The proposed project, Milestones, will enhance promotion, intervention, and treatment services for young children birth to 6 who are at risk of or diagnosed with a serious mental illness (SMI) including serious emotional disturbance (SED). Milestones will deploy an innovative treatment team who will provide a continuum of behavioral health services, and will strengthen caregiving relationships in the home, clinic, and community. The team will holistically integrate an array of family strengthening services to at-risk families with young children in eight diverse counties in North Texas (Cooke, Erath, Hood, Navarro, Palo Pinto, Parker, Somervell, and Wise) through person-centered, trauma-informed, and culturally-and linguistically-appropriate supports. My Health My Resources (MHMR), will augment stakeholder relationships and increase access to enhanced services to improve outcomes and identify participants at the earliest developmental stage. The Milestones population of focus consists of at-risk, rural families with children who, though they have a disability, are not eligible for MHMR's state-funded Early Childhood Intervention (ECI) due to the state's requirement that children have a disability level of 25% to access services, and, because of where they live, are ineligible for the strengthening supports of two essential programs operated in the other four MHMR counties of service: LAUNCH (SAMHSA initiative implemented through Texas), and the Health Outcomes through Prevention and Early Services Program (HOPES) operating through the state. Many participants present characteristics that Milestones services will alleviate. MHMR reports indicate that 49% of those referred last year did not qualify for state-funded services, even though they were at risk for abuse/neglect, and/or exhibiting developmental delays. Moreover, one in six of the children referred in 7 of the 8 counties in the catchment area were referred due to medical and/or global delays, disorders, and disabilities, highlighting the need for services such as telehealth. Milestones will address the following service gaps: 1) lack of capacity and funding to ensure targeted behavioral health services are provided and positive caregiver relationships are developed for all families in need; and 2) rural families' inability to access family-centered care, coordination, referrals, and visits with behavioral specialists needed to thrive. Collaboration with Cooks Children Health System, AccelHealth, school districts, and children's behavioral health coalitions in the catchment area, will ensure a continuum of behavioral health services is provided to families, and that participants are identified, screened, and assessed at the earliest stage. The evidence-based HealthySteps curriculum will be implemented via coordination with partners in clinics, integrating telehealth to reach children in all 8 counties. Milestones will serve 450 children over the project period with grant funds (72 in Year 1; 108 in Year 2; 108 in Year 3; 108 in Year 4; and 54 in Year 5). MHMR anticipates Milestones will provide training to 250 staff and professionals. The Milestones workforce will be trained in the implementation of evidence-based Trust-Based Relational Intervention, HealthySteps, Parent Café, Nurturing Parenting.