LOUISA — Around the office at Addiction Recovery Care, or ARC, Vanessa Keeton is still known as “Client One” — marking her status as the first client of the first recovery center the organization opened as a group home in Lawrence County.
But her official title is vice president of marketing for ARC, where she has worked since 2012, a little more than a year after she entered the program known as Karen’s House — choosing it over jail for a string of drug and alcohol-related offenses.
Vanessa Keeton is “Client One” and ARC’s vice president of marketing. (Kentucky Lantern photo by Matthew Mueller)
“Dec. 2, 2010, that was my first day,” she said. “That’s a day I’ll never forget as long as I live. That’s the day that everything changed.”
ARC, too, has changed dramatically since it started as a treatment home for women run by volunteers, based largely on Bible study and prayer.
It now operates as a for-profit company paid $130 million last year by Medicaid, the government health plan which in 2014 expanded access to addiction treatment, or substance use disorder, as it’s now known.
Gov. Andy Beshear has praised ARC for helping Kentucky — ravaged in recent years by addiction and overdose deaths — become the state with the most treatment beds per resident in the nation, according to an East Tennessee State University study.
“With the help of organizations like ARC, we are working to build a safer, healthier commonwealth for our people,” Beshear said, speaking at an ARC ribbon-cutting for a new facility in March.
Owned by founder and CEO Tim Robinson and his wife, Lelia, the company provides the couple an annual income of about $533,400, according to a 2022 tax-filing by Odyssey Inc, a non-profit affiliated with ARC.
Robinson said he and his wife struggled financially for years while establishing the treatment business — facing potential foreclosure on their home and repossession of their car. He doesn’t think that income is unreasonable.
“We took a lot of risks,” said Robinson, 48, a lawyer and recovered alcoholic who has been sober since 2006 — two years before he started building the faith-based treatment business that would become ARC. “I’m living the American dream. I’m doing better than I ever thought I could be doing financially.”
Kentucky’s largest provider
The fast-growing company is by far the state’s largest substance treatment provider, with 1,800 residential beds in 24 Kentucky counties, and reaches hundreds more clients through outpatient services. ARC, which estimates it provides 75% of treatment beds in Kentucky, also is planning programs in Ohio and Virginia.
ARC is operating the former Our Lady of Bellefonte Hospital in Ashland as a residential treatment center.
Earlier this year, ARC opened a 40-bed behavioral health unit with plans to expand to 300 at the former Our Lady of Bellefonte Hospital in Ashland, which closed in 2020. In 2020, ARC opened its largest center — with a capacity for 700 — on the campus of St. Catharine College in Springfield, which closed in 2016.
ARC is no longer simply a treatment organization, said Matt Brown, a former ARC client who overcame addiction and now serves as ARC’s chief administrative officer and president of ARC Healthcare.
“We view ourselves as a behavioral health system,” Brown said.
While Christian faith remains at the heart of its mission, ARC relies on professional therapists, medical specialists including nurses and doctors, a structured treatment program and medication such as Suboxone to reduce the cravings of some patients for drugs and help them maintain sobriety, Robinson said.
Its religious component — which includes tracking how many clients decide “to follow Christ” (1,320 in 2023) — is strictly voluntary, according to Robinson, who said he was able to get sober in 2006 with the help of a local pastor and friend who “led me to the Lord.”
More importantly, he said, is that the number of clients who agree to stay in long-term treatment up to six months has increased steadily, which he thinks is the best indicator of effectiveness of the program.
Medicaid, which funds the majority of substance treatment, doesn’t require programs to measure outcomes.
But ARC measures its own outcomes, which it reports to Medicaid quarterly, Robinson said. That includes a retention rate of around 70% of its clients in treatment for up to six months and even longer through periodic contact with a case manager.
“I’ve been in this a long time,” Robinson said. “Long-term residential treatment is the reason people recover.”
As an indicator of success in addressing addiction, the Beshear administration points to the decline, for the second year in a row, of overdose deaths in Kentucky.
The state’s latest overdose report, released in June, shows a decrease in deaths to 1,984 from 2,200 the year before, a decline of 9.8%.
But Beshear said the fight must continue.
“We recognize that even while we celebrate progress, there’s a lot of heartbreak and pain because of this epidemic that continues,” Beshear said.
Gov. Andy Beshear recognized Robinson during his State of the Commonwealth address, Jan. 3, 2024. (Kentucky Lantern photo by Arden Barnes)
Last year, ARC received about $130 million in payments from Kentucky’s Medicaid program — more than double the amount of its closest competitor, Spero Health, a Nashville- based company that received $60 million in Medicaid funds in 2023, according to the Cabinet for Health and Family Services, which licenses and oversees treatment facilities.
ARC accepts private insurance, but Robinson and Brown said that almost all of the company’s revenue is from Medicaid since their clients generally have lost jobs and any health insurance because of addiction.
Overall, the state spent $1.2 billion on substance use disorder services in fiscal year 2023, with the majority of funds coming from the federal government, according to the cabinet.
