After Decades of Life-changing Results, Clubhouses Get the Spotlight They Deserve

SEP. 14, 2015

By Kenneth Dudek

 Fountain House member Vivian and her nephew, Greg.

Lately, Fountain House and clubhouses modeled after it around the nation and the world have received significant recognition for their pioneering work in the treatment of serious mental illnesses.

E. Fuller Torrey’s latest book, American Psychosis, calls the clubhouse model “the best model,” citing its combination of access to supportive housing, vocational opportunities and socialization. In addition to Fountain House’s clubhouse in New York City, Torrey calls Genesis Club in Massachusetts, Independence House in St. Louis, Alliance House in Salt Lake City and Gateway House in South Carolina “outstanding.” I would add Club Cadillac in Michigan, Vincent House in Florida and Magnolia Clubhouse in Cleveland to the list as well. 

Simply stated, clubhouses are community-based centers open to individuals with mental illness. Clubhouse members have the opportunity to gain skills, locate a job, find housing and pursue continuing education.

In 2014, the Conrad N. Hilton Foundation selected Fountain House/Clubhouse International as the winner of the world’s largest and most prestigious humanitarian award, the Hilton Humanitarian Prize. This is the first time in the prize’s history that a mental health organization has been selected. Also in 2014, NAMI recognized Fountain House’s supported employment program as an evidenced-based model, and the New York Association of Psychiatric Rehabilitation Services (NYAPRS) presented Fountain House with the Marty Smith Memorial Award.

This recognition has positioned clubhouses at the center of an emerging global dialogue about mental health. I would like to seize the momentum generated by this favorable attention to point out what I believe is truly at the core of our success: The clubhouse model is and always has been a partnership, originated and built by people with mental illness and their families and supporters.

Countless programs throughout the U.S. (including several of those mentioned by Torrey) and around the world were started by mothers, fathers, sisters and brothers, together with, and in support of, their loved ones living with mental illness. These families have advocated tirelessly with local governments, leveraged personal and professional networks for funds and job opportunities, and undertaken myriad actions to ensure that their relatives with mental illness achieve their potential and live fulfilling and productive lives. For some, that has meant returning to school or work; for others, it has meant obtaining supportive housing and accessing comprehensive medical and psychiatric care; and for still others, it has meant having a community to which they belong. 

I recently had the chance to speak with a group of members and their families at our clubhouse in New York City.

Karen spoke to me about her son Justin’s journey from diagnosis to joining Fountain House. “The best thing I ever did was take the NAMI Family-to-Family class at the National Alliance for Mental Illness,” she says. “It taught me to understand his symptoms and to realize when he was having an episode.” It was through NAMI that Karen heard about Fountain House. “I knew Justin would be comfortable with the autonomy and sense of community of the clubhouse. People are different whether or not they have mental illness. Clubhouses understand those differences and work with members as individuals.”

I also spoke to Leslie about her son, another clubhouse member. “You beat yourself up a little when you have a kid with mental illness in a way a parent wouldn’t do if their kid had another illness, like juvenile diabetes. You think, ‘Well, if I hadn’t done this or if I had caught that….’ But in less than a year at Fountain House, my son has learned to manage his own medication, do chores, get around the city by himself and make some good friends. He wants to go to back to college. He is not only stabilized, but he is thriving.” 

Another member, Betty, describes what she feels makes clubhouses so effective: “A good community not only makes you accountable, it also pushes and inspires you to fulfill your potential. At first, a clubhouse for people with mental illness’ sounded like something out of a nightmare. It was quite the opposite. I found a professional work environment, where people go to happily volunteer their skills to learn, to heal and to prosper.” 

Since becoming a member, Betty has reconnected with her family after years of absence. “My mom flew in to visit me, and I gave her a tour of the clubhouse.  When she met my worker and the fellow members, she thanked them for giving me back to her. She had thought I was lost forever — sealed away by this disease that rattled my brain.”

Fountain House is visited by mental health professionals and family members from all over the world. In the 1970s, it received a grant from the National Institute of Mental Health to formally train people to replicate and implement its approach. Currently, there are more than 300 clubhouses in 30 states and 34 countries serving 100,000 people. To further disseminate the clubhouse model to the world, I co-wrote Fountain House: Creating Community in Mental Health Practice with our director of training and  education, Dr. Alan Doyle, and psychotherapist Julius Lanoil. The book, published in 2013 and  reviewed by experts including Oliver Sacks, M.D., recaps the history of its unique working communities. 

 In American Psychosis, Torrey writes, “Sixty years after clubhouses began, there should be 2,000 of them … and states should be opening additional ones, not closing them down.” But more empirical research on how we achieve such outcomes must be done to generate the kind of funding necessary to grow the clubhouse movement.

