Emotional wellness is the awareness and ability to express feelings and emotions in healthy ways. It is the sense of fulfillment and achievement in life and includes self-acceptance, self-awareness, self-esteem, and optimism.
As we honor LGBTQ+ Pride Month, it is important to acknowledge the health inequities experienced by the LGBTQ+ community, highlighting the importance of LGBTQ+ behavioral health which embraces both mental health and well-being. This blog explores how you can advocate for your well-being when seeking behavioral health services as an LGBTQ+ individual.
The Importance of Behavioral Health and Regular Check-ins
Regular check-ins with a behavioral health provider are crucial for everyone but hold a particular significance for LGBTQ+ individuals who may face unique challenges related to their sexual orientation, gender identity, or expression. These check-ins can play a vital role in maintaining various aspects of well-being, including mental health, emotional well-being, and social support. It is also important to ensure that these behavioral health settings provide a safe environment for you to discuss your concerns whether it be topics such as coming out, navigating relationships, coping with discrimination or stigma, managing mental health conditions, and accessing resources.
Understandably, seeking these safe-spaces within behavioral health settings as an LGBTQ+ individual can cause a lot of nervousness. Therefore, we are providing a list of questions you may wish to ask while you search to find a provider who is knowledgeable, affirming, and supportive of your identity and experiences.
Questions to Ask Behavioral Health Providers
The 2 Questions Method
One thing to take note of is whether the in-take forms include the use of a 2-question method. This approach acknowledges the difference between gender identity and assigned sex by asking the individual how they currently express their gender identity and then what gender they were assigned at birth.
Key Questions to Ask Your Behavioral Health Providers
1. Do you use the (SOGIE) Screening or a similar screen that would consider my personal needs?
2. Do you have experience working with LGBTQ individuals? Can you provide examples of how you've supported LGBTQ patients in the past?
3. How do you approach LGBTQ-specific mental health concerns, such as coming out, gender dysphoria, or experiences of discrimination?
4. How do you address issues of confidentiality and privacy, particularly for LGBTQ patients who may not be out to everyone in their lives?
5. Are you familiar with the unique mental health needs of different LGBTQ subgroups, such as transgender individuals, bisexual individuals, or queer people of color?
6. Can you explain your understanding of LGBTQ identities and how they may intersect with mental health issues?
7. How do you ensure a safe and affirming environment for LGBTQ patients in your practice?
8. Do you use gender-affirming language and practices, such as asking for preferred pronouns and respecting chosen names?
9. Are you knowledgeable about LGBTQ-specific resources and support networks in the community?
10. Have you developed skills for interacting effectively with interdisciplinary teams where some colleagues may be less familiar with LGBTQ communities and their behavioral healthcare needs?
11. As a behavioral health provider do you work closely with a patient's primary care health provider when needed?
12. How do you stay informed about current research and best practices in LGBTQ-affirmative mental health care?
13. How do you ensure a safe and affirming environment for LGBTQ patients in your practice?
14. Do you involve LGBTQ individuals in the development and evaluation of your treatment plans?
Next Steps Now I know some questions...what's next?
After reflecting over these questions, make sure to remember that advocating for your well-being is an essential part of your healthcare journey. By exploring these questions to seek an informed and knowledgeable behavioral health provider, you are taking wonderful steps to accessing inclusive and supportive care for both your mind and your body. Additionally, through this act of self-advocacy, you also contribute to creating a healthcare environment that respects the diverse needs of the LGBTQ+ community.
In conclusion, highlighting the need for affirmative behavioral health care and discussing strategies to navigate searching for a provider during Pride Month is important for the health of this community. By asking these informed questions, individuals can feel more confident in seeking out inclusive care for better outcomes in therapy. Ultimately, by advocating for inclusive care, we challenge stigma and dismantle barriers that hinder LGBTQ+ individuals from accessing the support they deserve. Together, let's continue the journey towards a future where LGBTQ+ individuals feel validated, supported, and empowered in their pursuit of mental health and well-being.
