Background Despite differences in mental health outcomes between rural and urban areas, little is known about rural mental health nursing practices in the UK.

Aim To explore the experiences and views of current registered mental health nurses working in rural settings across the UK, and to identify practice challenges and areas of future training needs and support development.

Method An online anonymous questionnaire was co-developed with rural mental health nurses and researchers, then promoted through social media and UK-wide professional nursing groups. A total of 104 respondents completed the questionnaire, most of whom were mental health nurses working in rural areas in England.

Findings Respondents reported experiencing unique challenges in their roles, including service model limitations, travel barriers, rural risk assessments and lone working concerns. They developed ways to adapt their practice, including autonomous and flexible working, being an advocate and going ‘above and beyond’ their duties to meet the needs of rural service users. Respondents expressed a need to better understand and communicate with farming and agricultural workers.

Conclusion This is the first known study of rural mental health nursing practice experiences in the UK. The findings have implications for clinical practice, rural community engagement, policy and nurse education.