Families In Recovery Staying Together (FIRST) is a team from Children's Hospital and Research Center at Oakland that has joined in collaboration with two local perinatal residential drug treatment programs to create early childhood mental health services at those sites. The authors highlight the collaboration strategies and challenges the partners experienced during the first year of operation. The success of the collaboration is due to strong leadership; a clear definition of roles, relationships, and program goals; sensitivity to the different priorities and regulations of the systems governing the women in drug treatment and the grant-funded mental health services; open communication; and ongoing opportunities for reflection and problem-solving.