Robinson, a former county prosecutor who started his business from a home office in Louisa, has emerged as a major political donor and well-connected business leader, last year appointed to the Kentucky Chamber of Commerce board.
Beshear singled out Robinson for recognition in his State of the Commonwealth speech in January, calling him “an essential partner in our fight against addiction.”
Robinson, a lifelong Republican, is effusive in praise for Beshear, a Democrat, in part because of the governor’s emphasis on addiction treatment and the governor’s frequent references to his own religious faith.
“I’ve never been for anybody like I’ve been for Andy Beshear,” Robinson said. “I hope he runs for president.”
ARC has rebuilt a block in downtown Louisa into a coffee shop, commercial kitchen, community theater and an event space. (Kentucky Lantern photo by Matthew Mueller)
‘Treatment on demand’
ARC employs 1,350 people with 500 based at its headquarters in tiny Louisa (population 2,600) perched on the edge of the Big Sandy River next to West Virginia. The company is Lawrence County’s largest employer, ahead of the school system and local hospital.
About 40% of its workers are “graduates” of its treatment program, Robinson said, and most of its upper management — himself included — are in recovery from addiction.
ARC promises “treatment on demand,” and operates a 24-hour hotline people can call to identify help within 15 minutes, including transportation, if needed, to one of its centers. Last year it served more than 12,000 individuals from 119 of Kentucky’s 120 counties.
It has developed a network of job-training programs including welding, automotive repair, lawn service, culinary arts, chaplaincy and food service. As part of that, ARC has rebuilt more than a block of rundown buildings in downtown Louisa into a coffee shop, commercial kitchen, community theater and an event space.
Community members rehearse for a theater production at ARC’s performance space in Louisa, June 27, 2024. (Kentucky Lantern photo by Matthew Mueller)
It offers clients a chance to get certification toward a trade and get college credit for some training.
ARC owns a pharmacy used to provide medication to clients, a laboratory for medical testing and operates a health clinic in Louisa. Also, Tim and Lelia Robinson founded the private Millard School, a Christian academy in Louisa attended by some children of their employees.
Vanessa Keeton’s husband, James Keeton, a 2011 ARC graduate, manages the Second Chance garage which repairs and restores autos for the public as well as maintaining an ARC fleet of about 200 vehicles.
“We restore cars and we restore lives,” he said.
The Keetons live in Louisa and their son attends the Millard School.
And ARC runs a sophisticated marketing program complete with a website, billboards, television and radio commercials, a social media presence, sponsorships and news releases, contracting with the Louisville-based public relations firm, RunSwitch. Scott Jennings, CNN commentator and Republican political consultant, is one of RunSwitch’s founding partners. ARC spends about 4.5% of its revenue, or about $5.8 million a year on marketing.
Vanessa Keeton said the marketing is important to promote awareness of its services to those in need, “to meet people where you are.”
Outside the concert hall and performance space ARC renovated for public use. The Robinsons also founded a private Christian school in Louisa. (Kentucky Lantern photo by Matthew Mueller)
‘Buying influence?’
Some outsiders criticize ARC for its rapid growth, its size and Robinson’s political giving, including Mark La Palme, the founder and former CEO of Isaiah House, a treatment program based in Harrodsburg.
La Palme, now retired, said he worked with Robinson on a project in the mid-2000s but parted ways over disagreement with practices including designating clients as “interns” in ARC programs for low pay while in treatment, saving the company the cost of paying a regular employee.
He calls ARC “huge,” has called it a “bully” in a social media post and questions its rapid expansion. La Palme also questions the prolific giving of Robinson and ARC entities, which rank among the state’s major political contributors.
“It seems like you’re buying political influence,” he said.
But he allows Robinson has been highly effective in building ARC into the state’s largest treatment system.
“He’s dangerously brilliant,” he said.
Robinson considered La Palme a friend and colleague but said they parted ways after a proposed collaboration fell through. Robinson said ARC’s programs meet all state standards, are accredited and the company works to provide high quality care.
He said internships are a way of introducing people to job skills they will need to succeed once they leave treatment and interns in various job training programs receive a paycheck either through ARC or an outside employer.
Robinson said he doesn’t apologize for political giving, seeing it as a way to support causes and politicians he believes in.
And he doesn’t think ARC is too big, saying that the company had to expand to remain viable within the constraints of Medicaid reimbursement, which pays for most of its clients.
“We had to grow to survive,” he said.
Matt Brown appeared on the cover of Healthcare Business Review magazine which recognized ARC as one of the nation’s “Top 10 Addiction Treatment Companies” for 2024. (Photo provided by ARC)
Robinson’s employees who spoke with Kentucky Lantern, including Brown, are highly enthusiastic about the boss.
Brown, trained as a physical therapist, battled addiction for 18 years before coming to ARC as a patient and remaining as an employee.
Robinson is “a visionary,” Brown said during a tour of ARC properties in Louisa, “He sees things in people before they see it in themselves.”
