Community-based mental health initiatives led by lay health workers (LHWs) across low- and middle-income countries (LMICs) have demonstrated some success in improving mental health outcomes for the general population. However, evidence is lacking on their effect on improving childhood mental health. There is potential to utilize this workforce to address the underlying causes of mental health burdens rooted in child maltreatment and familial dysfunction. Expanding the role of LHWs to address adverse childhood experiences (ACEs) offers a promising strategy for improving child and family mental health and well-being. LHWs can serve as first-line responders by identifying at-risk children and families and addressing the problems through parental education and support. However, the success of such interventions depends on providing adequate training and supervision to LHWs, as well as ensuring that a robust referral system exists at the primary health care level to address the mental health needs of affected children and families. LHWs, who are properly trained and supervised, can potentially play an important role in addressing ACEs and associated mental disorders in LMICs.