To address one of the many challenges facing rural mental health care, including issues of access, utilization, and quality of care, the following study investigated the role of population density in the utilization of rural emergency rooms for mental health issues. Utilizing archival data compiled by the New Hampshire Department of Health and Human Services, the study explored whether population density was inversely related to utilization of emergency rooms for mental health care. Our first hypothesis predicted that there would be an inverse relationship between population density of emergency room (ER) locales and mental health utilization of ERs. Our second hypothesis predicted an inverse relationship between population density of where a patient resides and mental health utilization of ERs. In other words, we predicted that as population density decreased, mental health utilization of emergency rooms would increase. The first hypothesis was explored using correlational analysis, whereas the second hypothesis was investigated using discriminant function analysis. The analyses found the inverse to be true: as population density decreased, mental health utilization of emergency rooms also decreased. Possible explanations for unexpected findings were discussed including use of alternative methods of mental health care in rural areas, the role of stigma, differences in the presentation of rural individuals' symptoms, and possible underdiagnosis of mental illness by rural practitioners. Implications of results for rural mental health care was discussed, as were limitations and directions for future research.