Objective: Documentation and evaluation of patient outcomes in a pilot study into the role of rural community pharmacists in the management of depression. Design: Parallel groups design with a control and intervention group. Setting: Thirty-two community pharmacies in rural and remote New South Wales, Australia. Participants: One hundred and six patient participants, mean age of 46 years, predominantly female, not currently employed, recruited by participating pharmacists. Interventions: Intervention pharmacists were given video-conference training on the nature and management of depression by a psychiatrist, psychologist and general practitioner and asked to dispense medication with extra advice and support. Control pharmacists were asked to provide usual care. Main outcome measures: Adherence by self-report, K10, Drug Attitude Index. Results: The results indicated that adherence to medications was high in both groups (95% versus 96%) and that both groups had improved significantly in wellbeing (a reduction K10 score of 4 (control) versus 4.7 (intervention)). No significant change was found in attitude to drug treatment once baseline scores were controlled for. Conclusions: Because both groups improved in wellbeing it is not possible to claim that the training provided to the intervention pharmacists was responsible for the success. However, the improvements gained in such a short time (two months) suggest that the involvement of pharmacists has had a beneficial rather than negative effect. Further research into the most appropriate ways in which to integrate the skills of pharmacists into a model of mental health care delivery in rural communities is recommended.