‘Papaw taught me’
Robinson said he grew up next door to Louisa in Martin County, his home in “the poorest part” of a poor county.
His introduction to business came from his grandfather who owned a country store.
“He put me on a pop carton to run the cash register,” he said. “Papaw taught me about business.”
Another boyhood business venture of Robinson’s — selling baseball cards — would provide a life-changing entrée into college and law school, when he was befriended by Inez banker and businessman Mike Duncan, a power player in Republican party politics and former chairman of the Republican National Committee.
Robinson said he and Duncan crossed paths when he began selling baseball cards to his young son, Robert M. “Rob” Duncan, who also would become a lawyer and, under former President Donald Trump, was appointed U.S. Attorney for the Eastern District of Kentucky.
Rob Duncan now serves as the top deputy to Kentucky Attorney General Russell Coleman.
Robinson considers both the father and son friends but said he remains closest to Mike Duncan, a trusted friend and adviser.
Mike Duncan, Robinson said, showed interest in his boyhood baseball card venture and became a mentor, encouraging Robinson to go to college — a prospect he hadn’t considered.
“Nobody in my family ever went to college,” Robinson said.
But with Duncan’s encouragement, Robinson graduated from the University of the Cumberlands in Williamsburg, earned a law degree from the University of Kentucky and was elected student body president at both institutions.
ARC employs 1,350 people with 500 based in Louisa, including at the Masterpiece coffee shop and cafe and Painted Cow Art Gallery. (Kentucky Lantern photo by Matthew Mueller)
Good times and bad times
“He helped me through the good times and the bad times,” Robinson said.
Among the worst times: Robinson’s 2003 indictment for felony vote fraud while he was student body president at UK, after some 750 voter registration cards collected during a student government drive were never turned in. Apparently forgotten, they were later found in a student government office, according to a 2003 Lexington Herald Leader story.
Art work for sale at the Masterpiece coffee shop operated by ARC in downtown Louisa. (Kentucky Lantern photo by Matthew Mueller)
“It was devastating,” Robinson said. “I thought my whole life was over.”
Instead, with the help of his lawyers, Robinson pleaded guilty to a lesser misdemeanor charge of failing to turn in the registration cards and paid $90 in restitution. Robinson said he dropped out of law school during the legal case, but was readmitted and graduated.
But that ordeal, plus the death of his mother while he was at UK, “finished my mental health off,” Robinson said.
He returned home to Eastern Kentucky to work but alcohol by then had a powerful hold on his life.
‘A raging alcoholic’
Back in Lawrence County, Robinson joined in law practice with a friend and became an assistant county attorney but by then said he had become a “raging alcoholic” though still somehow able to perform his job.
He would drink on weekends, come to work on Mondays hung over and avoid alcohol on days he had to be in court. Toward the end of the week, Robinson said, he’d resume drinking and stay drunk till the following Monday.
“I was leading kind of a double life,” he said.
That continued until a deputy sheriff at the courthouse where Robinson worked intervened. The deputy, also a pastor and a recovering alcoholic, helped Robinson stop drinking through prayer and support — taking him with him to nightly events where he would preach and play Bluegrass music.
Tim Robinson, founder and CEO of Addiction Recovery Care, outside a theater in Louisa his company acquired and renovated. (Kentucky Lantern photo by Deborah Yetter)
Though Robinson said he knew nothing about treatment or programs such as Alcoholics Anonymous, he decided he needed to expand services in the region that in the mid-2000s offered little.
“I was convinced God was calling me to stop practicing law and start a recovery center,” Robinson said.
So he did, leaving his law job and starting out of a home office on Nov. 3, 2008.
Robinson got help from Rev. Ralph Beiting, a Catholic priest who founded the Christian Appalachian Project based in Paintsville and together they opened a recovery house for women in Lawrence County called Karen’s House.
It was a makeshift operation run by volunteers with donated goods, including some old Army cots. Meanwhile, Robinson was taking men to the closest treatment center, Chad’s Hope in Clay County, getting occasional funding from Operation UNITE, launched in 2003 by U.S. Rep. Hal Rogers to help Kentucky battle rising addiction — in particular the tide of opioid pain pills engulfing the state.
But broke and discouraged, Robinson was close to quitting when he contacted a consultant who suggested he expand by opening a second recovery center for men. He located a site in Fleming County and in 2013, Belle Grove Springs was opened by the company that would become ARC.
Brown, now ARC’s chief administrative officer, was among the first clients admitted to the men’s center.
The following year, under the Medicaid expansion authorized by the Affordable Care Act, the government health plan began funding substance use disorder services and a reliable funding stream opened. Kentucky was among the first states to include addiction as a service covered by Medicaid.
While the income was welcome, it wasn’t enough to finance ARC’s operation and Robinson said the company’s only choice was to expand and recoup more money through a higher volume of clients.
“People thought we were growing because we were booming but we had to grow to survive,” he said. “You cannot make it on a couple of small facilities.”
ARC didn’t show a positive cash flow until 2019, he said.