The Behavioral Health Wellness Environments for Living and Learning (BH WELL) research team exists to promote behavioral health and wellness among individuals facing behavioral health challenges. To learn more about BH WELL, visit our website. Interested in more evidence-based, free mental and behavioral health resources? Follow us @ukbhwell on Instagram, Facebook, and Twitter.
Congratulations to Kevin Bryant, DNP, BSN, on his graduation from the University of Kentucky (UK) College of Nursing (CON) with his Doctor of Nursing Practice (DNP). Dr. Bryant’s project, “The Impact of an Educational Training to Front-line Nurses and Providers to Reduce Seclusion and Restraint: Assessing Knowledge, Practices, and Attitudes” explores effect of web-based educational intervention on front-line nurses knowledge, practices, and attitudes concerning use of seclusion and restraint of patients within psychiatric in-patient facilities. Dr. Bryant is Director of Inpatient Services at Eastern State Hospital (ESH).
Dr. Bryant traces his passion for nursing back to his experience working with residents at a nursing home in his senior year of high school. This early clinical exposure ignited his confidence to pursue UK’s College of Nursing program where he completed his BSN in 2011. Bryant began his career with ESH in 2012 as a clinical nurse and served as interim nurse manager beginning in 2014.
Bryant had the desire to continue his education and enrolled into UK’s DNP program in 2020. Flourishing under the mentorship of Dr. Woods, Bryant notes, “Dr. Woods was always very supportive and proud of us and always provided opportunities.”
Dr. Marc Woods, Chief Nursing Officer for UK Healthcare, shares, "Dr. Kevin Bryant's leadership journey reflects a strong commitment to bolstering the future of academic and clinical behavioral health nurses. His efforts in patient and staff safety are paving the way for robust and resilient care practices within the inpatient setting."
In addition to Dr. Woods’ support, Bryant credits the Work Learning Program (WLP) and his cohort for nurturing his success by providing resources and a supportive environment. Bryant states, “The Work Learning Program provided us great support, from helping with presentations and offering a relaxing study space with snacks to Dr. Okoli’s mentorship on writing literature reviews. In general, the WLP leadership’s support at ESH made it a whole lot easier for my cohort and I to successfully complete this program.”
As Dr. Bryant reflects on his DNP graduation, he emphasizes the importance of a strong support system outside of work and the WLP as well. “Outside of my cohort's support, I have a really great support system from my family- with my parents, my brothers, and my nieces that I love to hang out with. So, I am very grateful and appreciative of that” Dr. Bryant proudly states.
April is Sexual Assault Awareness Month. This month we are provided the opportunity to listen and honor survivors in our community. It is a time to show those who have been impacted by sexual assault that they are not alone, and we hear them. It is a time to educate yourself about sexual assault and the stigma associated with these acts. It is a time to start the change in how society treats victims of sexual assault. It starts with you.
Victim blaming is a common occurrence facing sexual assault survivors. Statements such as “Why didn’t you fight back?” or “Why didn’t you just say no?” suggest the victim or survivor was responsible for what happened to them. Because we live in a society of victim-blaming, survivors often don’t report their assaults.
We live in a society where the dominant ideology is that of a cis-gender male point of view, especially in relation to how we view sex and power. The rape culture society normalizes and minimizes sexual violence and rape.
Additionally, the experience of sexual violence often leads to serious threats to a victim’s mental health. Among survivors, there are high prevalence rates for mental health problems including PTSD, anxiety disorder, depression, substance abuse, suicide attempts, and feelings of guilt and shame.
It doesn’t have to be this way. Here are some ways to support survivors.
Challenge statements that normalize or minimize sexual violence.
Educate yourself on sexual violence. There are myths surrounding sexual assault and rape. Dispel those myths and change your mindset based on facts. Here are some resources. The first two are national and the last is local to Kentucky:
March is designated as Self-Injury Awareness Month to highlight self-injury which is often misunderstood, not discussed, or simply suppressed. It can be difficult to understand self-injury and it is a challenging topic for many to discuss. So, we welcome you to delve deeper into this topic with us.
This blog is dedicated to casting light on this misunderstood and stigmatized issue by providing insights, resources, and support for those who may be struggling with self-harm or are seeking guidance on how to help loved ones struggling with self-injury.
