Although existing research explores the need for mental health for students in P-12 schools, scholarship regarding mental health needs and support for teachers is lacking, particularly in rural contexts. This study used sequential exploratory mixed methods to explore mental health needs and support in school districts in a predominantly rural state. Analysis included qualitative survey data from P-12 teachers in school districts about how teaching impacts mental health, and a quantitative analysis of employee assistance programs in participant school districts. Findings demonstrated teachers struggling with mental health, and a lack of employee support available. Implications and exploration of district policy are discussed.