Written by Bailey Patterson

Inpatient stays at hospitals or other treatment facilities are a part of life for many people with psychiatric disabilities. While receiving inpatient services, maintaining a healthy body and mind is important. 

For those who menstruate, reproductive healthcare is essential, even at times when other health concerns might be at the forefront of the mind. Menstrual products, like pads and tampons, are a basic reproductive healthcare need. Many people receiving inpatient treatment don’t have access to quality menstrual products that protect their dignity and autonomy. 

It is common for hospitals and treatment centers to have strict and specific guidelines for what patients can bring into treatment. Many patients are not permitted to bring their personal  menstrual products, even if they had the opportunity to pack them for their stay. This means patients rely on facilities  to provide necessary products. 

Some patients have reported a lack of supplies or needing additional supplies. On the Stigma Silenced [Stories Spoken] podcast, episode two guest, Taylor Price, spoke about her experience with this situation. She recalled, “This is very personal, but one thing I remember is that [I couldn’t] get feminine products because they were, for some reason, it was some bureaucratic system, but they were like, ‘We don’t have them in this location right now.’ [So I went] two days without feminine products [and] normal clothes. I was wearing a hospital gown and [felt] uncomfortable in my skin.”

Price is not alone in this experience. The National Survivor User Network conducted research into menstrual health in psychiatric inpatient settings and found a variety of factors that may have adverse  effects on patients in the United Kingdom. They found reports of facilities that did not keep sufficient  period products, but this was not the only concern they discovered. For example, they found reports of:

• Lack of choice of menstrual product provided: Some patients are only afforded access to pads or adult diapers instead of their products of choice (like tampons) due to preferred products being deemed “unsafe.” Some patients who are in highly restricted environments  have reported being denied any products at all due to the “safety risk.”
• Difficulty accessing products: When period products are available, many facilities require patients to report they are on their period and in need of products. This can be embarrassing for some people, especially in a situation where the only staff on duty are cisgender men. 
• Inadequate menstrual education of staff: Some patients reported being given less than the needed amount of period products and receiving disbelief from staff when they communicate their need for more products. 
• Lack of  privacy: In many inpatient facilities, patients are not permitted to close the doors to their bathrooms. Some patients may even have “one-on-one” supervision, meaning staff has to accompany them to the restroom. This can result in additional anxiety and embarrassment to people who are menstruating. 
• Stigma against transgender patients: Transgender patients who menstruate have reported stigma and biased attitudes from staff members. 

The physical and mental health of psychiatric patients in inpatient settings should be prioritized in regards to menstruation. Adequate supplies, reducing stigma and promoting dignity should be supported. Patients strongly believe the state of menstrual wellbeing in inpatient psychiatric settings needs improvement. Patients have called for wider access to a variety of menstrual products on hand, more thoughtful systems for receiving needed products, increased privacy on wards to strengthen patients’ sense of dignity, and better menstrual health education for staff that includes anti-bias training.

Menstrual Health Access Resources: 

University of Kentucky’s Take a Tampon: /uky.campuslabs.com/engage/organization/takeatampon

Take a Tampon was started with the goal of providing free and accessible hygiene products to students at UK and in the Lexington community. This organization hosts donation drives, hosts events to raise awareness, and is responsible for the menstrual hygiene product baskets located around campus

Menstrual Freedom Coalition at University of Louisville: louisville.edu/womenscenter/resources/menstrual-freedom-coalition

The Menstrual Freedom Coalition (MFC) is a coalition of campus and community partners, who come together dedicated to challenging period stigma and dismantling barriers. MFC promotes menstrual equity through resource-sharing, educational workshops and community building to empower individuals who menstruate to live their lives to the fullest. Period.

KY Period Project: www.kyperiodproject.org

A menstrual equity program for women & girls in the Kentuckiana area.

Written by Eliott Hamilton

Anyone can benefit from being outdoors—exposure to nature is linked to improved mental and physical health. This can include urban green spaces, hiking on a trail, or getting some sun.