With Non-Suicidal Self-Injury (NSSI) being a pervasive global public health issue, it is important that this topic be brought out of silence. According to the Centers for Disease and Control (CDC), more than one in five adults in the U.S. live with mental illness and over one in five youth either currently struggle or have previously struggled with mental illness. While NSSI is most common among adolescents (15-20%), around 6% of adults also face the challenge of self-injury (Klonsky, 2014).
What is Self-Injury
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), Non-Suicidal Self-Injury (NSSI), also referred to as self-harm, is when an individual attempts to cause harm or potential injury to their body on purpose but without intending to cause death. Those who struggle with NSSI are at a higher risk of attempting suicide and dying by suicide if they do not receive help. In fact, studies have shown that NSSI is one of the strongest longitudinal predictors of future suicide attempts, even stronger than the predictive strength of prior suicide attempts (Wang et. al, 2024).
Understanding Self-Injury
The first important step to understanding self-injury is to recognize what motivates someone to engage in self-harm. There are different reasons for NSSI, so the best way to assist someone is to address what the underlying issue is.
Those who struggle with self-harm may use it to control negative feelings, dissociate from emotional pain, and cope with stress. A study noted that 85% of participants cited that their most common reason for self-injury was to release emotional pressure and that the next most common reasons were to control negative feelings and get rid of intolerable emotions (Klonsky, 2009).
Forms of Self-Injury
Individuals cope through various types of self-harm. Some might be easier to spot, while others may not be as noticeable. Recognizing different methods and signs of self-harm can help provide better support to those who are struggling.
Examples of Self-Harm:
Cutting one’s skin with a sharp object
Piercing one’s skin with sharp objects
Hitting or punching oneself or punching things
Burning oneself with cigarettes, matches, or candles
Breaking bones or bruising oneself
Scratching or picking scabs to prevent wounds from healing
Pulling out one’s hair, eyelashes, or eyebrows with the intention of hurting oneself
Inserting objects into one's body
Signs of Self-Harm:
Scars
Wearing long sleeves or pants, even in hot weather
Talking about feeling worthless or helpless
Fresh cuts, bruises, bite marks, or burns
Keeping sharp objects on hand
Frequent reports of accidental injury
Emotional and behavioral instability and unpredictability
The most common target areas of the body for self-harm are the arms, legs, chest, and stomach. Although these are the most vulnerable to enduring self-injury, any part of the body can be harmed through various methods.
Breaking the stigma on the topic of self-injury is important for the well-being of those who struggle with it and to promote advocacy, understanding, and empathy within our communities. By discussing the challenges of self-harm and how to identify warning signs, we can create a safe space where individuals feel more empowered to seek help. As we continue to educate ourselves and support those who self-harm, we break down barriers to healing and foster recovery.
If you or someone you love is experiencing or considering self-injury, please dial 988, the Suicide and Crisis Lifeline. There is hope. There is help.
The Behavioral Health Wellness Environments for Living and Learning (BH WELL) research team exists to promote behavioral health and wellness among individuals facing behavioral health challenges. To learn more about BH WELL, visit our website. Interested in more evidence-based, free mental and behavioral health resources? Follow us @ukbhwell on Instagram, Facebook, and Twitter.
References
Klonsky, E. D., Victor, S. E., & Saffer, B. Y. (2014). Nonsuicidal self-injury: what we know, and what we need to know. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 59(11), 565–568. https://doi.org/10.1177/070674371405901101
Klonsky, E.D., (2009). The functions of self-unjury in young adults who cut themselves: clarifying the evidence for affect regulation. Psychiatry Research, 166(2-3), 260-268. https://doi.org/10.1016/j.psychres.2008.02.008
Wang, Z., Li, D., Chen, Y., Tao, Z., Jiang, L., He, X., Zhang, W. (2024). Understanding the subtypes of non-suicidal self-injury: A new conceptual framework based on a systematic review. Science Direct. 334, https://doi.org/10.1016/j.psychres.2024.115816
Centers for Disease Control and Prevention. (2023, April 25). Learn about mental health. https://www.cdc.gov/mentalhealth/learn/index.htm
Substance Abuse and Mental Health Services Administration. (2023, April 24). https://www.samhsa.gov/mental-health/self-harm
Centers for Disease Control and Prevention. (2019, September 17). Preventing self-injury. https://www.cdc.gov/ncbddd/disabilityandsafety/self-injury.html
Centers for Disease Control and Prevention. (2020). Evidence-based resource guide series: Treatment for suicidal ideation, self-harm, and suicide attempts among youth (Publication No. PEP20-06-01-002). chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://store.samhsa.gov/sites/default/files/pep20-06-01-002.pdf
As Recreational Therapy Month comes to an end, it is important to reflect on the many ways this therapy impacts individual well-being and wellness. Recreational therapy uses music, games, and crafts to promote healing. It focuses on mental, physical, emotional, social, and spiritual functioning by organically integrating these activities into the week. Are you still wondering, what recreational therapy is? Well, we are glad you asked so that we can share how recreation and therapy, working together as a team, can promote well-being!
