Using a qualitative approach, this study explored the role of rural jails in the mental health systems in rural communities, investigating how rural jails manage mental health and substance abuse problems among inmates, determining barriers to providing mental health services faced by rural jails, and identifying promising practices for service delivery. Rural jail administrators and mental health providers understood the need for mental health services for jail inmates but were constrained by inadequate community mental health resources, lack of coordination with community mental health providers, and infrastructure challenges including facilities, transportation, training, and legal processes. Promising practices include short-term hold policies, separation of inmates with mental health concerns, and regular communication among stakeholders.