One of the most popular ways to spend time in the great outdoors is hiking, which is an excellent way to combine beautiful views with exercise and fresh air. Kentucky is full of a wide variety of trails, ranging from national park forests to urban walking trails. 

Many hiking options have fully or partially accessible areas, as well as information about the types of terrain along the trail. With a bit of planning ahead, you can experience the outdoors on mobility-aid-friendly hikes throughout the Bluegrass.

The Importance of Grade

A trail’s slope is important to consider when looking for an accessible path. If the grade of the slope is too high, it can become unsafe or impossible for wheelchair users to navigate. In the United States, the Americans with Disabilities Act (ADA) suggests that ramps be built with a 1:12 ratio. This means that a ramp should be 12 inches long for every 1 inch of height, leading to a maximum slope of about 5 degrees.

Many wheelchair users can comfortably manage an incline with a grade of 5 degrees or less, but this can vary depending on the trail surface, length of an incline, frequency of rest points, and individual accessibility needs.

Accessible Trails

Mammoth Cave

Click here for general information about accessible tours at Mammoth Cave by the National Parks service.

Click here for a review of the Mammoth Cave trails by Wheelchair Traveling.

1. Accessible Guided Tour

• Trail Type: Guided round trip
• Length: 0.5 miles
• Elevation Gained: -267 feet by elevator
• Estimated Grade: 2-5 degree slope leading to elevator; slope less than 2 degrees on trail
• Parking:
  • A paved path connects the parking lot to the visitor center
  • 1 van accessible spot
  • Use personal transportation from the visitor center to the elevator building (a paved lot with no marked spots)
• Trail Surface: Smooth & Paved
• Trail Width: 36 inches

Mammoth Cave is the largest known cave system in the world. This accessible cave tour can accommodate 15-20 people, but a full group may require more elevator trips.

The cost of this tour is $27 for adults, $21 for youth, and $13.50 for anyone with a Senior pass or Access Pass. The tour may be canceled with little notice because the facility only has one elevator. Reservations are required. View ticketing information here.

2. Sloan’s Crossing Pond Walk

All Trails Information about Sloan’s Crossing Pond Walk

• Trail Type: Loop
• Length: 0.4 miles
• Elevation Gained: 13 ft
• Estimated Grade: 2-5 degrees maximum at the trailhead, which levels off as you continue. 
• Parking: Paved without designated spots
• Trail Surface: wooden boardwalk 
• Trail Width: 36 inches

This trail leads around a pond with plenty of wildlife viewing and birdwatching opportunities for early-morning visitors. There are multiple 5×5 foot viewing platforms located around the pond and benches along the way to rest. 

3. Heritage Trail Loop

• Trail Type: Loop
• Length: 0.6 miles
• Elevation Gained: 42 feet
• Estimated Grade: Level with some areas of 2-5 degrees of slope throughout
• Parking: Accessible parking nearby at the Mammoth Cave Hotel or Visitor Center
• Trail Surface: Combination of pavement and boardwalk
• Trail width: 36 inches

This scenic trail takes visitors to Sunset Point, passing a small cemetery off the side of the trail along the way. There are multiple benches along the trail for resting and the boardwalk sections of the trail have handrails available. This trail is best viewed at sunset and features views of the Green River. 

Bernheim Arboretum and Research Forest

4. Forest Giants Trail 

Forest Giants Trail All Trails Information

• Trail Type: Out & Back
• Length: 2.1 miles
• Elevation Gained: 111 ft
• Estimated Grade: Mostly gentle with 2-5 degrees of slope in areas. 
• Parking: Paved parking lot at the trailhead with two designated spots
• Trail Surface: A mix of wooden boardwalk with railings, paved asphalt, gravel, and natural surface (dirt) sections
• Trail Width: 4 feet

This trail takes visitors to see the 3 forest giant statues built by Thomas Dambo located in the Bernheim Arboretum and Research Forest. It offers great photo opportunities and features rest stops with benches along the way. Due to the trail surface, some people using a mobility aid may need off-road wheels and/or power assistive devices. 

