About 85% of counties in the United States have either no mental health services at all, or they are inadequate. The mental health needs of rural Americans are huge, and while there are some promising new approaches to improving our mental healthcare system being implemented, there is still a long distance to travel in creating an adequate, quality, affordable system for all. Some involve creating new positions, and others involve constructing new paradigms. Decarceration is one new paradigm, but there are many others. In 2008, The President’s New Freedom Commission on Mental Health’s Rural Subcommittee outlined potential areas for improvement, most of which have yet to be put into place. There are also other new programs and ideas on the horizon. Some require collaboration between people, agencies, and the creation of more multidisciplinary teams. Many require grants, and grant writing and grant resources are discussed briefly at the end of this chapter.