Consistent support has been reported for the buffering effects family members provide rural elders (Beaver 1986; Bryant 1981; Schwarzweller, Brown, and Mangalam 1971; Weller 1965). Similarly, proximity to family members has been found to increase the amount and type of support available to older rural adults (Kivett 1988; Mercier, Paulson, and Morris 1988). Few studies, however, have examined the relationship of family proximity and social support to multiple measures of mental health among older rural adults, particularly in areas such as Appalachia where strong informal network values are expected to be the norm. This study had two purposes: (1) to examine the relationship of proximity, including children and siblings, to older rural Appalachian adults ' perceptions of social support; and (2) to examine the relationship of family proximity and social support to older rural Appalachian adult depressive symptomatology, anxiety, and affect. The sample for the study consisted of 100 older rural Appalachian adults randomly selected to participate in a pilot project examining the effects of social risks and resources on older adult physical and mental health. Hierarchical multiple regression techniques were used to examine these relationships. Results showed that: (1) family proximity was not significantly related to older rural Appalachian adult perceptions of social support; (2) family proximity was not significantly related to aspects of mental health among older rural Appalachian adults; and (3) social support was a significant predictor of mental health outcomes.