When she graduated from college, Sara Small planned to work with young children with autism. She studied applied behavior analysis at Western Michigan University, but when she graduated, there weren’t a lot of facilities serving that demographic – at least not around here. She had a friend who worked at Madison Center and encouraged her to apply. She ended up working as a case manager with adults with a serious mental illness – a position she still loves after almost 20 years in the field.
“It’s rewarding to know that you’re a client’s bridge to get through life, to help them have better days, to maintain a quality of life.”
“I think a lot of people right out of college think they want to work with children and that working with adults is scary,” she said. “But now I think the reality is the other way around. Helping a child is a lot to bear. Adults have some better decision-making skills. You guide them and help them, but they’re their own responsibility. I’m very glad that the world led me here.”
Sara’s position is a combination of care facilitation and skills training. She works with clients on things like personal finances, applying for or renewing entitlement benefits with other agencies, helping make and keep medical appointments and individual treatment planning. She serves between 25 and 30 people at a time. Some meet weekly, bi-weekly, monthly or at other intervals, depending on their level of need. She’s been with some clients for more than 15 years, and she’s good at building relationships with them. It takes dependability – and good boundaries, she says.
“You have to be compassionate, but you also have to be selfish because you have to leave all this somewhat-traumatic stuff you have to witness behind you,” she said. “It’s finding that balance of being really compassionate but being selfish enough to let it all go at the end of the day. It’s really heavy stuff, you see people facing homelessness, addiction, extreme poverty, loneliness.”
Despite the challenges of the job, Sara says it’s rewarding, too. She serves as a link between her clients and the world – a world that might otherwise disregard them. Clients with serious mental illness may have little social or family support, few resources, lack basic necessities or struggle with independent living.
“It’s rewarding to know that you’re their bridge to get through life, to help them have better days, to maintain a quality of life. It makes a difference to them,” she said. “Some days, you don’t feel appreciated, nobody’s doing what their supposed to be doing. Other days, somebody made progress with their health or their independence or keeping their apartment clean. You just got to remember the better days and the bigger picture.”