News and blogs Views from the frontline What does success mean in field full of tragedy? first published on "Go For It" Blog, by Melissa Kerschen I still can’t think about Larry* without feeling anxious. Several months ago, he dropped off a suicide note at the drop-in centre associated with the homeless charity where I work. Larry is British and an army veteran, so he should have had more options available than most of the homeless men and women who come to us for shelter, showers, food and support. After seven years of sleeping rough and months of conversations with caseworkers, he finally agreed to accept a place in a home that catered to formerly homeless men. I wrote a positive case study and was hopeful for him on a personal level; after many long discussions, I felt invested in his well-being. Rock bottom Then everything turned. Three days before he was due to move in, Larry was agitated and jumpy. That was the last time I saw him. When news of Larry did resurface a couple of weeks later, it wasn’t good: he had physically attacked someone. The suicide note was delivered a few days later. People experiencing homelessness are, by nature, tricky to work with. Identification documents go missing, mental illness is rife, and past traumas threaten to undermine enlightened self-interest. Advances can happen in fits and starts, with plenty of false starts. I accept the shaky nature of progress, but Larry’s tragedy left me distraught. Sure, we provide a certain number of meals and bed spaces to a large number of individuals over the course of the year, and I’ve always thought that was a positive end in itself. Some of those people may have died without a way to get out of the freezing cold. But did it really add up? Outputs versus Outcomes For many years, we were content to measure and record “outputs” or numbers of individuals served and services received. Now, the emphasis in the field is to measure and report on “outcomes”, or the difference you have made in people’s lives. Part of me first reacted to the trend by thinking of it as another hoop to jump through, or worse, an exercise that potentially took resources away from front-line work. The other part understands that theoretically, outcomes tracking should help make programs better: at best it can shed a light on what works and what doesn’t, and insights can be fed back to help shape better programs in the future. But I now see another reason to champion impact-measuring programs: Statistics can remind us of the bigger picture, when you’ve gotten your head stuck too close to the canvas. Ideally, we would record our guests' mental and physical well-being when they come to us so we have a baseline measure, and then track their progress as they use the daytime services, stay in the night shelters, and work with caseworkers. Yet the homeless charity I work for doesn’t do that, primarily because it’s tricky to align with our ethos. We treat people with dignity and respect, we are open to all without prejudice, and we give people the time and space to develop trust. That means we don’t ask too many questions when someone first arrives. And that’s actually one of the secrets to our success, I believe. Ironically, it also makes measuring that success a challenge. So instead we decided to just ask, after a relationship has been established: Are you feeling more optimistic than when you arrived? Are you feeling more hopeful about the future? And then we keep in touch with people once we’ve helped them find a job or a place to live: Are you still in housing? Are you still in work? Early data Data is emerging, and it is hopeful. Of the 98 guests we helped into housing last year, we couldn’t reach 19 of them. Of the 77 we were able to contact, 79% were still in housing a year later. And results of a survey to all our shelter guests showed that 83% reported feeling more optimistic about the future. Case studies are usually used to illuminate statistics. But in this instance it went the other way around: statistics offered me perspective on a case study. Larry didn’t make it onto the positive outcome column, but we came close. We talked about the death of his wife seven years ago, and we talked about the abuse his mother suffered at the hands of his stepfather. He articulated how his homelessness may be a way of punishing himself for not doing more to save his mother. And so I pushed him to stop and accept help. Did I push too far, or were the wounds too deep and too complex to think we could sort them by just offering a roof and some structure? Or was it all smoke and mirrors, and he was just a consumate con artist? I will never know his full story, and I know we will not be able to help everyone who comes to us. But I also see that the work we do to measure outcomes not only helps reassure funders, it can also help reassure ourselves. Several people have told me they’ve spotted Larry sleeping rough locally again. In this case, it’s a relief. We may not have helped him get off the streets, but sometimes success is relative. He found a reason to stay alive. For now, that is enough. *Larry’s name has been changed to protect his anonymity. All other details are based on actual events and conversations.