Government and Regulations

Telehealth for Native Americans With PTSD

Due to barriers of care for Native American veterans, the Native Domain's Telemental Health Services is able to provide mental health care via technology.


Native American veterans have the highest rate of posttraumatic stress disorder (PTSD) of any ethnic group and often face significant barriers to care, such as living in rural and remote areas. To help overcome those barriers, the Office of Rural Health (ORH) established its Native Domain, a national resource on health care issues for rural Native veterans.

The Native Domain’s Telemental Health Services provides ongoing mental health care—including medication management, case management, and individual, group, and family psychotherapy—via videoconferencing to veterans who live on or near rural American Indian reservations in Montana, Wyoming, and South Dakota.

This “unique service within the VA system” demonstrates an “innovative model,” according to the ORH. Studies have suggested that telemental health is as effective as face-to-face services. For example, a 2010 study of 125 veterans with PTSD found videoconferencing an “effective and feasible” way to increase access to evidence-based care.

Clinic staff include VA-employed Tribal Outreach Workers (TOWs), who are usually military veterans and members of the tribes they serve. Their varied duties range from helping Native veterans enroll in the clinic programs, showing patients how to use the videoconferencing equipment, troubleshooting clinic telecommunications equipment, to coordinating emergency crisis management. The TOWs also work closely with the remote clinicians and provide guidance on cultural and community issues that may be relevant to the patient’s care or treatment.

The American Indian Telemental Health video ( is an overview of a series of clinics that use videoconferencing. More information on the telemental health clinics is available at

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