In the rural and remote setting, nurses are often the first point of contact with mental health services. Nursing roles may include community-based rural or remote area nurses, nurse practitioners, or mental health nurses. Nurses work collaboratively with tertiary healthcare teams and other community services such as ambulance and police. The role of the nurse is multifaceted as they need to consider engagement with a whole community approach. This chapter will examine the distinctive features of the nursing role in the setting and what is required for effective practice. Similarly to urban mental health settings, interpersonal therapeutic relationships are vital, but the nurse in rural and remote communities undertakes many different tasks and activities while monitoring and assessing the consumer's mental state. Especially in very remote Aboriginal and Torres Strait Islander communities, it takes time to develop these relationships,