A mental health consultative service for rural health providers has been established (Rural Minnesota Telemental Health Network (RMTHN)). This supports rural providers and patients by establishing a telecommunications link - a virtual presence  - of mental health professionals to assist in the care of patients in underserved populations. Rural residents are among the most underserved for mental health as well as general health services in the USA. Most medical care is provided by family physicians in small and rural communities. The Center for Rural Mental Health Studies of the University of Minnesota Medical School Duluth has developed a consultation service for family physicians and other primary care practitioners to provide rural Minnesota residents with rapid access to mental Health services through their family physician. The telemental health providers consist of 3.5 FTE doctoral level psychologists, one master’s level trained counselor and .4 psychiatrists. All psychologists volunteer their time and are employed on a full-time basis elsewhere within the Duluth medical school. This off-site shared-care consultative model is a collaboration with the family medicine clinics in the Minnesota communities of Bigfork, Bois Forte Reservation, Cook, Ely, Littlefork, Mora and Paynesville, Minnesota. Services provided give support for rural/small community physicians, rapid diagnosis and treatment of patients within their “medical home”, decreasing access time for mental health consultation and treatment and efficient use of health professional time. The integration within the patient’s “medical home” diminishes stigma attached to behavioral and emotional care.