The short answer
About one-third of Veterans enrolled in VA health care live in rural or highly rural areas, according to VA's Office of Rural Health. Telehealth lets a licensed therapist reach them without either side driving hours, as long as the client is located in a state where you're licensed and has a private, reliable connection.
How many Veterans live in rural areas?
A lot. VA's Office of Rural Health reports that 3 million of the 9.1 million Veterans enrolled in VA health care in fiscal year 2025 lived in rural or highly rural areas, about one-third. VA also estimates about 4.5 million rural Veterans overall.
Rural Veterans enroll in VA care at higher rates than urban Veterans, and they're older on average: 65% of enrolled rural Veterans are 55 or older.
Why is mental health care harder to get in rural areas?
- Distance. The nearest VA medical center may be hours away, and many small towns have no therapist at all.
- Fewer specialists. Trauma-focused care and therapists who know military culture are scarcer.
- Privacy. In a small town, people notice whose truck is parked outside the counselor's office.
- Time and cost of travel. A one-hour session can cost a half day of work.
How does telehealth help?
It removes the drive and the parking lot. A therapist in one part of a state can see a client on a ranch three hours away, from the client's own home. VA uses telehealth heavily for exactly this reason, and many Veterans already know how it works.
What do you need to serve rural clients by telehealth?
- A license in the client's state. Telehealth follows where the client is sitting, not where you are. See Can Therapists See Telehealth Clients in Another State?
- A plan for weak connections. Agree on a backup, like switching to a phone call, if video drops. Check whether the client's program covers audio-only sessions before relying on them.
- Local emergency information. Know the client's address each session, plus local crisis and emergency contacts. Rural emergency response can be slow.
- Attention to privacy at home. Small houses and shared spaces make private sessions harder. Problem-solve that early.
How ValorWell handles this
ValorWell is telehealth-first, and it needs therapists in every state, including the most rural ones. You're matched with clients located in the states where you're licensed, so a license in a largely rural state can reach Veterans and families who have few other options.
ValorWell handles credentialing, authorizations, and billing for CHAMPVA and VA Community Care, and the ValorWell Foundation covers treatment VA won't. You set your hours, which helps when rural clients need early-morning or evening sessions around farm or shift work. Additional state licenses may be supported case by case, based on need.
Important limits
- Not every client can do video. Some lack broadband, a device, or a private space.
- Telehealth isn't right for every situation. Higher-risk clients may need in-person or more intensive care.
- VA decides Community Care eligibility. Distance and drive time factor into VA's access standards, but VA makes the call. See VA wait-time and drive-time standards.
- Your license limits your reach. You can't see a client located in a state where you aren't licensed.