Leadership in infant and early childhood mental health must take into consideration issues of diversity, historical context, power dynamics, and difference in worldview and experiences. This article describes the importance of equitable and effective partnerships with rural/remote, underserved, and Indigenous communities in the United States and Canada. It is important to build strong, foundational, respectful relationships rooted in humility, mutual learning, and trust. Effective leaders must also consider diverse concepts of children, childhood, and mental health as they are understood by different communities. All strategies, decisions, and activities that are brought into a community must be adapted in partnership with members of that community and also must be culturally grounded and aligned with the philosophies and practices of the community.