For those of us who love wide open spaces, living in rural America gives gorgeous vistas: broad horizons punctuated by snow-capped mountains or vast, windswept prairie, and a sense of never being hemmed in by too many people. 

The light traffic and short commutes are pretty nice, too.

But all that gorgeous scenery typically means long stretches between inhabited places.  And often even longer stretches to the places offering the health care services people need.  While most towns have a hospital that includes emergency services, usually your PCP or counselor isn't likely to be your neighbor.  Those people and the specialized services they provide are going to be in whatever we can define as a city out here.  And the cities are sometimes hundreds of miles away.

On dry roads, this is manageable with planning.  But in winter, when roads are not plowed out right away, or in some cases at all, long distances create the classic and often hard to overcome treatment barrier.  For those in poverty, this problem is exacerbated by unreliable or non-existent transportation.  The inability to get plowed out or get around once you are plowed out contributes to the very real isolation that can be so problematic here.

Even if roads are clear and an individual has transportation, the chronic shortage of service providers in rural areas creates yet another treatment barrier.  Unfortunately, too few service providers are interested in relocating to out-of-the-way places.

The advent of Telehealth has closed many of the gaps between small communities that otherwise may be completely cut off from services, whether by distance, deep snow, or the lack of service providers.  

Wyoming was actually a pioneer in Telehealth, initiating the first such program in 1995 to connect psychologists with service providers in remote parts of the state working with the developmentally disabled who also suffered from psychiatric disorders.  Telehealth has significantly impacted all populations, opening the door for medical and mental health providers to treat clients they would not otherwise be able to see in person.

Some clients don't like talking to someone on a television screen, but most will try and usually adapt.  In some of the remotest areas, however, wireless connections can be problematic, cell towers are not in abundance, and cable providers are hard-pressed to provide internet, adding another layer of challenge.

Not only does Telehealth provide services for those in need, but it also provides continuing education and supervision opportunities for providers who may not have as much support in rural communities.

Telehealth, in addition to the implementation of the Zero Suicide Initiative, is yet another way the state of Wyoming is rising to meet the challenges of its population.

How has Telehealth impacted your practice?  As always, I'd love to hear from you.
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Stormy Filson is an independently licensed counselor living and working in Wyoming, with special interests in treating trauma, community building, and empowering women.  She is also passionate about writing, photography and film.