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For Those with Chronic Mental Illness, Success Cannot be Measured in a Straight Line

"Micro-wins" may not seem like much, but every step forward counts

Shot of a wife consoling her husband during a counseling session with a therapist
Shot of a wife consoling her husband during a counseling session with a therapist

Two years ago, my brother Adrian became a missing person. As my family desperately searched for him, he was spending his nights in metro stations and his days walking aimlessly in the cold – until a stranger recognized him from a viral social media post. Months later, he took off again and became temporarily homeless, living out of his car, popping up only periodically in states across the country.

For half of his life, my brother has been living with chronic mental illness. He is one of 11 million Americans whose severe mental illness substantially interferes with their ability to pursue normal, productive life activities.

One day, exhausted by his struggle, Adrian drove home. He accepted my family’s help and began looking into tech certifications, attending an orientation for Per Scholas, a nonprofit that provides free technology training to unemployed adults.

The entrance exam would be the first test he had taken in 15 years. He made flash cards. He took practice tests. He asked my husband to tutor him in math. After weeks of studying, slowly but surely, he felt like passing the test was something he could realistically achieve. 

In the midst of the exam, a familiar crippling anxiety set in. He knew there were questions he was getting wrong. He knew he was running out of time. But when he finished and the instructor came over to grade his test, he had passed.

When Adrian started with Per Scholas, his confidence grew. He sent me photos of his good grades and pictures of him heading to class in a pressed suit. He felt supported and proud. He began to dream about the future for the first time in years. He got his first library card and began furiously reading about the tech industry. He watched YouTube videos on technology platforms. He became a consumer of knowledge – knowledge that could prepare him effectively for employment and independent living. 

One day, he told me, “Lauren, I wake up and look forward to each day.” I was overwhelmed with emotion. A year ago, this would have been unfathomable.

Unfortunately, Adrian’s story isn’t one where everything works out as planned. As anyone who has experience with mental illness can attest, success is not a straight line. Sometimes success only comes in waves. And sometimes, despite all good intentions, things spiral out of control.

After several months working with Per Scholas, Adrian’s health began to take a turn. Although his grades were still sufficient for the program, his paranoia increased, his sleep became sporadic, and the stress of the work became too much.  A month shy of graduation, Adrian withdrew from the program in the throes of another manic episode.

As an executive of the Stand Together Foundation, a philanthropic organization committed to helping people transform their lives, I am often confronted with the difficulty of evaluating the comparable impact of programs. We have built frameworks and tools to understand the depth of impact, the reach of a program, and the cost per outcome. We use this raw data to understand and discuss how best to leverage our resources towards the most impactful organizations.

If you only look at the metrics, my brother shows up as a failure.  A participant who didn’t complete the last certification. A sunk cost.

But as his sister, I know that the “micro-wins” – the small steps on the path towards that desired end outcome –aren’t reflected in the data. For the first time in over a decade, Adrian got into a routine that stuck. He tested his limits and pushed beyond his comfort zone. He put in the work. He studied. He passed his first industry certification. He proactively recognized his symptoms of his mania and asked for help. He took measures to limit the impact of his episode and didn’t end up in the hospital. 

Per Scholas helped him understand that he was capable and had value to contribute. It also helped him realize the impact of new triggers and stressors which will help inform his management of his illness in the future. 

My brother’s experience emphasizes the need for the social sector industry to create better tools for measurement and evaluation that take into account the whole person. In this industry, we have to have room in our metrics for failure. We have to know that sometimes short-term failure is just one step on the path to long-term success.

We also have to encourage those with mental illness to have the courage to fail. They need to know that if they do, they have the ability – and the support – to get back up again. This is how they will build the resilience they need for success.

I don’t know where my brother will go from here. But I do know that thanks to an organization that believed in him, he is in a better place than he was a year ago. And he is one step closer to taking his next courageous leap. 

Lauren McCann is executive vice president of the Stand Together Foundation.

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