Introduction: Pediatricians are more likely than mental health (MH) specialists to manage children’s MH concerns, and multiple factors complicate their abilities to do so adequately. Integrated care initiatives mitigate systems-related shortcomings that hamstring MH management in primary care. These initiatives, which improve outcomes for adults, are not widespread for youth. Integrated health care for children with MH concerns requires regular collaborative communication among pediatricians and MH specialists. The nature and quality of this communication in typical practice are not fully clear. Method: We conducted an anonymous pilot survey of 123 pediatric primary care providers from 41 states. We examined respondents’ experiences with and attitudes about collaborative communication barriers and strategies. Results: Respondents estimated that 28% of their patients had MH concerns. Nearly 30% reported discomfort treating these concerns, 54% described MH care resources in their communities as inadequate, and 24% of pediatricians reported no communication at all with MH specialists about shared patients. Actual contact among communicators was less frequent than desired. Satisfaction with communication was low. Barriers to satisfactory communication included systems factors, inconsistent/nontimely responses from specialists, and the perception that MH specialists are unwilling to communicate.Discussion: Many pediatricians appear to view communication with MH specialists as less systematic than it ought to be. Efforts to address communication barriers may advance integrated care aims and mitigate pediatricians’ perceptions of MH treatment resource inadequacy. As an important step toward integration, MH specialists should consider prioritizing systematic ongoing collaborative communication about shared patients.