Children and adolescents in rural communities have statistically more unmet mental health needs and fewer mental health resources than their urban counterparts. The rural population is ill-served by the traditional medical model of hyperspecialization and would benefit more from a population-based approach. By embracing the community, including each area’s distinct culture, mental health providers can best affect change in these areas. Increased pediatric integration via telepsychiatry, including clear and codified teleprescribing parameters for controlled substances, can reach more rural youth and eliminate current burdens to primary care providers who currently treat most rural mental illness.