Adequate access to mental health care is a global problem, including in the Federated States of Micronesia (FSM). The Collaborative Care Model (CoCM) offers an opportunity to deliver improved access to mental health services in primary care centers, and key factors to program sustainability have been investigated in high-income country settings. This study's objective was to evaluate how well factors associated with sustainability have been incorporated into a CoCM in Kosrae, Federated States of Micronesia. The Kosraean CoCM's strengths included its supportive leadership, team member training, and having a strong care manager and engaged primary care provider champion. Opportunities for growth included further development of its financial viability, information technology systems, change readiness, and operational procedures. Our program found that having a stable and invested staff and leveraging its current strengths were important to its viability. In an international partnership, it is also critical to develop strong relationships among team members and to have stable internet connectivity to facilitate regular communication. These lessons learned can be applicable to other integrated care programs in similar Pacific Island countries.