Culture of Wellness
With stress levels higher than ever, now is a perfect time to ask, “What is wellness?” A vague term that may mean different things to different people, wellness is not something to take lightly. For many, it is one of life’s pillars, and has enormous influence on self-directed whole health and quality of life. In the context of behavioral health and primary care integration, the SAMHSA-HRSA Center for Integrated Health Solutions promotes wellness as a personal awareness of creating a healthy lifestyle, understanding its role in mind-body resiliency and disease prevention.
“Resiliency” is a term usually associated with “bouncing back.” However, as science-based resiliency factors become better known, our understanding of its centrality to prevention grows. A key concept in health care reform, prevention is essential to people living with mental illness and substance use disorders (SUD) who die younger than the general population often because of preventable and untreated chronic illness such as diabetes, obesity, and heart disease aggravated by poor health habits, such as smoking and poor nutrition, and social determinants like poverty.
CIHS built upon existing research and information to develop 10 whole health, wellness, and resiliency domains. These domains are meant to inform patients and primary care and behavioral health professionals as they develop treatment goals that address the “whole person” and promote prevention through resiliency. The 10 domains include:
- Support network. Human connections — either through ensuring a robust “support network” or providing “service to others” — are integral to health and wellness. People with strong social ties have much lower rates of disease and premature death than those who feel isolated and alone. Living in isolation not only increases cellular wear and tear, but also paves a highway to super stress.
- Stress management. Prolonged stress has an undeniable adverse effect on health. It can — and does — lead to illness. It can also precipitate relapse, both in mental illness and in addiction. The ability to reduce and/or counter stress is critical in dealing with behavioral health problems, as well in promoting health and wellness.
- Healthy eating. Most people have some idea of what foods are healthy, and understand that eating more calories than you use leads to weight gain. Developing personal eating habits that promote better health is important for everyone, especially people who have, or are at risk for, health problems like diabetes, heart disease, and high blood pressure. In the context of some chronic illnesses, eating healthy becomes vital to prevention and recovery.
- Physical activity. Exercise and other forms of physical activity not only help maintain a healthy weight, but also help improve overall health and behavioral health — and reduce stress, a daunting provocateur of poor health and wellness.
- Restful sleep. Getting adequate sleep is more important than many people realize. Long-term sleep deprivation is associated with many illnesses, including high blood pressure, heart attack, stroke, obesity, and behavioral health problems.
- Service to others. “Service to others” and “support network” are two sides of the same coin. We all need connectedness to survive. It’s no surprise that service to others and support networks play a major role in initiating and sustaining recovery.
- Optimism based on positive expectations. Personal hope that one’s life can be better encourages happiness and a sense of wellbeing. In fact, research has found that heart patients with optimistic recovery expectations are 30% less likely to die over the next 15 years than less optimistic patients, regardless of disease severity.
- Cognitive skills to avoid negative thinking. Whereas “optimism based on positive expectations” is based on attitude towards the future, “cognitive skills to avoid negative thinking” have to do with attitude towards oneself. A person increases their chance at happiness by telling his or her self a more positive story, rather than a miserable one. As Health Consultant and Writer Martha Beck stated, “Your situation may endanger your life and limbs, but only your thoughts can endanger your happiness.”
- Spiritual beliefs and practices. Spiritual beliefs are tremendously personal, and spirituality means something different to everyone. For some, spiritual beliefs are clear and concrete, and spiritual practices translate into specific religious rights, rituals, and ceremonies. For others, spiritual beliefs are vague and more mysterious. Regardless, for many, spirituality, meaning, and purpose are inseparable, and spirituality involves seeking meaning and purpose.
- A sense of meaning and purpose. Many people develop a sense of meaning and purpose through spirituality, ultimately converging a person’s beliefs and values. This sense of meaning and purpose helps a person weather life’s storms.
- Caregivers — whether primary care, behavioral health, or peer support — are in an ideal position to educate people about wellness and resiliency, and the importance of both in prevention. People with addictions and mental illness must include wellness and resiliency in their overall treatment goals to achieve recovery, better health, longer life, and a greater sense of wellbeing.
For more information on wellness, visit our webpage on Healthcare & Wellness for Integrated Healthcare.
