Sunrise co-founder Kevin Mahoney on burnout, mental health and substance use

A conversation with Kevin Mahoney takes you on adventures around the world. The Middle East and the Persian Gulf, where he served in the Air Force. Greece, where he was stationed with the military but also partied a lot. Germany, where he recuperated after deployments. And a base in Texas, where “the biggest thing in town was the rattlesnake roundup — 10,000 rattlesnakes,” Mahoney says with a laugh. “You eat them, you make clothes out of them, you take them home as pets.”

After the military honorably discharged Mahoney in 2000 after 20 years in the military, he struggled with civilian life. His marriage fell apart, and he couldn’t hold a steady job.  Mental health struggles and substance abuse followed, and he experienced years of homelessness.

Now 68 years old, Mahoney leads a completely different lifestyle. He started to pursue recovery in Georgia in 2005 and three years later settled in Western North Carolina. He’s worked as a wilderness therapy guide with young adults and served in other behavioral health roles at RHA Health Services and Vaya Health. But he sensed gaps in service for people who are in recovery — particularly the need for a supportive community. And so in 2016, Mahoney co-founded Sunrise Community for Recovery and Wellness, an Asheville-based recovery community organization that is fully staffed and managed by people in recovery.

For the past four years, Mahoney worked as a peer support specialist at Mountain Area Health Education Center, primarily with people who were unhoused. This summer, he decided to return to Sunrise, where he will focus on educating the younger generation of peer support specialists. Sunrise employs more than 50 such specialists, and he’s working on a curriculum to teach PSS certification to others.

Mahoney spoke with Xpress about how to recognize burnout and prioritize mental health, the essential role of peer support and the difficulty of addressing fentanyl and xylazine abuse in Asheville.

This interview has been shortened and edited for clarity. 

You recently decided to make a career change on account of burnout. Tell me more about that.  

I’m not third-degree toast, but I can see it heading that way. [When I train peer support specialists, I say,] “You’ve got to take care of yourself. This is a difficult job. I’m not saying [that] to stop you from doing it. But you’ve got to know what you’re getting into — it is a toxic environment that has become even more toxic.”

How is it a toxic environment? Do you mean that the drug supply is more dangerous?

The chemicals are stronger. The drugs are more lethal. I make a comparison to Russian roulette. You’re not playing with no bullets in the gun or one bullet. You’re playing with all six chambers loaded. …  If I’d had these kinds of drugs [when I was actively using], I would not be here now. It’s just so strong. As for the psychiatric symptoms, I’ve never quite seen it like this where whole tent communities of people are not plugged into this reality.

And the systems are overwhelmed. One of the things that I despair over is getting a housing question. I can direct you to Homeward Bound, I can direct you to [Housing Authority of the City of Asheville]. I can direct you to resources, but I don’t have any [housing] to offer you. That really gets under my skin.

How do you recognize when you’re burned out, and how do you take care of yourself day to day? 

The HALT thing. [It’s an acronym for] “hungry, angry, lonely, tired,” and it’s a mantra for a lot of people in recovery. My red flag is that I just burst into tears. … I’ll reach out at the slightest sign of [distress]: “Hey, I need some help. Talk me through this.” I have plenty of clinical friends who have really good listening skills.

What are some skills you’ve developed to work with people who are in recovery? 

I’ve had to be patient and let things develop. Sometimes you have to put in the ingredients and let them percolate — and that’s not my strategy. My strategy is “I want to fix it right now!” [laughs] I had to stop being a fixer and be more of a chef, an alchemist, and let the process work and give it space, time and love.

Also, organizational thinking and critical thinking. I tend to be knee-jerky sometimes because I want to get things done. [I’ve learned to] step back for a minute. And to be able to roll with failure. Because sometimes people die. It sucks. It hurts. And that can’t stop you.

That sounds really intense to deal with.  

I can do my best, and there can still be [people dying from substance abuse]. But I’m not blaming the person I’m serving; sometimes these things are too much. The body’s too shot. People are too beat up from substances. Substances have gotten stronger and stronger and stronger.

Yesterday, there was a guy out in the street with the barest of clothing on, on his bike. I don’t know how he was even balancing on the bike. There’s this new kind of walk around here. It looks like a horror movie. This is fentanyl and xylazine. … They’re walking slumped over. How are you even mobile? How are you ambulatory? There’s a person [in there], but how am I going to reach this person?

How did you start abusing substances yourself? 

In short, I had a catastrophic life crash when I left the Air Force in 2000. I had no idea that I was ill. We didn’t call it PTSD; they called it “battle fatigue” and “shell shock.” … I’d had 20 years of stress and I had a crash for about four years. I was functional, barely. Self-medicating all the time.

How were you self-medicating? 

I had one of those physicians who gave me everything I wanted or what he thought I wanted. So, I was addicted to four different pharmaceuticals — I mean, legal stuff. And I added other things as need be. From there, I actually have holes in my memory.

How was your mental health impacted by your substance abuse?

[Substance abuse] became a lifestyle due to my homelessness and disconnectedness. It was desperate. I remember one Christmas, if my friend hadn’t sent me a care package of Fig Newtons and 20 bucks, I would have starved to death. I just couldn’t get out of bed, just sitting there watching TV and consuming anything I could consume. I wanted to sleep all the time.

Yup, that sounds like depression. 

Yeah. It’s either substance use driving the mental health [issues] or mental health [issues] driving substance use. It’s a horrible bus to be on, in any respect.

But connection to community — that’s what gave me a lifeline. And I did the rest [of recovery] with a lot of support and support groups.

Why do you think peer support is successful?

Peer pressure is like, “Do it because we’re telling you to do it.” The law, your attorney and your medical person — they’re pushing. That’s just the opposite of what peer support is. Peer support is: “Here’s your pathway. I’m showing you the pathway and I will be with you every step of the way, as long as you want me. I’m not doing it for you. I’m doing it with you.”