Behavioral Health Advocacy

Kephen Merancis 2021My name is Kephen Merancis and I am a behavioral health advocate.  As such, I advocate for the fair and equal treatment of individuals with mental health conditions and substance use disorders in employment and society.  I also provide information about resources and support services to people who are struggling.  Behavioral health includes both mental health conditions and substance use disorders.  Mental health conditions, in this context, includes but is not limited to chronic stress, anxiety disorders, mood disorders, depression, post-traumatic stress disorder, and so on.

The term ‘substance use disorder’ refers to what was previously known as addiction, whether that be to illicit substances (analgesics, depressants, stimulants, or hallucinogenics) or alcohol which is also classified as a depressant.  Words such as abuser, addict, druggie, drunkard, and junkie have fallen out of common language in the behavioral health industry due to being derogatory and stigmatic.  In other words, they are a form of shaming and that’s not helpful to those struggling towards or currently in recovery.

Years ago, when I became a professional development instructor, I had the opportunity to teach classes I developed on motivation, resiliency, and stress and anxiety management. These subjects were particularly important and personal for me. As someone who lives with a clinically diagnosed mental health condition, I am very passionate and outspoken about behavioral health, specifically mental health awareness and suicide prevention. I took every opportunity as an instructor to speak to our employees about the importance of behavioral health. And when I was not given the opportunity, I created the opportunity by writing proposals to management and coordinating awareness campaigns with public and private organizations to give presentations at our department on the topic. I also recommended changes to department practices to better provide our staff with access to information and resources needed for self-care and support.

My interest in behavioral health awareness extended beyond the office. I have been a field advocate for the American Foundation for Suicide Prevention since 2018, responding to proposed legislation regarding suicide awareness and prevention as well as sharing behavioral health information and resources with the general public. That same year I also became a member of a local county committee for suicide awareness and prevention until it unofficially disbanded in March of 2020. The committee met on a monthly basis to discuss actions the group could take to increase communication within the community regarding suicide prevention and awareness, some of us also volunteered for seasonal events where we could share information about those topics with the public.

I was a Missouri Certified Peer Specialist (CPS) from October 2019 to April 2021, via a statewide partnership program between the Missouri Department of Mental Health, Missouri Mental Health Foundation, the Missouri Credentialing Board, and other behavioral health focused agencies, to train and certify peer specialists to provide support services to individuals struggling with mental health conditions and substance use disorders. Most individuals with this certification become employed by various behavioral health organizations, but I performed this role strictly on a volunteer basis as I was already employed full-time elsewhere. I privately assisted individuals and offered my services to the committee, this included hosting support groups with the public.  We found that the local rural public was generally reluctant to participate in discussions regarding mental health and substance use.

When I was a certified peer specialist, my role was to assist in creating stability by confronting the issue at hand, whatever that may have been.  Depending on the condition being experienced, this may have included assisting in accessing treatment options from mental health professionals, in other situations this may may have included establishing and achieving personal goals, in finding resources and information, and locating additional services to aid in the recovery process.

Essentially, I focused on helping individuals envision a future not controlled by the disabling power of their mental health condition, substance use, or otherwise circumstance.  Together we explored the establishment of personal goals and made progress towards an optimistic future.  In the pursuit of that future, I continually provided coaching to maintain recovery.  Coaching is an effective strategy that encompasses both feedback and support, wherein we discuss what’s working well and what isn’t working well as identified by examining the eight dimensions of wellness, then collaboratively find ways to address those areas of concern.

Aside from my previous certification and volunteer work, I have completed a lot of other training in the behavioral health field and have attended various conferences and seminars where I had the opportunity to learn about new research, developments in treatment options, and new services available. Primarily in suicide awareness and prevention, but also in substance use prevention, mental health support, trauma-informed care, diversity, equity, inclusion, and ethics.

One of the most memorable situations I’ve encountered was when I assisted a 27-year-old man who was struggling with symptoms of bipolar disorder triggered in part by enormous external pressures. He had become divorced, lost his job, lost his driver’s license, lost visiting rights with his son, was evicted from his apartment, mistakenly purchased a vehicle with a bad title and had no other form of transportation, was financially impoverished, and had no family in Missouri who could/would assist him. This young man crossed paths with me because he had lost hope, becoming overwhelmed and expressed the desire to attempt suicide due to everything he was up against. Over a period of two months, we worked together to get him on the path of recovery.

I accompanied him when his attorney insisted he be admitted into the hospital to receive mental health treatment as part of his divorce and child custody proceedings. After his release I located low-cost healthcare services for the cost of his necessary medication and was able to help him get an employment interview. When he was hired, I connected him with a compassionate and understanding rental property owner and helped him secure a place to live. I guided him through the process of getting his driver’s license reinstated, and I drafted the declaratory judgement paperwork he needed to file with the court in order to be granted ownership of his vehicle. He was re-issued a title and was able to get it registered and street legal.

Other situations in which I provided support services were less intensive and less involved, for example I have communicated with individuals via online applications and text messaging. Some of these engagements included individuals struggling with mental health conditions and emotional challenges such as stress, anxiety, depression, grief, relationship issues, and so on, or they were with individuals who had loved ones who were struggling. I have also assisted someone dealing with substance use, specifically with alcohol, cocaine, and marijuana.

