The New York State Office of Mental Health (NYS OMH) has led the nation in adoption and scale of the Psychiatric Collaborative Care Model (CoCM) and seeks to build on that success by expanding the number of youth-serving primary care practices participating in the program to address the youth mental health crisis and advance health equity. This initiative will address mental and behavioral health problems among children and adolescents with co-occurring Serious Emotional Disturbance (SED) and physical health conditions or chronic disease, such as depression, anxiety, ADHD, substance use disorders, and suicidal thoughts and behaviors, by providing integrated behavioral health services. An explicit goal of the project is to ensure equitable access of services to populations who have historically lacked access, including BIPOC, LGBTQ+, and rural youth. This project will be implemented statewide in New York, the fourth most populous state in the country. Participating providers will represent the diversity of NYS, including both urban and rural primary care settings, large public hospital clinics, and small private practices serving over 3500 youth across 15 sites. The hallmarks of the NYS CoCM implementation approach are 1) extensive technical assistance and support for participating practices and 2) robust process and outcomes metrics to ensure delivery of care that makes a difference in the lives of youth and their families. In addition to technical assistance and support for the adoption of CoCM, participating practices will also receive training in suicide prevention best practices. A significant portion of award funds will be aimed at overcoming workforce shortages, an identified barrier, and supporting development of a sustainable model by the end of the five-year project.