| Summary: | <p> The rural primary care provider is likely to treat patients with mental health issues in rural populations due to lack of mental health providers, comorbidity and multimorbidity of patient illness, and stigma associated with seeking mental health services. The very nature of rural primary care allows for patients to be comfortable with their PCP and therefore, rely on the strong foundational relationship they have in entrusting them with their mental health concerns. Being a primary care provider in a rural setting offers both rewards and challenges unique to the rural culture.</p><p> The main goal of the study was to explore what might enhance, diminish, or otherwise give meaning to the rural primary care provider’s experience of engaging in discussions about mental health issues with their patients. This was achieved through identifying themes in response to two primary research questions. The primary research questions were: (a) How do rural primary care providers engage in conversations about mental health issues with their patients?; and (b) What are factors of being in a rural setting that affect and/or influence the primary care provider in having these conversations?</p><p> Data from ten participants across the three rural primary care clinics was analyzed using the qualitative method of thematic analysis to identify embedded themes. Five themes were revealed: (a) The relationship between the patient and the rural primary care provider allows for the conversation about mental health issues; (b) Rural primary care providers routinely provide mental health services; (c) Rural primary care providers experience challenges treating complex mental health issues; (d) Rural primary care providers navigate barriers in rural communities; and (e) There are benefits and drawbacks of rural living.</p><p>
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