Through peer support volunteering and behavioral health advocacy, I have learned that sometimes all people need is information or techniques on handling stress and anxiety, or how to regain motivation.  Sometimes people need contact information for an organization that provides specific services, or they would like someone to accompany them to meetings, hearings, or appointments where they want the support of someone else’s presence.  Sometimes they just want an opportunity to sit down and have someone listen to what they have experienced or what they are struggling with.

There are times when the things we are struggling with can become less stressful, less scary, or less burdensome when we unpack them and share them with someone else who is willing to listen and try to understand.

My personal background is that I live with bipolar disorder, a condition that affects my emotional stability, causing me to fluctuate between phases of major depression and phases of mania.  Bipolar is considered a mood disorder and it is one of several.  I’d like to identify two specific types for the sake of comparison.

Bipolar Disorder Type One causes phases of major depression and phases of hyper-mania (high mental or physical energy).  The second type, Bipolar Disorder Type Two, is what I was diagnosed with, it causes phases of major depression and phases of hypo-mania (moderate mental or physical energy).  The period that passes between these phases, or what is sometimes referred to as episodes, can be quite varied.  Sometimes a phase will last days, other times it may last for months.  What triggers an episode is not entirely known, sometimes it can be an external stimulus, or it can seemingly occur for no reason.  Currently, there is no cure for bipolar disorder, but treatment is available.

Individuals who are living with type one (bipolar I) can experience very risky behavior during a hyper-mania phase, to include such behavior as uncontrollably spending excessive amounts of money, making rash and consequential decisions without utilizing critical thinking, behaving irrationally and putting oneself or others in danger, delusional thinking, not sleeping for days and still feeling energetic, or any number of other extreme behaviors.

Those living with type two (bipolar II) also experience phases of mania, but more moderately.  They may stay awake for extended periods of time and be very productive, experience periods of obsession, extreme focus or creativity, heightened or excessive emotional states, and prolonged optimism.  When not experiencing a mania phase, both types may experience major depression, which carries with it a higher risk for suicide.

For those living with bipolar disorder or any other behavioral health condition, having self-awareness of our emotional and mental state is the first essential step in the recovery process.  With treatment or therapy such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT), most can notice or feel the onset or triggering of a phase/episode and learn how to appropriately respond to it.  In other words, we know when we are in the process of transitioning from equilibrium or typical mental stasis into a state of depression or hyper/hypo-mania, and this ability to acknowledge that transition is the difference between coping with our disorder and being a victim of our disorder.

Support groups are helpful to individuals working towards and maintaining recovery for the following reasons:

  1. Creates a confidential environment where individuals struggling with a behavioral health condition or related circumstance can openly discuss what they are experiencing or struggling with and be able to receive emotional support from those with a similar condition or circumstance.
  2. Permits social validation for their struggle without the stigma or the insecure and judgmental responses from those who do not have a lived experience with, or understanding of, a behavioral health condition or related circumstance.
  3. Provides an opportunity for those who often struggle alone with a behavioral health condition or related circumstance to communicate with, learn from, and recover or grow alongside those who are similarly affected by their condition or circumstance, establishing a network through which factual information, proven methods, and helpful resources can be openly exchanged.

Attending and participating in support groups is very much a type of therapy and is quite common.  Other common types include psychotherapy (talk therapy) and eye movement desensitization and reprocessing (EMDR).  Though it may be challenging to accept and initiate the process, recovery cannot happen if we do not seek support and treatment.

In one of my previous employment positions I worked on a major proposal to bring behavioral health support training to the workplace. It is a topic that I have been particularly interested in for many years and have advocated for. The primary barrier preventing positive change in the workplace for behavioral health challenges is not caused by a lack of employee interest or need, but by the employer and their leadership team, who for any number of reasons often avoids the topic and prefers to outsource any such education or support to third party employee assistance programs. This avoidance allows people to continue to suffer, generally in silence, due to feeling isolated from their fellow employees and because their workplace fails to acquire a culture that embraces mental wellness. This frequently perpetuates stigma, resulting in people being absent from work or even leaving their employment all together. Once word gets out that the employer is not a safe and supportive environment, other people will be less inclined to apply to their job openings.

From employees struggling with substance use disorders or mental health conditions, to supervisory and management staff being ill-prepared and overwhelmed by employees struggling with these types of behavioral health challenges, there has been and continues to be a need for education and training as well as policy and procedure changes in the workplace. Both private and public companies can make fundamental changes to how behavioral health challenges are addressed in their workplace and can consequently make a positive change in our society for those who struggle with these challenges and those who care for them. I support any initiative taking steps to make these improvements and urge employers to do more for their staff so that both the employer and employees can benefit from an integrated, inclusive, and collaborative system of support and care within the workplace.

For additional resources:

If you or someone you know is experiencing a mental health or substance use crisis, please access my immediate assistance resource page.  A comprehensive listing of online and phone resources and services is also available.

Disclaimer:  By navigating this website and utilizing the information and resources provided herein, you declare an understanding of and are acknowledging that I, Kephen Merancis, am not a licensed psychiatrist, psychologist, social worker, counselor, therapist, or any other clinical behavioral health practitioner that can diagnose or treat a mental health condition or substance use disorder.  By navigating this website and utilizing the information and resources provided herein, you also declare an understanding that I am not a practicing attorney nor licensed to provide legal advice. Any resources, information, advice, recommendations, and support services provided are non-clinical in nature and are not a replacement or substitute for the mental health services such as therapy or medical advice, typically provided by a licensed behavioral health clinician or physician. Any legal discussions are not provided as a replacement or substitute for the legal advice provided by a licensed attorney.

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