There is a severe shortage and a maldistribution of child and adolescent psychiatrists in the United States. Public-academic collaborations play a major role in attempting to address these conditions. This column describes examples of two types of collaborations: newer programs that emphasize consultation, education, and support to primary care providers and more traditional efforts that provide consultation to general psychiatrists and psychiatric nurse practitioners. In both cases videoconferencing plays a role in reaching difficult-to-serve populations. Residency programs for both child and adolescent psychiatrists and primary care providers should include training in collaborative treatment approaches.