Four fundamental challenges to the provision of mental health services to indigenous populations are discussed, including proximity to services, community knowledge of mental health principles, human resource use, and cultural congruence. We describe concepts common to most indigenous approaches to mental well-being, including restoring health through balance and relatedness. Some strategies of practice are suggested to facilitate the cultural competence of psychiatric nurses and other mental health professionals who work with indigenous peoples. We contend that changes in availability of mental health services to indigenous peoples across the globe can be initiated with local actions by professionals who serve this population.