For years, Keris Myrick has held some of the highest-level positions in the world of mental health peer support. She was executive director of a large nonprofit, president of the board of directors of NAMI (the National Alliance on Mental Illness), and director of the Department of Consumer Affairs at a federal agency. Today, as chief of peer and allied mental health professions for the Los Angeles County Department of Mental Health, she oversees the training and supervision of some 600 community health workers, mental health advocates, peer supporters and medical case workers.
She also was diagnosed with schizophrenia and obsessive-compulsive disorder (OCD) and can honestly — and humorously — look at herself. She jokes that in a way, she was well prepared for the Covid-19 pandemic. “I have OCD,” she says. “So handwashing…” Let’s just say she does plenty of that already. She also stocks toilet paper, even in normal times.
But these are not normal times — and when her bathroom sink sprung a leak a couple of weeks ago, it soaked her TP supply. With almost none in the stores at the time, she talked herself out of a minor panic and ended up drying her damp toilet paper on her balcony, not caring too much what the neighbors might think. “I kept thinking this completely abnormal situation helps people come into our world,” she says.
She also reframes things for other people with mental health conditions. “Some people have told me, ‘I’m so manic, I went to the store and spent all my money,’” she says. “I said, ‘Did you look around? What were other people doing?’” The other shoppers, of course, were doing the same thing.
Feeling different was part of her childhood. At age 7, she could smell colors, a trait called synesthesia. “I thought everybody smelled colors. My mom would say, ‘That is the color purple. It has a look but not a smell.’” Today, she smells colors “only when I’m super-duper stressed.” She lived for several years in Korea, where her father, a colonel, served in the Army. She joined a Girl Scout troop, vaguely aware that “I was black, with a bunch of Korean girls.” When the family returned to the US, she spoke a bit differently and was made fun of. “You don’t talk black,” African American kids would tell her.
On her 21st birthday, she had her first major mental health scare. She went to a grocery store to buy Cheerios and voices in her head told her the boxes were poison. Confused and frightened, she began pulling boxes off the shelves. “I was frantic and then a ‘Clean up on aisle 7’ voice came over the PA,” she recalls. She ran home, told her parents that all food was poisoned and stopped eating for months. She was misdiagnosed as having an eating disorder.
Around that time, she was asked to take time off from Wellesley College, and then finished her undergraduate degree at Temple University in Philadelphia. She also managed to earn a masters’ degree in business at Case Western Reserve in Cleveland — aided by almost daily conversations with her mother to cope with her anxiety.
In her early 40s, she found herself in Southern California and worked for a while in a college admissions office. After a raft of hospitalizations, she got a good psychiatrist who was also her therapist — a rare combination — and got involved in the mental health recovery movement. She started attending conferences and made an observation: “I noticed that a lot of people in the audience looked like me but the people on stage didn’t.”
She was introduced to Jackie McKinney, an African American woman who spent years as an involuntary patient in a Washington DC mental hospital and later became a social worker and activist. “It was a beautiful meeting, exactly what I needed,” Myrick recalls. “She told me her personal story and I was like, “Okay, if she can do it, I probably can too.”
She started volunteering at a local NAMI chapter, which was populated mostly by white mothers of adult children with mental illness. They didn’t know what to make of Myrick. “They kept asking me, ‘Who’s the consumer?’ I didn’t know what they meant. ‘Who is the person who has the mental illness?’ And I said, ‘Me.’ They’re like, ‘Oh, no, dear, this meeting isn’t for you.’”
But she stayed, and they brought her tea and “turned into loving moms.” They also encouraged her to take peer training classes. Eventually, she was discovered by mental health administrators who recognized that this passionate, educated woman had insights and relational skills that only someone who’d been a mental health consumer could have.
In 2009, Dave Pilon, then the CEO of Mental Health America’s Los Angeles chapter, recruited her to run Project Return Peer Support Network, one of the first peer-run mental health programs in the country. She served as president and CEO for four years, then spent five years directing the Office of Consumer Affairs at the Substance Abuse and Mental Health Services Administration in Washington. In 2018, she returned to Los Angeles, recruited by Jonathan Sherin, the county’s new director of mental health.
Today, as chief of peer services in the country’s most populous county, Myrick is in a unique position to elevate the role of peers in behavioral health. Her years in the peer-support movement gives her a unique view of the vital role an expanded peer workforce could play in addressing the heightened mental health needs of the Covid-19 era.
With the right training and support, she says, peers can connect with users of mental health services in community settings, help them access supports they need, and stay out of crisis and out of the hospital. That, she says, is how you care for people in the community and slow the spinning of the revolving door that takes people with mental health challenges from the street to emergency rooms and jails and back onto the streets — at enormous cost.
“Peers are extremely good, according to research, at supporting and activating people, helping them connect to things that have meaning and purpose,” Myrick says. “Activation means the difference between ‘Oh yeah, maybe I’m showing up for an appointment,’ and ‘I’m showing up for appointments.’ What we’re really looking for is: I’m an active partner in treatment.”
Peers help people with treatment adherence, she says. That seems odd to many who assume peer advocates may oppose mainstream treatment. Myrick, who has benefitted from both psychosocial supports and medications, says peers can help people ask their providers questions about treatment recommendations, including the risks and benefits of medications.
“We help people figure out how to be active in treatment,” she says. “They can adhere to treatment because they’ve been part of making the plans. The plans aren’t imposed.”
In these days of pandemic and isolation, Myrick has been working to train more peers as volunteers to staff a new warm line providing phone support to anxious Southern Californians.
“There’s a lot peers could be doing,” she says. “We just don’t have the funding mechanism to do it.” One thing that stymies the effort is that California is one of only two states — the other being South Dakota — that doesn’t provide certified training and credentials to peer support specialists.
“Because we don’t have certification, we technically cannot bill Medicaid for peer services,” she says. “We’re leaving (federal) money on the table.”
For the fourth year in a row, a bill — this year SB 803 — setting up a peer certification process is pending before the California Senate. It passed on two previous occasions, only to be vetoed by Governors Brown and Newsom. Myrick is preparing to testify for it — but whether the bill will move in a legislative session cut short by the pandemic is still unclear.
“California needs peer certification,” she says. “I will yell it from the mountaintop.”