Mental health challenges for youth continue to be a growing concern. Youth-serving organizations have the potential to play a significant role in recognizing the signs and symptoms of mental health challenges in youth. The Youth Mental Health First Aid (YMHFA) training course is widely used to equip adults working with youth with skills to support mental health and de-escalate crisis situations. Cooperative Extension is a trusted organization in many local communities nationwide that delivers YMHFA. Program Leaders from 11 states, representing all five regions of Cooperative Extension, describe their successes and challenges in implementing YMHFA. Experienced program leaders suggest partnering with a supportive organization, securing long-term funding, and establishing dedicated staff for program delivery.