Although there is a similar prevalence of mental health issues in rural and urban areas, the obstacles to getting help are very different. This chapter explores the major obstacles to mental health treatment, which are accessibility, availability, acceptability, and affordability. Stigma is the largest barrier of all, as people in small communities are very hesitant to have others know that they are seeking outside help, preferring to cling to the stereotype of rugged individualism. The ratio of providers to residents is explored, as well as the issues surrounding the obstacles. The closing of psychiatric hospitals and workforce shortages are just two of the many barriers for rural populations to overcome in the quest for mental wellness.