Recent national data suggests that there is a similarity between the prevalence of clinically defined mental health problems, as well as comorbidity including substance abuse, among rural and urban adult populations. However, due to the lack of a mental health and substance abuse infrastructure in rural areas, many times these disorders go untreated. This issue paper offers the following 10 recommendations for addressing the problems of mental health care in rural America: (1) encourage integrated interdisciplinary approaches combining mental health and addiction treatment; (2) create incentives offsetting states' cost of developing and maintaining current data on the distribution of mental health professionals by gaining access to federal dollars or mental health professionals; (3) increase the availability of interdisciplinary training for rural mental health providers; (4) develop and support training programs integrating mental health providers and primary care practitioners with the mental health system; (5) have contractors monitor the impact of their policies on the effectiveness of mental health services provided to rural beneficiaries; (6) conduct rural mental health programs in a culturally competent manner; (7) provide community based programs that lend support to self help groups, consumer operated services, and consumer roles in policy and governance of mental health services; (8) encourage mental health professions to examine their current training programs and internships; (9) urge federal agencies to support and fund this agenda; (10) encourage federal agencies to add their research on the development and evaluation of mental health outreach services designed to overcome rural barriers to help-seeking. (Contains 22 references.) (ADT)