How can I heal my monk efficiently on higher difficulties?

One of my favorite ways to keep my Monk topped off is with the Transcendence passive. Every time you deal damage with one of your spirit spenders, you get a heal. The more attacks you make, the more spirit you can spend, the more you can heal. The best thing about this is that it's also an affix that can show up on Spirit Stones and monk weapons.

You should also look into items with +Life on Hit or +Life on Kill. The Vampiric line of affixes (gain % of damage done as life) is generally too small to be noticeable with low levels, but Life on Kill stacks pretty well, especially when wading into hordes of minions.

The alternative, of course, is to reduce the damage you take in the first place, so that you require less healing overall. The Monk, like the Barbarian, gets an innate 30% damage resistance for being melee, but there's no reason you can't add to that with a shield, the Resolve passive, or keeping up a Mantra of Evasion.

And of course, there's nothing stopping you from doing all of these together!

The problem with relying on the Monk's heals is that they scale with Level, and not with any other stats. So you should look into finding a way to heal that does scale with stats, as offered above.

My monk doesn't take much damage to begin with. I'm using the Mantra of Evasion with the Hard Target rune for great dodge chance and armor (I have 41% dodge chance). Additionally I'm using the The Guardian's Path (dodge chance when using dual weapons), Seize the Initiative (100% of dexterity as armor) and Resolve (Reduces hit enemies incoming damage by 25%) passives.

For the primary and secondary attacks I'm using Crippling Wave with the Concussion rune (Enemies hit do 20% less damage) and the Cyclone Strike with the Implosion rune (increases the range of the cyclone's pull).

When in combat use Dashing Strike to jump into the middle of the fight and cyclone strike to pull everybody to me. Then I proceed to Crippling Wave the bunch of them. I dodge a lot of the attacks, and the remaining attacks do little damage.

My backup plans are Serenity with the Peaceful Repose rune for making me temporarily invulnerable and healing me, as well as Seven-Sided Strike which also makes me temporarily invulnerable while it's being used.

I'm having no issues with surviving, so hopefully this will help you. It's also worth mentioning that I'm making the Vitality attribute a priority when choosing my gear, so I have quite a lot of HP.

On my lvl55 monk that just finished act1 Hell, I'm starting to find that all the vitality on my gear is making Breath of Heaven (the aoe heal, 15sec CD) not that great, it's only 7k of my 28k HP. So as Raven said, with higher gear levels, you need to start relying more on healing that scales with gear.

A lot of healing comes from pumping the heal mantra to put up the absorb shield that scales as 15% of your max health. Generating spirit for that is how you keep yourself and your party alive.

EDIT: lvl60 for a bit, and have spent some time playing with people that are starting to make progress in act2. The % of max HP heal was nerfed to a max of 1k, which makes this whole approach not viable. Inferno act2 seems untankable, I just avoided elites on the way to kill Maghda, then went back to farming act1. My current setup is Evasion mantra, stacking one resist stat really high (one with everything), life per hit, dual wield fast weapons, heal, cyclone strike w/dodge, or mystic ally. I only have 27k health, but my effective health taking into account my 524 resist all lines up ok with other people that have higher HP but didn't stack resists. I still can't stay in and melee most elites in act2, and neither can they, so it's still just about the uptime on the immune bubble and heal-fear and aoe blind, as far as getting damage into elite packs. In act1 inferno I can comfortably tank molten elites in early act1, and often kill elite packs without dieing even once. I have dex, vitality, and lightning and/or all resist on every piece of armor, some with bonus armor too. Life per hit on neck and weapons, running 600 total. More would help some, as would attack speed. 10k dps is a bit low for inferno, but farming act1 still goes decently quickly solo.

END EDIT

I run this build most of the time, switching up the primary to FoT thunderclap for faster spirit gen and mobility in some situations. Also switching up the runes on the other abilities esp. sweeping winds to the longer duration one for packs where it's harder to refresh while running out of stuff. I change some glyphs for more damage output when soloing, since I normally run with a wizard

It is fully possible to solo with this build, it just takes longer on the easy stuff, but will let you actually win against some of the hardest combinations of affixes. Sometimes you have to graveyard zerg a really nasty pack, like arcane frozen jailer, that will lock you in the path of cutter beams. I rarely use lashing kick, except for damage while solo, or for the knockback situationally while grouped, or on a treasure bandit.

For simple grinding of large groups of weaker monsters, heal on hit is AMAZING when tanking a ton of monsters. Putting the best amethyst you can afford in a socket on a weapon is one way to get more of this stat. Flawless square gems are the highest you will find on the AH with any kind of supply. 65 hp per hit is pretty strong.

