Virginia Expands Mental Health Services with Telehealth

Public Health Watch and the Investigative Reporting Workshop at American University by Natalie Hausmann, June 9, 2026.

Mental health was the last thing Wendy Dudley discussed with her family as they struggled to make ends meet in rural Roanoke County, Virginia.

Nobody made the connection between living paycheck-to-paycheck and fighting to stay afloat emotionally, Dudley said. So she moved through life the way she thought she was supposed to, by pushing her feelings down.

But then Dudley’s first husband died of a drug overdose, and her own addiction to prescription pills and alcohol “went skyrocketing … just trying to numb that kind of stuff,” she said. She went into long-term recovery for substance use disorder and now uses that experience to help patients at the Bradley Free Clinic, where she’s the manager of behavioral health.

The clinic is part of the Virginia Telemental Health Initiative, a first-in-the-nation effort to meet the growing need for mental health services by pairing free services and workforce development, with a noted impact in rural communities. Its services are particularly important now, as more Americans are losing their federal healthcare benefits and as Spanish-speaking patients cope with fears of deportation.

About 80% of patients referred to telemental services are bilingual, and the initiative is trying to ramp up translation services for appointments where bilingual therapists aren’t available, said Anna Hardin, the initiative’s clinic director. At one point, she said, there was a six-month waitlist for people seeking online therapy in Spanish.

Dudley said bilingual community members are increasingly reluctant to show up for in-person appointments at the Bradley Free Clinic. The clinic once required that all first appointments be in person, but it now allows all appointments to be online.

“Even though they saw the clinic as a safe space, they still had to travel from their house to here, not understanding what their rights were once they got in the building,” Dudley said.

Read more at Public Health Watch and Investigative Reporting Workshop.