The Southwest Iowa Mental Health Center recently completed a 4-year project to increase use of mental health services by normally reluctant rural populations and to increase coping ability among persons affected by the farm crisis. During the first 2 years, program goals included aggressive outreach to potential patients, mental health education seminars for non-mental health professionals, stress management workshops for at-risk farmers and other distressed persons, mental health treatment, and development of independent support groups. These development activities created a tremendous unfilled demand for psychiatric treatment and consultation services. During the last 2 years, the program sought to meet this demand by obtaining the services of a resident psychiatrist from a nearby university and by opening four satellite offices. The Center's experiences have shown that increasing delivery of effective mental health services to rural residents requires attention to both service delivery issues and treatment issues. Service delivery issues include (1) person-to-person outreach, (2) availability of services at the client's site, (3) extensive public relations to maintain high visibility for services, (4) satellite offices that offer both accessibility and a measure of anonymity to clients, (5) awareness that stress management and depressive symptoms are of prime interest for rural persons, and (6) a system that provides multiple services at one location. Treatment issues include: (1) alleviation of stress as the most important goal, (2) acceptance of emergency services as legitimate treatment, (3) diagnosis and treatment of the situation alone in some cases, (4) economics as the incentive for farmers to use mental health services, and (5) the importance of support groups. (SV)