I think almost everybody takes Transcendence for heals per spirit spent (only scales with level, not gear, but it's still pretty solid. I run with that, dex->armor, and resolve (25% demo shout on mobs I damage). I assume resolve stacks with the crippling wave, so monsters are left doing 0.75 * 0.8 of their full damage, with slowed attack speed. (Although this depends on me hitting them frequently, which doesn't always happen when running away from nasty elites. Sweeping winds is your main source of damage on multiple targets, as well as keeping up Resolve on anything that gets close). I'll probably drop Resolve from my build, for One With Everything to survive the elemental damage from monsters I'm running away from and not hitting.

For harder survival challenges like molten desecrator frozen elite packs, or similarly nasty affixes, we finally get to the answer to the original question: pump Mantra of Healing with Boon of Protection. 3 seconds of much higher hp/s, the Transcendence heal from spending 50 spirit, and very importantly, 15% of your max HP as an absorb shield that lasts 2 seconds, for you and your party. Finally a heal that scales with gear.

Staying alive is a matter of building spirit any time you can without standing in bad stuff, and pumping your heal mantra every time you are low health. On monsters that you can't just stand and tank and generate a lot of spirit, you can't really spend spirit on offensive abilities at all, just Breath of Heaven, Serenity, and your mantra. Damage output mainly comes from Sweeping winds and your spirit generator. Or much more helpfully, a friend playing a wizard. Your job is to keep them alive while they dodge ranged attacks as best they can. The range your mantra is MUCH farther than the range on Breath of Heaven, so often I'll pump my mantra if my partner is lower HP than I am.

Currently farming Act 2 Inferno mostly solo.

Primary - Deadly Reach with keen eye - 50% armor boost is crazy and you have a bit of range to kite and get through wallers and around aoe like arcane lasers and desecrator while still hitting.

Secondary - Sweeping Winds with extra range rune - Extra range so it will still hit while in deadly reach range but out of close combat range. Sweeping winds is important because of the passive 'Resolve' which decreases the damage of all enemies you damage by 25%, so all enemies surrounding you will have decreased damage.

1 slot - Serenity with 4 secs - best skill in game and longer is better. Dont need the heal as we will be life on hitting.

2 slot - Breath of heaven with fear rune - Useful for a top up of health during long fights but the main use is the fear aspect, getting elites to run from you for a short time is invaluable. It can also interrupt some actions.

3 slot - Flash with 60% elites missing rune - great for interrupting wind up attacks and giving you a second of not taking damage to recuperate.

4 slot - Play around here but currently using Mantra of conviction with the 10% reduction in enemy damage - Its a string of ears plus 24% bonus damage if you keep it on the first 3 sec cycle.

Passive 1 - Resolve - reducing enemy damage by 25%, works great with sweeping winds.

Passive 2 - Seize the initiative - more armor is good.

Passive 3 - One with everything - more resistance is good.

Dont need transcendence here as we will be life on hitting.

For gear you'll need around 1000 life on hit with an attack speed above 2 per second for inferno act 2- mine is currently 2.8. Attack speed is great for monks for a lot of reasons: First most monk spirit generators have a special attack on every third hit so you wanna get to that third hit as soon and often as possible. Secondly we need as much spirit regen as possible to keep mantra pumped to the 3 sec phase. Thirdly, and most obviously, more life on hit.

You also need to pump dex and resistances - remember dex will help armor, dodge and damage, while resistances are easy to get highish (aim for 70% reduction in both armor and res all for act 2) as we can pick up all items with arcane resistance or lightning resistance which will increase all resist due to 'one with everything'.

So. stack attack speed, life on hit, dexterity, your chosen resistance and then vitality with what space you have left. I use a shield, seems easiest, and a fast attacking weapon with 700 life on hit. Try to get to at least 10k damage if you can but mantras and sweeping winds can close to double whatever damage you do get up to.

Movement speed on boots is great. I find it invaluable although you probably could do with out it.

With this build youll be able to tank anything in act 2 solo except for ground damage like desecrator, arcane lasers and molten. You can kinda tank plague. You also should be able to do enough damage to kill elites before they enrage, as even though your weapon might be low dps (mine is only 570 atm with 700 LOH), you attack speed and actives will keep your damage up.

You may need to kite some elites with fire chains, and shielding is tough as you need to keep hitting things to keep your life regen up. Invunerable minions isnt as bad as shielding for this build as you can at least keep hitting the elite to tank the minions.

For groups I swap to overawe for mantra of conviction to boost party damage, other than that pretty much the same. Keep fiddling and changing your skills to see what works best, this is by no means a perfect build, its just the one Im using now, but it does work great farming act 2.

Good Luck.