Despite the need for mental health services, current treatments are far from being widely embraced by families. This chapter focuses on identification and management of the top three presenting symptoms in mental health presenting to pediatric primary care providers. It helps the readers achieve a comfort level in the management of anxiety, depression, and attention deficit hyperactivity disorder. The chapter explains that it is critical to be appraised of the most common presenting problems to pediatric primary care in order to be effective at addressing the gap in mental health services. This is accomplished in several ways: in being a gateway to specialty services and/or being part of a safety net; in identifying and helping families who fall out of the specialized mental health system for one reason or another; and by providing early intervention services and catching things before they get worse.