Robinson first opened a recovery home for women in Lawrence County, followed by a second site in Fleming County for men as the tide of opioid pain engulfed the state. (Source: Addiction Recovery Care)
‘Take our time’
While ARC expansion has slowed, Robinson said the company is still looking at other opportunities, including expansion into Virginia, which has far fewer treatment beds than Kentucky.
“We’re going to take our time,” he said.
ARC also was flagged in a budget item this year by the state General Assembly with a $12 million allocation over two years directed to the Life Learning Center in Covington, an organization aimed at helping people develop skills to improve their lives “through gainful employment.”
The budget line says the funds are to be distributed to the center to support “treatment, rehabilitation, and community reintegration in partnership with Odyssey Inc.”
Odyssey is the non-profit arm affiliated with ARC.
Robinson said he expects Odyssey to submit a proposal as treatment provider for a program the center plans to establish in Somerset.
And while his work has expanded statewide and beyond, Robinson said he’s committed to staying in Louisa and keeping his company headquartered there.
“I’m where I’m going to be,” he said. “This is my adopted hometown.”
Kentucky Lantern is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Kentucky Lantern maintains editorial independence. Contact Editor Jamie Lucke for questions: [email protected]. Follow Kentucky Lantern on Facebook and X.
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[YAOUNDE] Nigeria is to begin the immediate rollout of 5,000 doses of mpox vaccines while the Democratic Republic of Congo (DRC) eyes its first shipment of 65,000 doses, as Africa steps up measures to control the multi-country outbreak.
The vaccine, administered in two doses, will go first to people at high-risk, including health workers and those living in areas with high infection rates, according to Nigeria’s National Primary Healthcare Development Agency.
Matshidiso Moeti, WHO regional director for Africa, said the delivery of 10,000 doses to Nigeria by USAID this week signified “a clear demonstration of international solidarity in the face of global public health emergencies”.
“The emergence of the new, more virulent variant (Clade Ib) and the increase in human-to-human transmission, with new routes such as sexual transmission, remains a cause for concern.”
Flaubert Mba, Centre for Research on Emerging and Re-Emerging Diseases
Nigeria became the first African country to receive the vaccine after confirming 40 cases of the disease, whose symptoms include fever, swollen lymph nodes and a rash leading to blisters.
The DRC, the country worst affected, is expecting to receive 65,000 doses of the vaccine on 1 September, announced Jean Kaseya, director-general of the African Centres for Disease Control and Prevention (Africa CDC), during an online press conference on Wednesday (28 August).
A health worker examines skin lesions that are characteristic of mpox on the back of a young child at the mpox treatment centre at the Nyiragongo General Referral Hospital, north of Goma in the DRC on 14 August 2024. Credit: Guerchom Ndebo / WHO
He said 50,000 doses would be sent by the US while 15,000 will be provided by Gavi, the Vaccine Alliance.
Kaseya said the JYNNEOS vaccine, made by Danish pharmaceutical company Bavarian Nordic, was one of the surest ways of stopping the mpox epidemic, alongside epidemiological surveillance and screening.
He stressed the vaccine was the same one used in the US and Europe to stem an outbreak of mpox – formerly known as monkeypox – in 2022.
“It has been given to millions of Americans and Europeans, which has made it possible to stop [that] epidemic,” he told the press conference.
Residents of Weta village in Maniema province, eastern DRC read information about how to avoid mpox, provided by health officials. Credit: Eugene Kabambi / WHO
In July, the emerging infectious diseases foundation CEPI announced trials in the DRC to see if vaccinating people already exposed to mpox stops them getting sick and spreading it.
Kaseya said Africa CDC would be sending 72 epidemiologists to affected areas in September to collect more data on case numbers, citing problems with the reliability of current data.
“These epidemiologists, in addition to the support they will be giving to the teams in the field, will also be focusing on the quality of the data, so that we can have data that will enable us to make good decisions,” he said.
“In the coming weeks, we will begin to provide what we believe to be quality data thanks to this support.”
Bushagara camp for displaced people in North Kivu, DRC. Identification of mpox cases in camps around Goma is concerning because the high population density can result in further spread. Credit: Guerchom Ndebo / WHO
Response plans
For the first time since its creation, Africa CDC declared on 13 August that the new mpox epidemic constituted a public health emergency of continental security (PHECS) in Africa. The next day, the WHO declared it a public health emergency of international concern (PHEIC).
Nicaise Ndembi, Kaseya’s scientific advisor and mpox response coordinator for the African Union and Africa CDC, told SciDev.Net: “This declaration marks an important moment in the history of public health in Africa and demonstrates the seriousness of the situation and the need for a unified, continent-wide response to this rapidly spreading disease.”
He stressed that it is now “urgent to take coordinated action at national, regional and international levels to stop the spread of mpox”.
Africa CDC is working to develop a “continental response plan”, which, according to Kaseya, should take into account the individual needs of each country. He said the plan will be presented to African heads of state for endorsement in the coming weeks.
