The three-year project at $148,842 aims to improve the outcome of training rural physicians about mental depression by adding a two-hour behavioral rehearsal component to the standard six-hour didactic course. The goal is to make rural clinicians more likely to refer (not treat) persons with possible depression for a mental health assessment at the nearest township-level hospital. Four hundred rural physicians from three counties in Hunan will be randomly assigned to standard training or standard training plus behavioral rehearsal and differences in changes in knowledge and clinical skills (assessed by using trained proxy patients) between the groups will be compared. The current proposal—by an experienced researcher from a well-known center—compares two training models for doing this, and hopes to show the added benefit of including behavioral rehearsal in training packages for rural physicians (which may also be useful for training other content to rural physicians). But referring patients for a mental health assessment is only one small part of the bigger problem of why so few rural residents with depression receive adequate care; the authors will subsequently need to show that increased referrals actually leads to improved community mental health.