Coordinated health services are required for complex patients with comorbid mental and physical health conditions. Health Links (HL) is an initiative in Ontario, Canada promoting integration across the mental and physical health sectors. Collaborative structures in HLs were determined by local partnering organizations, resulting in various integration approaches. Therefore, HLs offers a unique opportunity to examine different approaches to mental and physical health service coordination under the umbrella of a common initiative. Our aim was to contrast two approaches to coordinating mental and physical health services, and to explore the sustainability of each approach.