The WHO has already launched a global strategic plan for mpox preparedness and response, which it says requires US$ 87.4 million over the next six months (September 2024-February 2025).
WHO director-general, Tedros Adhanom Ghebreyesus, speaking at the WHO Regional Committee for Africa in Brazzaville this week (26 August), stressed the need for more research and surveillance of the disease, as well as equitable access to vaccines.
WHO director-general Tedros Adhanom Ghebreyesus (centre) convenes the first meeting of the Emergency Committee to discuss the upsurge of mpox, on 14 August 2024. Credit: Lindsay Mackenzie / WHO
“I am certain that with the leadership of the affected countries and the support of the WHO, partners such as CDC Africa and others, we will be able to bring this epidemic under control quickly, as we have been able to do with other epidemics in recent years,” he said.
New variants
According to the latest WHO epidemiological data, 14 African countries have reported cases of mpox so far, with Gabon confirming its first case of the virus on 22 August.
The DRC remains the country hardest hit by the epidemic, with a total of 3,244 cases and 25 deaths recorded to date this year.
Burundi has recorded 231 cases, while a number of cases have also been confirmed in Central African Republic (45); Côte d’Ivoire (28); South Africa (24), and Congo (23).
There are two main types of the virus, Clade I and Clade II. Clade I, endemic to Central Africa, causes more severe illness and disease. The less severe Clade II strain caused the global outbreak in 2022 and is the type being seen in Nigeria.
People with #mpox may experience all or only a few symptoms. Mpox illness typically lasts 2-4 weeks. Source: CDC
However, a novel, sexually transmitted strain of the virus, identified as Clade Ib, has started spreading across the DRC and neighbouring countries, causing alarm.
Flaubert Mba, wildlife specialist and One Heath focal point at the Centre for Research on Emerging and Re-emerging Diseases, told SciDev.Net: “The emergence of the new, more virulent variant (Clade Ib) and the increase in human-to-human transmission, with new routes such as sexual transmission, remains a cause for concern.”
In addition to vaccination and the recommended hygiene measures, he believes that African countries need to focus on epidemiological surveillance, particularly in areas where wildlife and people interact.
“Mpox is a re-emergent zoonosis, meaning that it is transmitted from animals to humans and vice versa,” he explained.
“Particular emphasis needs to be placed on at-risk areas associated with risk mapping and areas where there have been outbreaks in the past.”
This piece was produced by SciDev.Net’s Sub-Saharan Africa French desk and edited for brevity and clarity.
September 10, 2024 was World Suicide Prevention Day. According to the World Health Organization,
“Every year 726,000 people take their own life and there are many more people who make suicide attempts.”
When I was five years old my mid-life father took an overdose of sleeping pills after he had become increasingly depressed because he couldn’t support his family doing the work he loved. Fortunately, he survived, but our lives were never the same. I grew up wondering what happened to my father, when it would happen to me, and what I could do to prevent it happening to other families.
Although females, as well as males, can die by suicide, males at every age are at higher risk than are females. Yet rarely is suicide discussed as a health issue for boys and men.
World Suicide Prevention Day (WSPD) was established in 2003 by the International Association for Suicide Prevention in conjunction with the World Health Organization (WHO). On September 10th each year they focus attention on the issues, reduce stigma and raise awareness among organizations, governments, and the public, giving a singular message that suicides are preventable.
The triennial theme for World Suicide Prevention Day for 2024-2026 is “Changing the Narrative on Suicide” with the call to action “Start the Conversation”. This theme aims to raise awareness about the importance of reducing stigma and encouraging open conversations to prevent suicides. Changing the narrative on suicide is about transforming how we perceive this complex issue and shifting from a culture of silence and stigma to one of openness, understanding, and support.
The call to action encourages everyone to start the conversation on suicide and suicide prevention. Every conversation, no matter how small, contributes to a supportive and understanding society. By initiating these vital conversations, we can break down barriers, raise awareness, and create better cultures of support.
I have been writing a series of articles—”Homecoming: An Evolutionary Approach for Healing Depression and Preventing Suicide.” In Part 1, I shared statistics from the National Institute of Mental Health, comparing the suicide rates for males and females at various ages:
Even during our youth where suicide rates are relatively low, males are still more likely to die by suicide than are females. It is also clear to me as my wife and I move into our 80s, that males and females face many challenges as we age, but it is older males who more often end their lives by suicide with rates 8 to 17 times higher rates than for females.
In Part 2, I discussed the evolutionary roots of male/female differences and quoted Dr. Roy Baumeister, one of the world’s leading social scientists. Understanding his work can better help us understand a lot about why men are the way they are and specifically why men are the risk-taking gender.
In his groundbreaking book, Is There Anything Good About Men? How Cultures Flourish By Exploiting Men, he says,
“If evolutionary theory is right about anything, it’s right about reproduction. Nature will most favor traits that lead to success at reproducing. But for thousands of years, men and women have faced vastly different odds and problems in reproducing. On this basic task, women faced good odds of success, whereas men were born to face looming failure.”
