Scaling up evidence-based models of integrating behavioral health care in primary care settings is a cost saving and effective way to reduce levels of distress and despair. They constitute our fourth pathway to mental health. More than 90 controlled studies of the Collaborative Care Model (CoCM) show increased rates of remission from depression and other conditions. Through universal screening for behavioral health problems, CoCM and other integrated care approaches detect problems early in their development, when they are easier to treat and have not yet led to despair. The CoCM is effective for people of all ages and across diverse populations. Two reasons for CoCM’s success are relational: CoCM is delivered in the context of a team, in which the patient is considered a key member; and second, the behavioral health care manager and other team members assertively and proactively engage patients, ensuring they do not fall through the cracks of the health system. The challenge is to dramatically increase the number of primary care providers who incorporate CoCM into their practices. The authors calculate the number of lives saved, amount of distress alleviated, and financial savings that would accrue from a nationwide implementation of the Collaborative Care Model.