Compelling research indicates that the mental health trajectory of an individual begins before birth. Engaging with parents and young children based on risk factors for future mental health problems allows an opportunity to guide the trajectory in a positive direction. When behavioral and emotional problems do emerge, intervening early has a much better chance of helping the child get back on track with social–emotional development before issues become entrenched. Using a case example, this chapter highlights the importance of developing systems within health care and other settings for early identification and treatment of both parental and early childhood mental health problems. Specific strategies for implementation of screening, assessment, and intervention are explored in depth for parents and young children.