Tips for Creating a Culture of Wellness at Your Organization
“What a great idea — we should do that!” “If we had the money, that would be a great program.” “I’d love to have a program like that at our clinic.”
Ever said one of these phrases? Well, when it comes to wellness, there are simple ways to promote it among your patients without facing financial or clinical hurdles. Here are 6 ideas:
- Encourage patients to know their ABCs (A1c, blood pressure, BMI, and cholesterol levels). The National Council for Behavioral Health developed ABCs of Wellness: Facts and Tips for Whole Health to encourage patients in primary and behavioral healthcare settings to prevent or improve chronic conditions like heart disease, obesity, and diabetes that are often associated with behavioral health problems. You can print the fact sheets and a health screening form off the CIHS website to share with patients and others in your community.
- Start an informal, open “Wellness Chat” once a week. Have a staff member or nursing student run the event using a Q&A format and host it in a communal area where people already congregate. Trilogy, Inc. in Chicago started one called “Rush Hour,” run by Rush University nursing students. The informality puts participants at ease to discuss topics that they may not bring up with providers.
- Post wellness tips in communal spaces and exam rooms where people will read them often and internalize the concepts. Glenn County Health Care Collaborative developed a series. Check them out.
- Put a dispenser of SPF 50 at your center’s front desk with fliers or wallet cards that offer ways to prevent skin cancer. In that same vein, place a bowl of individually wrapped gum at the front desk, each affixed with the number for a tobacco quit line.
- Get involved in SAMHSA’s 10x10 Wellness Campaign to promote wellness and increase life expectancies for people with mental health and substance use problems by 10 years, in 10 years. The campaign provides myriad materials for you to use in your community.
- Replace three items in your vending machines, like soda, chips, and candy, with healthy alternatives such as water, nuts, and juice.
Looking for more information?
Take a closer look at these resources.
Adult and Child Mental Health Center
Creating a Culture of Wellness through Spirituality
“As part of our training and life experience we all have our own spirituality and to each of us it is a personal journey. Looking back at my "story" it was a journey all of its own. We all need to learn accepting differences and the various levels and pathways to recovery. I can tell you today I am so grateful to the people who were patient with me and allowed me to grow at my decisions. However, being exposed was the first step to my spiritual journey. Each day my spirituality grows as I practice new tools for coping so I would hate to see the topic of spirituality silenced because for some it has been a productive tool. Old saying from recovery, ‘take what you need and leave the rest.’ …It is ok to not duplicate others in recovery. I cannot offend someone if I ask permission to share that part of my recovery and respect their wishes.”
- Nancy Morton
“The Adult and Child Mental Health Center, a SAMHSA Primary and Behavioral Health Care Integration (PBHCI) grantee, heard from clients who identified the importance of spirituality in their recovery, many who ranked their spiritual health as a higher priority than their physical or mental health. It became rather apparent that people were “missing” something from a medical model perspective. To address this gap, staff and clients worked together to find and review any existing spirituality curricula to address clients’ questions, concerns, and desires.
This led to the development of our spirituality group, the Heartfelt Opportunities for Personal Enhancement (HOPE) program. To support and drive the group experience, members and staff are flexible and open to developing our own “curriculum.” The group members identify core concerns, areas of interest for discussion, and create worksheets. The effort is a collaborative process between clients, peers, and other staff. This collaborative effort has established a level of ownership with the group, its existence, and the continued quality of “curriculum” presented.
Areas explored include the idea of life after death; the notion of eternal existence (or not); individual choices versus fate; quantifying the existence of sin, forgiveness, and grace; and how to deal with guilt.
There was no magic involved with establishing this group. The group is successful because the agency is supportive and understanding, acknowledges this dimension to healthy living, and because of the connection of people (clients, peers, and staff) to support and encourage each other. The balance of someone’s belief system and refraining from proselytizing is critical.
Members have reported that they appreciate being able to talk about their experiences and beliefs without having questions asked such as, “Are you taking your meds?” or “Do you need to see the psychiatrist?” The group has encouraged increased levels of trust and hope among clients and staff.
Many of us experience some sort of spirituality. Expressing, connecting to, and defining these feelings and experiences is an integral piece of people’s recovery journey. Our journey continues, developing and establishing relationships along the way, connecting to people as just that - people.”
James A. Dilger, Team Leader and Clubhouse Director, Adult and Child Mental Health Center