In this insightful conversation, Bianca D. McCall and Erik Schoen discuss the challenges and opportunities in addressing opioid use disorder and mental health in rural Nevada. They explore the importance of community engagement, pro-social activities, and the need for a shift in mental health models to better serve the unique needs of rural populations. Erik shares his experiences and insights on building infrastructure, fostering connections, and the existential aspects of health and wellness. In this conversation, Erik Schoen and Bianca D. McCall discuss the importance of building trust in rural communities, the role of lived experience in treatment, and the integration of holistic approaches and technology in mental health care. They emphasize the need for cultural competence, the empowerment of community members, and the significance of mentorship in fostering growth within these communities. The dialogue highlights the challenges and opportunities in bridging the gap between traditional treatment methods and innovative, community-driven solutions.