The seeds of Primary Care Behavioral Health (PCBH) were planted when clinician researchers from the fields of primary care (PC) and behavioral health (BH) became curious about the potential benefits of co-locating medical and behavioral health services and promoting collaboration between these historically siloed services. Might providers of PC and BH services realize better outcomes and greater on-the-job satisfaction by taking a team approach to delivery of services? Could mental health providers (MHPs) accustomed to practicing in a specialty setting make significant adaptations to their delivery of services, such that they would mirror key features of PC? Could primary care providers adjust their practice habits and their view of behavioral health services, such that an integrated MHP would become a routine part of PC, rather than a specialty service? Without these adjustments, the benefits of co-locating a MHP would be limited to being “good neighbors” and fall short of the teamwork that full integration aspires to. Leaders who commit to tending the soil and growing integrated behavioral health services are the ones most likely to obtain the results they desire in PC. In this chapter, we describe four steps leadership can take to help implement PCBH with success.