Early childhood mental health consultation (ECMHC) is an important and burgeoning approach for building front-line staff capacity to recognize, interpret, and support young children's and family's social, emotional, and behavioral health care needs across early childhood systems. ECMHC helps prevent longer-term negative impacts to physical and mental health. The application of ECMHC may differ in scope across settings, however, there are central tenets of the consultative stance that are critical to building staff capacity and positive child and family outcomes. The authors use vignettes to illustrate how ECMHC may be practiced in an early care and education setting, a domestic violence shelter, and pediatric primary care. (author abstract)