To address the twofold problem of mental health disparities and limited access to health resources in rural areas, the University of Hawai'i Rural Health Collaboration aims to increase access to behavioral health services to rural areas across the state, primarily via telepsychiatry. The authors highlight lessons learned in regard to forging a university-community partnership, specifically community engagement for patient referral, the shift toward integrated services and away from a specialty clinic model, the importance of community diversity and contextual relevance, and ethical research and practice with indigenous communities.