Men not only take greater risks than women, but also are less resilient and more prone to feelings of failure when they don’t feel they can offer something of value to those they love.
In Part 3, I show that suicide is the most prevalent form of violence and is the cause of more death than either war or homicide. We don’t often think of suicide as a form of violence or depression as an underlying cause of violence, but they are intimately related. The World Health Organization (WHO) produced an in-depth analysis of violence and published the information under the title, “The World Report on Violence and Health.” The report is the result of 3 years of work, during which WHO drew on the knowledge of more than 160 experts from more than 70 countries.
The report detailed estimated global-related deaths as follows:
These numbers vary in different years and rates of violent deaths also vary according by country and within each country with different groups. But clearly violence from suicide accounts for nearly as many deaths as war-related violence and homicides combined. All forms of violence are tragic and many have come to believe that violence is simply a part of human nature. But this is not true.
Violence of all kinds can be understood and prevented.
“Violence thrives in the absence of democracy, respect for human rights and good governance,”
said Nelson Mandela. We often talk about how a ‘culture of violence’ can take root. This is indeed true—as a South African who has lived through apartheid and is living through its aftermath, I have seen and experience it. No country, no city, no community is immune. But neither are we powerless against it.”
As we approach another presidential election in the United States, most everyone is aware of the threat to democracy we are facing and the conflicts that divide our country.
In Part 4, I offered guidance for all those who are ready to see the truth about the times in which we live and how we can live, love, and work, for good in the world.
For most of my professional life I believed that treating depression and preventing suicide involved helping individuals, couples, and families. A new perspective opened for me in 1993 at a men’s leadership conference in Indianapolis, Indiana. I’ve written a number of articles about my experience over the years, including my most recent, “Transformations: The End of the U.S. and the World as We Know It and The Truth About Our Collective Future.”
I said that an old kind of masculinity was on the way out. My colleague Riane Eisler describes two competing systems that humans have been engaging with that she calls the dominator system and the partnership system. Throughout the world emotionally wounded men who ascend to power have chosen a dominator approach to asserting power.
The old dominator systems were ruled by frightened men who came to believe that the only way to survive was to rule by force. Historian Ruth Ben-Ghiat describes these men in her book, Strongmen: Mussolini to the Present. She says,
“For ours is the age of authoritarian rulers: self-proclaimed saviors of the nation who evade accountability while robbing their people of truth, treasure, and the protections of democracy.”
Among the seventeen protagonists in her book she includes: Adolph Hitler, Saddam Hussein, Benito Mussolini, Vladamir Putin, and Donald J. Trump. Pulitzer-Prize winning journalist Anne Applebaum describes the way modern-day autocrats support each other in her book, Autocracy Inc.: The Dictators Who Want to Run the World.
“Nowadays, autocracies are underpinned by sophisticated networks composed across multiple regimes…The autocrats are rewriting the rules of world trade and governance as their propagandists pound home the same messages about the weakness of democracy and the evil of America.”
At MenAlive I have been supporting men and their families to embrace the partnership system and have recently created a way for organizations and individuals to belief in these ideas and practices to stay connected. You can learn more at our website, MoonshotforMankind.org and get news you can use on our substack, substack.com/@moonshotformankind.
If you’d like to read more articles on men’s mental, emotional, and relational health, you can subscribe for free at https://menalive.com/email-newsletter/.
Every suicide is a tragedy that affects families, communities and entire countries and has long-lasting effects on the people left behind.
Suicide does not just occur in high-income countries but is a global phenomenon in all regions of the world. In fact, close to three quarters (73%) of global suicides occurred in low- and middle-income countries in 2021.
Sticking to new habits isn’t easy, especially when they mean giving up old ones that make you feel good—at least temporarily—like binging talking dog videos or inhaling a burger on the way home from work. But there comes a time when making a change in the name of your health and happiness is more attractive than another night spent plastered to your couch. That’s where a program like the 75 Hard Challenge comes in. It’s not a weight-loss app, although followers do tend to shed some pounds. Instead, it’s a “mental toughness” protocol that helps instill new habits in fewer than three months. That’s not to say it’s without flaws.
This challenge is not easy to stick to. People often believe the more intense something is, the better the results. But this is a mistake if you aren’t careful. It’s important to learn about any new routine that overhauls your diet, exercise, and entire life and really evaluate if the pros and cons make it worthwhile. Learn all about 75 Hard, including 75 Hard Challenge rules and what you might stand to gain—or lose—if you try it.
What Is the 75 Hard Challenge?
The 75 Hard Challenge is primarily a mental toughness program with physical and behavioral habits created by entrepreneur and author Andy Frisella in 2019. In short, the challenge aims to build discipline and resilience—physically and mentally—by adopting a set of daily rules that you complete without fail for 75 days straight. Frisella sells a book about the challenge, but you can also learn about it from his podcast and all over the internet.
