Objective: Because of COVID-19, higher education changed as institutions went remote and students' mental health was challenged. Rural universities were disproportionately affected because of limited Internet access. The purpose of this study was to investigate the psychological need satisfaction/frustration and mental health among rural college students during this pandemic. Participants: Six hundred ninety-eight students (M[subscript age] = 22.15 ± 2.55) at a rural South-eastern university were recruited. Methods: Participants completed a survey examining stress, anxiety, need satisfaction/frustration and previous experience with online courses. Results: Anxiety, autonomy and competence frustration were found to predict 60% of the variance of stress. Another regression analysis found stress, autonomy, competence, and relatedness frustration to predict 70% of the anxiety variance. Conclusions: Students are frustrated due to the lack of control and restrictions affecting their social interaction. Understanding the relationship between need satisfaction/frustration and mental health can aid university administration in developing interventions that address rural students' needs.