Although estimates of prevalence vary, suicide rates among farmers are high and pose an important challenge for mental health policy and practice. The lack of mental health resources in many rural communities is a significant barrier to improving farmer mental health outcomes. The current paper will review (1) current findings related to the psychosocial functioning of agriculturalists including rates of suicide and common mental health concerns within this population; (2) describe stressors and risk factors associated with mental health symptoms in rural and agricultural communities; and (3) discuss barriers associated with accessing mental health treatment. This article also includes recommendations for increasing the cultural competence of social work practitioners working with rural communities. Finally, existing research on using technology and workforce development approaches for increasing access to mental health in rural communities is presented and recommendations for future research are explored.