Purpose of review Pediatric mental disorders are among the most common disorders of childhood and are routinely seen in primary care. We review innovative management strategies, treatment technologies, and models of collaboration with behavioral health specialists in general medical settings. Our goal is to advance the integration of behavioral health services into primary care. Recent findings The application of mental health interventions with proven efficacy holds great promise for youths with mental disorders. Unfortunately, traditional primary-care management of pediatric mental disorders is characterized by nonspecific counseling, low-dose prescribing, and referrals to specialty settings that are often not completed. Summary The development, study, and refinement of new assessment and treatment technologies, supplemental treatments, and collaborative models of care delivery will be necessary to ensure more effective care for youths with mental disorders and their families. The promise of pediatric mental healthcare will not be fulfilled unless primary-care clinicians and behavioral health specialists forge new collaborative relationships that enhance the delivery of evidence-based care to affected children and their families.