Does Everyone Get a Chance, or a Few Chances, to Succeed?

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BY PETER VARNUM

I met James* in the psychiatric ward of Massachusetts General Hospital in Boston in the summer of 2017. I was six months into a job with the World Economic Forum, seven months removed from a wrenching breakup, and a couple of days through jet lag following my flight from my home in Geneva. My feelings were at once familiar and untrustworthy: I had been through episodes of psychosis before and knew the realness that accompanied them; still, it was hard to distinguish what was supposed to be helpful from what my brain had convinced me was part of an elaborate plot to recruit me to the CIA.

I didn’t have the same paranoia when interacting with James, perhaps because he seemed uninterested in me. He was young, like me, in his late 20s or early 30s; most other patients were older. He had an easy, languid walk that fit his tall, lanky frame. Though he seemed to have his guard up, he was not quiet; on the contrary, his voice was unmistakable. James often listened to music and moved with the beat.

He was the only Black patient in the unit. I never learned why he was there.

As I recovered my grip on reality through regular sleep, an absence of stimuli, and connection with my family, I spoke to James a few times. I found out he wrote music and, as I recall, played at least one instrument. He told me about his college football career. It was clear, to me anyway, that James was hardened but aware; he understood people and chose carefully how and with whom he interacted.

I thought back on my own story: I’ve been hospitalized four times for mental health issues, including episodes of psychosis that have interrupted my school and work lives. I also played collegiate sports, wrote a musical in college and led a band while in graduate school, and finished a selective executive education leadership program. I too choose carefully how and with whom I interact.

I don’t know James’s life story other than these bits and pieces I remember from our brief conversations. But during that stay, and many times since, I’ve thought of him. I recovered, returned to Geneva and kept working, ending up leading the Forum’s nascent work in mental health. I communicated the fact that I had been at MGH for a week and a half to only my most trusted work confidants, and I gradually rebuilt my self-esteem.

Where had James gone after leaving MGH? Did he have employment to return to? How has he been over the last years? How has COVID affected him and those close to him? The parallels between James and me – both dealing with a mental health issue, both musicians and athletes, both likable and quick to smile – were the reason I felt so drawn to him in the psych ward. But now, as I continue managing myself and living my life, I have affirmations of various successful life chapters, such as degrees, professional photos, memories of facilitating high-level meetings.  

Did he, a Black man with talents similar to mine, receive the same opportunities to succeed that I did?

It is well-documented that the social determinants of health, including of mental health, have an outsized effect on health outcomes. And this makes sense: if you don’t have fresh food and clean water, or you’re not sure where next month’s rent is going to come from, then you’re more likely to feel constant anxiety about these things. Increasingly in the US, these conditions pair with other inequities like structural racism to rob certain individuals and populations of the advantages that others enjoy. These include food, water and a paycheck, but also the freedom of existing without commanding uninvited interest in your right to exist. Collectively, these factors have been termed “vital conditions” for thriving.

My story illustrates that when given support from family, close friends, teachers, bosses, and power systems – when these vital conditions are met – you can truly thrive while living with a mental health condition.

Things out of your control, such as where your house or apartment is located, what color your skin is, and how much money your parents make, should never dictate whether you have a chance, or a couple of chances, to succeed. Let me be clear: this is not just a human-interest issue. Yes, giving support and showing kindness to all people is the right thing to do. But it’s more than that. I’ve done good work in my life and will do more. I pay my taxes, I contribute to the economy, and my lived experience with mental health challenges adds a layer of expertise to my professional life. There are millions of others like me, and we all deserve opportunities to lead productive and fulfilling lives. And we are often great friends and partners because of our sensitivity and empathy.

Shouldn’t leaders be supporting more people to reach their potential, for the benefit of all, instead of ignoring their duty to make society better and allowing deep-seated, systemic injustices to fester? Shouldn’t someone like James and someone like me have similar opportunities? It’s time to push for policies that are grounded in equity. Policies that ensure equitable access to housing, food, education, and healthcare — including mental healthcare.

*Not his real name.


Peter Varnum is the Chair of the Board of The Stability Network and Associate Director for Orygen Global, looking after Orygen’s collaboration with the global youth mental health community. Prior to Orygen, he built and led the World Economic Forum’s work on global mental health. He also serves on the Healthy Brains Global Initiative’s Lived Experience Council. He earned a BA in English from Carleton College and an MA in Law and Diplomacy from The Fletcher School at Tufts University, and completed the World Economic Forum’s Global Leadership Fellows executive education program.

5 responses to “Does Everyone Get a Chance, or a Few Chances, to Succeed?”

  1. You have said so much! As a society we have a compassionate obligation to care about the basic needs of all, vital conditions. When this happens, it is better for each individual and for everyone!

  2. Thank you for sharing your story Peter, and the parallels of your journey alongside James. I grapple with my emotions; and the need to understand how, and why this has gone on so long. My emotions end in anger that we cannot/don’t wipe the slate clean; instead we try to undo the systems, every four to eight year political cycle, using the same rules. This is when I stop and breathe. I acknowledge my gratitude for you seeing James and articulating societal injustices in a way that I cannot. Best.

  3. Thank you for finding the courage to share your very personal story Peter. As a psychiatrist, I see a lot of people like James during the course of my work. And you are spot on when you say, “It’s time to push for policies that are grounded in equity. Policies that ensure equitable access to housing, food, education, and healthcare — including mental healthcare”

  4. […] am also extremely privileged. I was given multiple chances to recover and succeed – chances that many people are not given – and my family’s ability to pay out of pocket for private university education allowed me to […]