Local educational events:

Too many to list, with 100's of universities and thousands of educational programs.

Most common communication tools used in the country:

In the country of New York? Well, New York City in particular reflects more nationalities, languages, and cultures than any other American City, and is blessed with a great variety of hard-copy magazines and newspapers, the largest open-shelf library in the country, and every variety of satellite, cable, and telecommunications connection. New York State is similar, though there are farming and rural areas, suburban areas, and wilderness areas as well, not to mention Niagara Falls.

In NY, as in much of the US, high-speed Internet access is readily available in most urban areas and many suburban areas, especially those serviced by cable companies. Although there are options for very fast connections, the average connection is not as fast as in Europe and other parts of the world, and many people still access via dial-up connections or medium-speed DSL.

Level of access for the general population:

See above. There is ready access in New York, and many types of "package" deals for consumers which include telephone, cable television, and broadband Internet access.

Level and examples of online mental health services/research/education/supervision:

Well, for starts, ISMHO's legal home (incorporation as a non-profit) is New York! We also have some of the world's great universities, both in the city of New York (e.g., NYU, Columbia) and "upstate", like Cornell University. Client-centered counseling was "born" at Teachers College, NY, as espoused by Carl Rogers- who, despite the jokes about the reflective style, actually was among the first to actually do therapy outcome studies (with Truax). Many universities are beginning to have portions of courses utilize the Internet, but health and mental health clinics seem to be slower to embrace online services than in other countries, perhaps out of concerns for the US privacy (HIPAA) laws.

Legal/regulatory issues:

See my post in the forums about New York. It's one of 50 states, each with licensing and certification schema, and many professions are regulated state-by-state, from physicians and lawyers to counselors and psychologists, psychoanalysts, marriage/family therapists, and also special-circumstance licensing (for example, for military, government, or educational institutions).

The main issue with online mental health is that states which have clarified their policies, such as California, have been oriented towards protecting their citizens and controlling commerce within their states. They do not see counseling as happening "in Cyberspace" but see it as a service industry or professional consultation where the recipient resides in their state, no matter where the practitioner is (physically, rather than "online"). Thus, anyone who wants to be cautious about not violating another state's laws (or one's own ethical standards which may include adherence to the law) is probably likely to practice within only the jurisdictions where one is licensed. Not only must one be aware of where the counselor is, but in theory it is important to realize that where the client is, that is a controlling factor should the client or state decide to take action against a counselor for "practicing without a license" while providing services within the home and state of a client. Maybe unfair, maybe preventing easy access for those who have no other option, but that is the current status.

Insurance/payment options: Some reimbursement does happen, particularly when treatment is both online and offline. Individuals have worked out insurance agreements with individual insurors. For non-Americans it may be difficult to understand this, but health and mental health treatment in the US is largely dictated (financially) by the insurance companies who decide what is acceptable treatment, at what cost, for how many sessions, etc. They tend to be "evidence-based" and short-term in nature. There is a new law which may soon be enacted (in the US) which will mandate "mental health parity" and ensure that mental health services can be covered by insurance on an equal basis as physical health. Stay tuned on this... it will impact fee payment, if not autonomy of providers in setting treatment goals.

Languages spoken: Several hundred languages in New York... you can hear a good sampling of them in Times Square or in a subway train in New York City! Immigrants and 2nd/3rd generation immigrants live in both urban and suburban areas and many enclaves exist where one can find and maintain the preferred language and culture.

Relevant cultural issues: As above, if a culture exists someplace on earth, it is likely represented in New York. There are counseling and educational services available in hundreds of languages, and often in community centers and agencies which are very aware of cultural factors.

Resources in the field of online mental health: ISMHO!! (for information) and also several large companies based in New York who offer services which match client to counselor, by state.