No standard definition of rural areas exists for use in developing health care policy, research, and planning, or for purposes of federal program administration or distribution of funds. Families in rural areas define themselves in terms of values--typically a solid work ethic; traditional morals and values; hardiness; determination; a general acceptance of life's challenges; and a strong belief in spirituality, religion, or a higher power. However, many rural areas are plagued with drug and alcohol abuse, domestic violence, and teenage pregnancy. In some rural areas, the rates of these social ills exceed the rates in major urban centers. Barriers to mental health care for young children and families include (a) lack of access to affordable health and behavioral health care, (b) lack of specialized providers, and (c) stigma. Service providers' productivity is hampered by demanding travel, unreliable telephone communication, and a dearth of public funding. The author provides evidence of the effectiveness of high-quality training and supervision of staff in improving infant mental health services in New Mexico. Because every rural community has its own history and cultural norms to which "helpers" must be sensitive, the author argues for the benefits of building a cadre of well-trained infant mental health providers who are members of the local community and committed to staying and serving there.