This book provides a comprehensive overview of mental health in rural America, with the goal of fostering urgently needed research and honest conversations about providing accessible, culturally competent mental health care to rural populations. Grounding the work is an explanation of the history and structure of rural mental health care, the culture of rural living among diverse groups, and the crucial "A’s" and "S": accountability, accessibility, acceptability, affordability, and stigma. The book then examines poverty, disaster mental health, ethics in rural mental health, and school counseling. It ends with practical information and treatments for two of the most common problems, suicide and substance abuse, and a brief exploration of collaborative possibilities in rural mental health care.