I have spent many years as an executive in community mental health at the National Institute of Mental Health and in managed behavioral health at United Behavioral Health, and examples are not difficult to find. Ideological disagreements, competition for resources, separate organizational structures, and disparate training programs divide mental health services from substance abuse services. Behavioral health professionals are trained in separate professional silos, with slight if any interdisciplinary training and scant knowledge of important research published in professional journals other than their own. Progress in integrating service and science, and evidence-based practice with practice-based evidence, has been painfully slow, despite widespread acknowledgment of its importance. Integration of behavioral health care with the other human services, such as schools, housing, employment, and social services, so vital to prevention through early intervention, remains more a belief than a reality. Consumers and family members acknowledged to be a potentially important part of the behavioral health workforce have yet to be sufficiently integrated as such.