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Reinforcement learning (RL) algorithms usually require a substantial amount of interaction data and perform well only for specific tasks in a fixed environment. In some scenarios such as healthcare, however, usually only few records are available for each patient, and patients may show different responses to the same treatment, impeding the application of current RL algorithms to learn optimal policies. To address the issues of mechanism heterogeneity and related data scarcity, we propose a data-efficient RL algorithm that exploits structural causal models (SCMs) to model the state dynamics, which are estimated by leveraging both commonalities and differences across subjects. The learned SCM enables us to counterfactually reason what would have happened had another treatment been taken. It helps avoid real (possibly risky) exploration and mitigates the issue that limited experiences lead to biased policies. We propose counterfactual RL algorithms to learn both population-level and individual-level policies. We show that counterfactual outcomes are identifiable under mild conditions and that Q- learning on the counterfactual-based augmented data set converges to the optimal value function. Experimental results on synthetic and real-world data demonstrate the efficacy of the proposed approach.