The integration of behavioral health and primary care has become an increasingly important topic, with health care reform placing new emphasis on providing care that meets the spirit of the “Triple Aim”: better clinical outcomes, cost containment, and enhancing the patient experience of care. Models of integration range from the identification and treatment of mental disorders in primary care settings to addressing chronic medical conditions in patients with serious mental illness in public mental health settings. In addition, high utilizers of healthcare resources frequently have comorbid behavioral health conditions and present opportunities for proactive interventions in the other medical settings. Over the past decade, new approaches have been developed to provide solutions in these areas. This paper will discuss these emerging models and new roles for psychiatrists.