75 Hard rules dictate you drink one gallon of water daily and cut out alcohol and cheat meals including soda.
Jarren Vink
75 Hard Challenge Rules
There are five 75 Hard rules to follow during the 75 Hard Challenge. Here’s where it gets particularly tough: If you skip any of the items on the 75 Hard checklist on any given day, you need to start over from day one as a practice in forging mental toughness and self-control.
1. Follow a Diet
During the entire challenge, you should stick to a specific meal plan without cheat meals or alcohol. There’s no 75 Hard diet, per se. You get to choose. If you’re hoping to drop body fat, we recommend the best diets for weight loss. But if you’re just trying to adhere to a lifelong habit of healthy eating, stick to the best diets recommended by experts. Something like the Mediterranean Diet is more sustainable for life than, say, the keto or Paleo diet. Get more tips below.
2. Two Daily Workouts
Every day, you have to complete two 45-minute workouts with one being outdoors. Unfortunately, you can’t count activities like mowing the lawn, yard work, or leisure sports into the 75 Hard workout plan like golf, because they’re considered “daily chores” or “routines.” Typically, we don’t recommend two-a-days, especially if you’re not a professional athlete. To ensure you don’t overtrain, keep one akin to an active recovery, like steady-state cycling or yoga. If it starts to diminish your physical and mental well-being, stop.
3. Drink a Gallon of Water
Drink one gallon of water every day. This doesn’t include any other fluid intake, just clear H2O. Hydrating is obviously important. Drinking a gallon is likely unnecessary, but it won’t necessarily hurt you. If it helps up your intake, great.
4. Read Nonfiction
Part of the mental fortitude aspect of the challenge is reading 10 pages of a nonfiction book each day. Unfortunately, audiobooks don’t count, nor do magazines or sports pages. Sorry—there’s a reason this is called the hard 75 challenge.
5. Take a Daily Progress Picture
Take a photo of your body to track your progress each day. This could be a mirror selfie or one you loop your partner or roommate into taking for you. Just be sure to keep the lighting, location, time of day, and clothing items similar for each shot. For some, this is helpful over time to see incremental progress, however a daily log can be detrimental to others’ self-esteem if their body image isn’t positive.
Mediterranean Diet
Sam Kaplan
75 Hard Diet
Diet just might be the worst four-letter word in the English language. The good news is that you can choose your own diet structure for the 75 Hard Challenge.
Choose a Diet Plan
While you can pick your ideal diet, it has to be one that fosters positive physical change. Whether you’re losing fat, gaining muscle, building strength, boosting your intake of a specific micro or macronutrient (like protein), or improving overall diet quality for skin health, just pick something you think you can stick to for the entire 75 days without falling off the wagon.
Can you go 75 days without a hot slice of pizza or a burger? If you want to complete the 75 Hard Challenge, you’ll have to give up all of your normal cheat meals for the duration. That’s right—zero cheat meals (what would Dwayne “The Rock” Johnson say?). Instead, make some healthier swaps that are still tasty but easier on the waistline.
No Alcohol
There’s a strict no-booze rule for the 75 Hard Challenge, so plan accordingly. If you know you’ll be in a high-pressure social situation like a bachelor party or Super Bowl gathering, and you don’t have the willpower of steel, you might want to forego the plan until you know you can stick to it. Might we suggest nonalcoholic drinks like NA spirits, wine, and beer.
Running
Patrick Giardino/Getty Images
75 Hard Workout Plan
If you aren’t currently very physically active or have a difficult time sticking to a consistent routine, this may be a wallop: For the 75 Hard Challenge, you have to do two 45-minute workouts each day, and one of them has to be in the great outdoors. Luckily, the types of workouts you can do are pretty flexible so long as they are physically challenging and aren’t part of your regular daily routine. Here are some examples:
Cardio Workouts
Cardio should be part of your workout routine during 75 Hard, but you don’t have to go hell-for-leather every day. Many of the best cardio workouts can double up as your outdoor workout session.
Resistance training is a must for any serious training plan, so pick a style you enjoy or one you’re excited to try and stick to it for 75 days. Be sure to plan out your sessions in advance, increase the challenge as you go, and track your progress.
Bodyweight exercises (like pushups, pullups, and squats)
Powerlifting
Recovery and Flexibility Training
Including some low-key workouts into your routine is the ultimate overtraining prevention strategy. The less fit you are, the more of these sessions you should include—maybe four to five per week counting toward the 45-minute sessions. Scale down from there if you are more fit or as you progress throughout the challenge.
Yoga
Pilates
Mobility work
Walking
Stretching
High-Intensity Interval Training (HIIT)
If you plan to include HIIT training, do it sparingly. Too much high-intensity work will burn you out in no time. It’s not possible to do true HIIT training for a full 45 minutes, so if you’re going to add this modality to your routine, stick to 10 to 15 minutes at the end of a cardio session or after resistance training two to three times a week.
Pro tip: Skip high-intensity training altogether if your diet plan includes cutting calories. It’s a recipe for burnout.
Circuit training
Tabata workouts
Sprints
Battle Ropes
Justin Steele
75 Hard Pros
There’s a lot going for the 75 day Hard Challenge. Here are some of the main pros.
