be able to maintain that, that workflow overnight, otherwise it can't exist.

Yeah, that seems like a pretty enormous challenge actually.

Yes.

Maybe with some creative solutions, but definitely love your approach to taking the 18 months, seeing where you need to pivot and being able to make those changes and those pivots. What do you think that just people in general, maybe people in the mental health industry, maybe just people who are looking for childcare. What do people most need to understand about the needs, the challenges, the barriers? Like what would, what message would you want to get out there about what you're doing?

About Twilight in particular? About just early learning in general?

Whatever you want.

Yeah. Whatever we want to talk about.

Yeah.

So I think it's really important for people to know that there is no one traditional way to care for your child. Like it is all hard. There are lots of options. Some people prefer at home providers, some people prefer grid homes, some people prefer, prefer centers. And if one of those options isn't working for you, I mean even if it's overnight during the day, if you need weekend care, whatever that looks like, that it's okay. Care is best, community is best, the village is best. And so whatever that looks like for your family will need to be like. You will need to feel good about it. It will need to be the best situation for you with your hours, with what you can afford. Because the other part we haven't talked about is the enormous cost over early learning for families which can also create mental health issues. But to know that you need to find something that works for you and to start that process as early as possible.

Yeah, yeah, I love that piece of advice. To get on it quickly, get on a waiting list or get on a few quickly. That's awesome. Well, I want to thank you, Sarah. I feel like what you're doing does support mental health of our communities, wellness of our children, wellness of parents, wellness of families, and especially those workers that do jobs that are challenging in different shifts. Right. We want those people to be doing that work. It's a service to our community to have people in those organizations and being able to do what they do. So I appreciate how you are supporting wellness in your, in your community. So thanks for being here, thanks for sharing what you're doing and I'm just glad to have had this conversation.

Yep, no problem. I sincerely appreciate it. Yeah, thank you very much for having me. And yeah, thank you.

So for our listeners, we will have all of the in the show notes, we will have links to everything that Sarah and her team are doing and to the articles as well, if this is something of interest and something that you want to dig into a little bit more. And we will be back next time to talk about everything on how the landscape in the mental health industry is changing. I'm Rachel Harrison. This is Mental Health Evolution, and we'll see you next time.