The American Therapeutic Recreation Association (ATRA) states that recreational therapy involves treatment services that, “are designed to restore, remediate, and rehabilitate a person's level of functioning and independence in life activities, to promote health and wellness as well as reduce or illuminate the activity limitations and restrictions to participate in life situations caused by an illness or disabling condition.” This therapy is provided by Certified Therapeutic Recreation Specialists (CTRS) in a variety of settings which include, but are not limited to, mental health facilities, physical rehabilitation facilities, skilled nursing facilities, and acute care hospitals. No matter what the setting is, our health, wellness, and quality of life are likely to benefit from participating in various recreational activities because while in addition to being fun, our body enjoys the wellness benefits from them as well.
Within the recreational therapy process, leisure activities are used as interventions to determine what can help enhance the client's mental and behavioral health. When participating in recreational therapy, the client will learn how to work through feelings more comfortably and increase positive emotions. The recreational therapist facilitates activities that help with goal setting, coping skills, processing trauma, and expressing feelings which may lead to improved self-esteem and increased independence. Hope Therapy Center notes that benefits of this therapy include, “improved self-determination, increased emotional regulation, increased optimism, and feelings of autonomy”.
Additionally, recreational therapy can integrate physical activity which has shown to increase positive mood. Cardio drumming is a cardio work-out that has risen in popularity as a recreational activity that nearly everyone can enjoy whether you are a drummer or just want to have fun! This exercise uses vibrant music, a work-out ball, and drumsticks to engage in movement and fitness. In fact, a study examining the effects of cardio drumming on stress and self-esteem levels in an in-patient psychiatric hospital found that after doing this activity, stress levels decreased and self-esteem scores increased. Through these findings we can see the benefits of emphasizing the interconnection of mind, body, and spirit within the healing journey.
Recreational therapy is recognized for its ability to incorporate fun and enjoyable activities for therapeutic purposes. Recreational therapy offers people who are living with mental and behavioral health challenges a variety of unique methods to navigate the healing process. Through goal setting, coping skill enhancement, and cultivating a sense of positivity, individuals are provided with an opportunity to explore their emotional experiences in a liberating and empowering manner. Recreational therapy in mental health recovery emphasizes holistic well-being and focuses on empowering individuals to lead fulfilling and meaningful lives. It complements other forms of treatment and supports individuals in developing coping strategies, building resilience, and achieving their recovery goals.
The Behavioral Health Wellness Environments for Living and Learning (BH WELL) research team exists to promote behavioral health and wellness among individuals facing behavioral health challenges. To learn more about BH WELL, visit our website. Interested in more evidence-based, free mental and behavioral health resources? Follow us @ukbhwell on Instagram, Facebook, and Twitter.
Citations
Herwig, J. M., Gennaro, V. E., Layne, A. S., & Okoli, C. (Zim) T. (2023). Effect of cardio drumming on stress and self-esteem in an inpatient psychiatric hospital. American Journal of Recreation Therapy, 22(1), 31-38. https://doi.org/10.5055/ajrt.2023.0277
The authors regret the following error. The second affiliation of the first author was omitted from the article. The corrected affiliations are as follows:
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China;
School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province 611137, China.
