DEFRA has produced a welcome framework and associated guidance for rural proofing policy but, for instance, claimed close working with DHSC and NHSE 78 Rural Mental Health over the new 10-year cross-government Mental health and wellbeing plan has not so far resulted in a single reference to rural priorities (rather the reverse). Furthermore, there is no indication yet that any consideration has been given to the effect of subsuming national mental health and well-being into the new holistic Major Conditions Strategy on the struggle of rural mental health for attention and appropriate prioritisation. The profile of rural mental health needs to rise much further for real progress to be made, with DEFRA taking a more active role alongside DHSC. We recommend: a) DEFRA and DHSC should establish a new joint rural mental health policy and delivery team to lead and improve on current “rural proofing” of health policy; and work with NHS England to set targets to measure and improve outcomes for rural mental health services and support rural health providers. b) The new joint DEFRA/DHSC rural mental health team should also set up a national working group, drawing together a range of experts, to identify practical changes to support more effective rural prioritisation within mental health services provision. c) The new joint DEFRA/DHSC rural mental health team should work with NHS Digital, to evaluate the availability of data and information on rural mental health services to start to address the gaps we have identified. d) DEFRA should consult on how the Rural Wellbeing Framework will be used to measure rural communities’ mental health.