Understanding and responding to the unique mental health needs of rural populations and communities as a society and nation can potentially have global implications. Unlike the United Kingdom and other European partners, healthcare in the United States differentiates health and mental health as if there is a disjuncture between the two. According to the Scottish Government Mental Health Strategy (2017), Scotland’s National Health Service includes mental health holistically within the realm of health services. If there is to be any substantive resolution to the mental health crisis here in the United States, there must be open, purposeful, and resolute dialogue to identify and address mental health as a fundamental component of health and wellbeing.

Americans have witnessed the worst acts of violence in the nation’s history. Yet federal, state, and local governing bodies continue to vacillate over proactive measures related to mental health such as developing policy, committing financial support, and treatment initiatives. The deadly scenes in Parkland, Florida, Las Vegas, Nevada, and Sutherland Springs, Texas are stark gauges of the mental health crisis in both urban and rural regions. The National Institute of Mental Health (2019) reported that nearly one out of five Americans live with a diagnosable mental illness. In rural America, issues related to mental illness tend to be even more problematic due to higher rates of diagnosis and provider shortages, leading many experts to believe mental health in rural America is at a crisis stage (Latzke, 2017). According to the 2020 National Survey on Drug Use and Health: Detailed Tables (Rural Health Information Hub, 2021a),“approximately 7.7 million nonmetropolitan adults reported having any mental illness (AMI) in 2020, accounting for 20.5% of nonmetropolitan adults”(para. 1). The report also asserts the provision of mental health services in rural areas are complicated by factors such as accessibility, availability, and stigma related to receiving treatment for mental health issues (Rural Health Information Hub, 2019, para. 2). On a global scale, rural inhabitants make up 46% of the world’s population (Pendse & Nugent, 2017) resulting in significant numbers suffering from mental illnesses and treatment shortages. This article will review four critical questions related to rural mental health advocacy, examine what the literature reveals concerning major challenges to advocacy for rural populations, propose provisional suppositions, and conclude with a review of opportunities for Texas A&M University-Kingsville in relation to rural mental health.