Background: Depressive symptoms are common in patients with coronary heart disease (CHD) and heart failure (HF) living in rural areas and are associated with worse health outcomes. Cognitive behavioral therapy (CBT) can effectively improve depressive symptoms in patients with CHD and HF, however, traditional CBT is not accessible to most rural individuals, and some, particularly males, may be reluctant to participate in traditional CBT even if available. Therefore, we developed and tested two types of virtual CBT, video conferences with a therapist (vCBT) and self-directed CBT (iCBT). Aim: To determine whether gender moderated the effect of vcCBT or iCBT interventions on depressive symptoms in rural people with CHD and HF.
Quality of Life: One’s satisfaction with life in terms of self-concept, hopes for oneself, health, functional abilities, and socioeconomic factors (American Occupational Therapy Association, 2020).
Many people have little to no advance notice of when their life will end. However, others may be told, “We’ve done all we can do medically. What can we do to help make you more comfortable as you near end-of-life?” In those days, discussions occur (and rightfully so) about pain management, medical findings, treatments, associated costs, and more. But does anyone address mental wellness? Life satisfaction, and the hope that accompanies it, demands focused attention to mental wellness.
As a loved one nears the end-of-life, one’s ability to perform daily tasks often decreases, and the activities that are most meaningful change. For example, functional mobility may decrease or be lost completely. While this impacts daily life greatly, there are ways to modify meaningful tasks that encourage continued participation. For example, while your loved one may not be able to take an evening walk, they might enjoy chair aerobics or a drive to familiar parks or green spaces. Maintaining gentle activity may help decrease joint pain and increase your loved one’s ability to maintain personal hygiene. For most people who are nearing the end of life, independence often equals increased quality of life.
It is also common for a loved one to experience emotional difficulties, such as depression and anxiety, due to the stressors associated with end-of-life. These types of emotional difficulties can make completing self-care tasks, participating in social events, and participating in many other typical daily experiences difficult or seemingly impossible. However, understanding that emotional difficulties are common among individuals nearing end-of-life allows for preventative treatment that may lessen the occurrence of these difficulties. Preventative treatment includes seeking the support of a mental health professional who can help process thoughts and feelings. The practice of mindfulness in one’s daily routine can help to focus on simple daily accomplishments and build a sense of gratitude. Simply encouraging participation in life activities may help combat these emotional difficulties because they are engaging in one of their favorite activities with you, thereby increasing life satisfaction.
Importantly, as you support your loved one through end-of-life experiences, remember that you, too, are experiencing loss. Take time to get the support you need as a caregiver. Struggling with your own emotions? Consider professional counseling. Talk to a friend. Extra energy? Go for that walk. Racing thoughts? Take time to stop and breathe. Be mindful.
Does end-of-life mental wellness matter? Yes. In fact, mental wellness probably matters more at that time than at any other time.
If you or someone you love is experiencing end-of-life and would benefit from mental wellness support, call SAMHSA’s National Helpline at 1-800-662-HELP (4357).
References
American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001
Hammill, K., Bye, R., & Cook, C. (2019). Occupational engagement of people living with a life‐limiting illness: Occupational therapists’ perceptions. Australian Occupational Therapy Journal, 66(2), 145–153. https://doi.org/10.1111/1440-1630.12557
Smith, S., Wilson, C. M., Lipple, C., Avromov, M., Maltese, J., Siwa, E., Colombo, R., & Seidell, J. W. (2019). Managing palliative patients in inpatient rehabilitation through a short stay family training program. American Journal of Hospice and Palliative Medicine, 37(3), 172–178. https://doi.org/10.1177/1049909119867293
We have all likely experienced the shame, pain, and sting of being stigmatized at some point. Stigmatization appears in diverse forms-including derogatory comments about skin tone, hair texture, or body size; denial of resources due to social standing; and devaluation of persons because of sexual/gender identity, religious affiliation, or political preferences. Regardless of its form, stigmatization is never productive and poses a considerable threat to mental health and well-being.
There are an estimated 52.9 million adults (21.0% of the adult population) suffering from mental health disorders (MHDs) in the United States (1). Among those with mental health disorders,~ 17 million are also diagnosed with a cooccurring …