Builds Habits
We all know that consistency is king when it comes to results, and that’s the main tenant of 75 Hard: to build and maintain a consistent routine that includes five daily tasks every day without fail. Habits are automatic behaviors triggered by specific cues and learned through repetition, strengthening every time you complete the behavior—think brushing your teeth every night before bed or locking up when you leave the house, according to 2021 research published in Social Psychology.
Good habits help you keep up desirable behaviors over time since you’ll start to automatically perform them without having to rely on conscious motivation—something that’s notoriously fickle, according to the study.
Tracks Progress
Tracking your progress is the best way to see how far you’ve come and it’s also a great way to get a motivational buzz when you start seeing a difference in how you look, feel, and act. Progress tracking with a photo is one of the Hard 75 rules, so it’s built into the routine.
Gets You Active
Obviously, physical activity is a huge part of the challenge and a behavior many people struggle to maintain. If you’re doing 75 Hard, you’ll definitely get your daily movement in through the two 45-minute workouts each day.
Includes Time in Nature
While you don’t explicitly have to go on a nature walk, even cityscape fresh air and sunlight are better than nothing. Since the challenge requires you to complete one 45-minute workout outdoors each day, you’ll get benefits from sunlight exposure (which improves sleep), stress relief, and a brain boost.
Aside from giving up your favorite tasty snacks and foregoing a beer during the game, the 75 Hard Challenge has other practical issues.
Not for Everyone
Although 75 Hard has consistency built in, if you don’t include your own context cues for each habit you want to keep once the challenge is over, you likely won’t stick to it. In other words, if you don’t incorporate the habits into your everyday routine in a way that you’ll stick to once the challenge ends, you’ll probably revert to the same old habits—good or bad—that you were doing before. This is the exact reason why most people regain all the weight they lose during diets.
Easy to Overdo It
Without any actual professional nutritional or fitness guidance (Frisella is not a health expert), you can easily go overboard trying to meet the steep expectations of the challenge. You might not pair the ideal diet with your exercise program—such as a muscle-building calorie surplus with your hypertrophy training—unless you know what you’re doing.
You can accidentally choose habits that do more harm than good if you attempt high-intensity training alongside a low-carb diet or push past your body’s signals for rest in order to get in that second 45-minute workout.
Very Strict
Rigidity is the entire point of the 75 Hard Challenge. In fact, Frisella says in an interview with Megyn Kelly, “The whole point of the program is to put yourself in the most inconvenient, non-compromising situation that you possibly can,” with no room for substitutions.
He goes on to say that giving yourself a break or a “mental day” is a no-go because “letting yourself off the hook is the reason you are where you are in this state of unhappiness and unfulfillment.” If you get sick, sore, or have an emergency—too bad—you’ve failed.
Can Lower Confidence
Battering yourself into submission is not always the best for your mental health and certainly won’t work for everyone. Plus, not everyone who wants to improve their health is unhappy or unfulfilled.
In reality, positive thinking can boost self-confidence by helping you see challenges as temporary and conquerable. Overcoming setbacks and still working toward your health goals is a fast track to becoming more resilient and increases internal motivation and confidence. And for the record, internal motivation is stronger than the kind you’ll get from any challenge.
Final Verdict: What Do Experts Say About the 75 Hard Challenge?
As a personal trainer and nutrition coach, I believe that most people, even those with advanced fitness levels, shouldn’t attempt two workouts every single day. Combining cardio and strength training can interfere with recovery and overall results and is a recipe for burnout. Physically, mentally, and socially, two-a-day workouts can be draining and unsustainable and put you at risk of overtraining, which requires lengthy recovery.
If you’re set on following the two-workouts rule, make sure one is recovery-based—light yoga, walking, or stretching. Organized activities like jiu-jitsu or gym classes can count as one workout, with walking or something gentle for the second. For strength training, limit it to three to five days a week and always pair with recovery exercises.
I don’t recommend avoiding rest days, as even lighter workouts can be mentally exhausting and, on a practical level, can get in the way of other areas of your life, like relationships, work, and family responsibilities. Missing a session and starting over can feel defeating, which I’d never want for my clients. If you miss a workout you had intended to complete, it’s better to reassess and adjust instead of stressing over rigid plans.
In my opinion, the idea that “mental toughness” comes from strict workout rules is absurd. True consistency comes from internal motivation, doing what you enjoy for reasons that matter to you. Building skills in activities you love—whether yoga, strength training, running, or a new sport—will make you proud and boost your confidence in the long term.
Real toughness also means listening to your body. Sometimes, backing off is harder than following a rigid plan. Focus on consistency and finding joy in what you do rather than chasing the next challenge.
Why You Should Trust Us
I’m a certified personal trainer, strength and conditioning specialist, and nutrition coach, among other fancy titles—but my passion is communicating the countless benefits of being active and striving toward a healthier mind and body through attainable action. I use a hefty dose of science to guide the advice I give, along with the real-world experience I’ve gained over the last 15 years.
