A dominant urban focus in previous research on the social geographies of mental health has obscured the experiences of people with mental health problems living in rural localities. Critiquing this urban focus, we report on research conducted in the rural and remote Scottish Highlands. Evidence derived from in-depth interviews with over 100 users of psychiatric services in the Highlands is deployed to investigate the complex socio-spatial dynamics of inclusion and exclusion experienced by these users on a daily basis. A discussion of the explanations that usersthemselvesoffer of their experiences is accompanied by a theoretical framing of these issues pivoting on relations of proximity distance and intimacy repulsion.