To address the mental health needs of children and adolescents, Patient-Centered Medical Homes (PCMHs) need the capacity to screen for and detect significant mental health symptoms at the earliest stages of expression, the ability to develop treatment plans with patients and families, and systems to monitor and guide treatment over time. Given the complex nature of children’s mental health issues, primary care providers cannot be expected to perform these functions without the help of specialized child psychiatry resources offered in a collaborative fashion. PCMHs need access to consultation services and specialized care coordination.