Alcoholics Anonymous (AA) is an international fellowship that was founded in 1935. The fellowship serves individuals who are struggling or have struggled with alcohol addiction. AA operates under its main principle of mutual aid and support. 

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.   

Congratulations to Johna Arnett, DNP, RN, on her graduation from the University of Kentucky (UK) College of Nursing (CON) with her Doctor of Nursing Practice (DNP). Dr. Arnett’s project, “The Impact a Nurse Recruiter has on Nursing Staff Shortages and Nurse Manager Satisfaction in an Acute Psychiatric Facility” explores the impact of a nurse recruiter role in addressing nursing staff shortages and nurse manager satisfaction within an acute psychiatric facility. Dr. Arnett is a Nurse Manager at Eastern State Hospital (ESH). 

Congratulations to Michele Van Outer, DNP, BSN, on her graduation from the University of Kentucky (UK) College of Nursing (CON) with her Doctor of Nursing Practice (DNP). Dr. Van Outer’s project, “Improving Structural Empowerment Through the Co-Creation of a Professional Governance Program of Nurse Managers and Frontline Nurse Leaders” aims to uncover the potential benefits of a collaborative approach on staff members’ patient care outcomes. Dr. Van Outer serves as a Nurse Manager at Eastern State Hospital (ESH). 

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.

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. 

Ah, relationships! We love them. We hate them.  We are challenged by them. So why do we need them to be well socially? 

Social well-being is defined as the ability to interact in a healthy way with those around us. This involves having supportive friends and family, the ability to develop deep connections, and communicate in healthy ways. Social well-being is one of the 8 dimensions of wellness.

This might surprise you; but, social well-being has nothing to do with whether we are extroverted, introverted, or fall somewhere in between. We ALL need healthy interactions in order to live our best lives. In fact, people who have healthy relationships and a strong social network tend to respond better to stress and even tend to live longer. Surrounding ourselves with healthy relationships leads to a stronger immune system, happier endocrine system, and a healthier heart!  

The Green River District Health Department (GRDHD) is located in Western Kentucky and serves seven counties – Daviess, Hancock, Henderson, McLean, Ohio, Union, and Webster. GRDHD’s mission is to “promote, protect and strengthen the health and well-being of all by helping develop and maintain healthy lifestyles and environmentally safe communities.” Since 1998, GRDHD has been working to educate the community about the dangers of tobacco use and secondhand smoke exposure through its tobacco prevention and education program. As part of their partnership with the Behavioral Health Wellness Environments for Living and Learning (BH WELL) research team, GRDHD supports behavioral health organizations working towards advancing tobacco-free policy and tobacco treatment services for people living with mental or behavioral health challenges who want to stop tobacco use.

People living with a mental or behavioral health challenge who use tobacco have a substantially reduced life expectancy and may die 10-25 years earlier than those who do not have a mental or behavioral health challenge and do not use tobacco. The most common causes of death among people living with mental and behavioral health challenges are heart disease, cancer, and lung disease, all of which can be caused by tobacco use. Provision of tobacco treatment services has a positive impact on both the mental and physical health outcomes of people living with mental and behavioral health challenges and can aid in recovery. Given such an impact, GRDHD works diligently in the community to integrate tobacco treatment services within local mental and behavioral health organizations.