5. Sun & Shade Loop 

Sun & Shade Loop All Trails Information

• Trail Type: Loop
• Length: 1.1 miles
• Elevation Gained: 55 feet
• Estimated Grade: Mostly gentle with 2-5 degrees of slope in areas.
• Parking: There are two designated spots in a paved parking lot near the north end of the trail
• Trail Surface: A mix of gravel, wood mulch, or a natural surface (dirt, grass, leaves).
• Trail Width: 6 feet

Also located in the Bernheim Arboretum and Research Forest, the Sun & Shade Loop trail offers a calm route through grassy meadows and forested areas. Featuring a couple of small bridges over a stream, multiple landscaping features, and a small graveyard sitting off the northernmost section. Visitors using mobility aids may require all-terrain tires and/or power assistive devices.

6. Buttermilk & Emmert Falls 

Buttermilk & Emmert Falls All Trails Information

• Trail Type: out-and-back
• Length: 3.2 miles
• Elevation Gained: 206 feet
• Estimated Grade: Mostly gentle with a slope of 5 degrees or lower in most areas. There are steeper sections at the 0.9 and 1.5-1.6 mile areas when going east. 
• Parking: Paved and gravel parking lot near the trailhead with no designated spots
• Trail Surface: Cement asphalt
• Trail Width: 6 feet

Created by turning 2.5 miles of county road into a nature trail, Buttermilk & Emmert Falls features unique flora, creek views, waterfalls, and an ancient Osage Orange tree. The path has many rest points with picnic tables and benches, and bridges on this trail are lined with grip strips.

The trail out to Buttermilk Falls (the first 0.6 miles) is wheelchair accessible. Visitors using mobility aids may need assistance if attempting to continue past this point in the trail. 

7. Natural Arch Scenic Overlook

Natural Arch All Trails Information

• Trail Type: out-and-back
• Length: 0.2 miles
• Elevation Gained: 26 feet
• Estimated Grade: Mostly 5 degrees or less
• Parking: Paved parking lot at the trailhead with two designated spots and access isles
• Trail Surface: Paved asphalt
• Trail Width: Average of 6 feet

Located in the Daniel Boone National Forest, this short trail takes visitors to an overlook providing a panoramic view of a 100-foot long, naturally formed, sandstone arch. While the grade of this trail is mostly gentle at 5 degrees or less, there is a steeper section around the 0.1-mile mark going north. Visitors using mobility aids with wheels may need assistance navigating this area. There is an accessible vault toilet. 

The Lexington Area

8. Wellington Park Path 

Wellington Park Path All Trails Information

• Trail Type: Loop
• Length: 1.3 miles
• Elevation Gained: 45 ft
• Estimated Grade: 3 degrees or less
• Parking: Paved lot with two designated spots at the trailhead
• Trail Surface: paved asphalt 
• Trail Width: 8 ft

This sunny path loops around the open green space and forested areas of Wellington Park. Other features of the park include a dark park and a meditation labyrinth. 

9. Beaumont Walking Trail 

Beaumont Walking Trail All Trails Information

• Trail Type: out-and-back
• Length: 3.3 miles
• Elevation Gained: 91 ft
• Estimated Grade: Mostly 5 degrees or less
• Parking: 8 designated spots in a paved lot at the north end of the trail
• Trail Surface: paved asphalt
• Trail Width: 6 ft 

This trail winds through the Beaumont residential area and is a great spot for viewing wildlife in the city. The trail is highly shaded and features rest points along the path with benches. While mostly flat, this trail does have some sections with a moderately steep grade (about 5 – 8 degrees) at the 1.1 and 3.3-mile points. Visitors using mobility aids may need assistance traversing these sections of the path. Additionally, the path does cross over Beaumont Centre Lane at the 1.0-mile point. 

10. Brighton East Rail Trail 

Brighton East Rail Trail All Trails Information

• Trail Type: out-and-back
• Length: 3.3 miles
• Elevation Gained: 78 ft
• Estimated Grade: gentle – 3 degrees or less
• Parking: There is one accessible spot in the paved parking lot off Pleasant Ridge Drive, which is located at the midway point on the trail.
• Trail Surface: Paved asphalt
• Trail Width: 6 ft

This trail runs through lightly wooded residential areas of Lexington. The original 1-mile section of this trail connects Bryant Rd and Pleasant Ridge Park, but it was expanded in 2013 and now continues East to Walnut Grove Lane. Another recent expansion extends the trail west, connecting with the Liberty Park Train via a walking bridge over Liberty Rd. While the new trail development is paved, we are unable to find the information on the area’s grade or width. People using mobility aids may need assistance if the newer section of the trail has any steep grade.

11. McConnell Springs Trail 

McConnell Springs Trail All Trails Information

• Trail Type: Loop
• Length: 0.6 miles
• Elevation Gained: 19 ft
• Estimated Grade: 3 degrees
• Parking: Two designated spaces in the parking lot off Rebmann Lane at the north end of the trail
• Trail Surface: Paved with partial railings
• Trail Width: 4 ft with some wider areas throughout 

McConnell Springs Trail winds through a natural landscape with dense tree coverage in areas and features of Kentucky history such as sections of stone fencing throughout. This trail is a historic site popular among bird watchers and has benches along the trail to rest and take in the scenery. Only service animals are allowed on this trail. 

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https://www.apa.org/monitor/2020/04/nurtured-nature

https://pubmed.ncbi.nlm.nih.gov/27527193

https://www.hsph.harvard.edu/news/hsph-in-the-news/time-spent-in-nature-can-boost-physical-and-mental-well-being

Written by Bailey Patterson

This Disability Pride Month, we are shining a spotlight on peer support! Within the mental health community, it is widely understood that lived experience is a valuable asset. People who are experiencing a crisis or need mental health support may seek out the help of doctors or other professionals, but, increasingly, this is not the only option available. 

Many organizations are choosing to build systems of support focused on connecting people with mental health conditions to their peers with lived experience. The philosophy of this model of care centers around the leadership of people with lived experience of mental health conditions. These individuals are valuable due to their first-hand knowledge of what others in similar situations may need. Through their expertise in their own lives, they are able to connect with people seeking support in deep and meaningful ways. One important feature of this approach is the emphasis of a lack of hierarchy between someone providing and receiving care. Many times, professionals such as doctors, therapists, and social workers are viewed as being in positions of authority over their patients. They follow policies and procedures that may require them to refer their client to care that the client may not have consented to. In a peer support model, this breaks down that barrier. 

One organization championing this approach is Project LETS. Project LETS’ mission is “[to] build peer support collectives, lead political education, develop new knowledge and language around mental distress, organize and advocate for the liberation of our community members globally, and create innovative, peer-led, alternatives to our current mental health system.” To this effort, Project LETS has satellite programs in universities and high schools all over the country where people with lived experience of psychiatric disability are trained to provide peer support. Additionally, Project LETS has an online form where individuals who need support can be matched with a peer for support on a rolling basis. 

Project LETS identifies peer support as one of their core values and states, “People who have lived experience with mental illness, disability, trauma, and/or neurodivergence can offer a specific, unique, culturally and socially responsive, and accessible type of mental health care (known as peer support). We do not believe that peer support happens on a hierarchical level — between someone who is ‘recovered’ and someone who is ‘still sick.’” 

There is evidence to support this philosophy. One systematic review of peer support for young people with anxiety and depression concluded that “Altogether, the available evidence suggests that peer work is a safe, effective, flexible and cost-effective intervention for adults, which promotes hope, empowerment, patient activation, and self-efficacy, and reduces hospitalisations.” All this considered, peer support is part of the future of effective and liberating crisis care for people with psychiatric disabilities. 

To learn more about peer support visit these resources:

The effectiveness of peer support from a person with lived experience of mental health challenges for young people with anxiety and depression: a systematic review

When There’s a Crisis, Call a Peer by The Bazelon Center for Mental Health Law

Project LETS Peer Support Webpage