Over the years, academic researchers have intermittently attempted to measure the effectiveness of the Fountain House model, but for the most part, their studies have been inadequate in capturing the true impact of its work. Aside from recent recognition as an evidence-based program by SAMHSA — not to be discounted as insignificant — little has been done to determine what really makes its community-based approach, which has been developed by people with mental illness and their families, so successful.

There is hope on the horizon, however. Recently, Dr. Zachary Grinspan of Weill Cornell completed a study showing how members at the clubhouse in New York City are less likely to be admitted to the emergency department than non-members. Additionally, Fountain House has recently entered into a partnership with the World Health Organization and Columbia University’s Mailman School of Public Health to study early mortality among people living with mental illness. I am heartened that this research will establish best practices to extend and improve the quality of life for people with mental illness that can be implemented by governments and health care professionals around the world.

Still, more research needs to be done; in return, more funding for clubhouses will likely follow. Now that recent attention generated by Hilton, NAMI, SAMHSA and the World Health Organization has placed clubhouses in the spotlight, we implore academia to conduct independent studies of these programs around the country. I am certain that our members and their families would gladlyvolunteer to demonstrate the transformative power of what we have created together.

Kenneth J. Dudek is president of Fountain House. His career spans more than 25 years in community mental health. Under his leadership, Fountain House won the 2014 Conrad N. Hilton Humanitarian Prize, affirming the success of its recovery model and placing mental health on the global humanitarian agenda.


JAN, 10, 2017 05:58:55 AM
a small test with

DEC, 29, 2016 06:43:24 AM
I think this is a very good innovation

NOV, 02, 2015 06:05:26 PM
Id rather not
b tw i dont care about visibility just helping

NOV, 02, 2015 06:04:38 PM
Id rather not
Honestly reconstructing there thought, telling them they are wrong to feel that way is saying, makes a person feel like if they cant feel better its there fault. Ur not asking is there any motivation what helps u because the last thing u want a person to feel is theat whatever they say ur answer is always better, ur intentions dont mean that but when u spiral and really try and feel u must be watch that already makes a person depressed due to what u see as irrational and countinue to spiral. That means listening and actually admiting this treatment maynot help all but it helps and schenziphenic and panic dont even derserve the same reasons. Especially if attacks are so bad u truly never forget and wonder am i crazy and being treated as a danger to urself already makes a feeling shame happen truly even if u feel it may not help at least try thats all they ask but few listen to u if u dont fully lsiten to them not judging them and if someone who didnt have panic dealt with it would make them feel no one understands its a diease which is not like anxieties u batttle if u dont stop it and it comes on 15 min they fear those attacks so bad they change there whole lifestyle 7 treatments and 1 year of panic and getting bipolar when in fact i have low dopamine after brain scan and having movement issue and abuse risk is only a problem if the patient feels euphoric woory about it once suicide phase is over and dont force them off most even me treated friends and can barely remember positive memories but my father who dies just a week ago had it given barbitures 2 weeks vs 7months of fear and i cant leave my hosue and making something which let me stop choking to death on the floor is meant for that reason and never think about it but cant get off effexor but even clonezepam was *****ing easier im sorry just abuse in panic doesnt exist its not sedation its physical is been shown fearing for ur life for no reason losing all ur friends due to u worrying about the attacks saying for 7 months trying every *****ing antidepressent saying no addiction but having nor more desire for any relationship and suicide risk show u maybe even things we may not like may help the fact they want to die is scary knowing 2 other friends went through 2 random panics a day and because they decided to actually go to a doc and still cant get xanax unless they get a bipolar medis absurd and counter treatment i am sorry i was there the whole time and couldnt relate and honestly said so but now having them u cant some anxiety is not *****ING panic i hate my language but this effected my family and i couldnt work but u believe i have a bias but the irony was i believed hard and why are adverse effects ok especially with ireegular heartbeat when thats panics problem but 3 more weeks each time it makes u go why do i even try to treat it abuse and delusions happen in bipolar schizephenia not depression and having to tell my doc after calling antipyschotic, mood stabilzers then u are at tricyclic and sudden death is a 'rare side effect' vs on drugs of abuse why do u focus only on abuse and say do u think u can actually help urself metnally and help pul u out of the hole but mood stabilzers made paralyzed movement happen and if u cant even get ur patients with pyschoitic issues and half the reason they use with the antideprresents is due to my desire for any person in love hasdisappeared but it says 10% when in fact its 80% and the side effect of the adjunction drug is erection and imagine finially finding intimacy having to reduce dose vs why is xanax adverse efects if a person doesnt a drink more dangerous than any adverse side ilisted they arent uncommon and rarely some months getting 1 day early saying u took 1 more than usual when in fact a horrific scare happen and wanted to not literally battle this and xanax withdrawl caused no anxiety just i know what was too stressful nd becomes pill in the pocket because 10 min of onset of panic may be wondering hey this is used in few and why are they going under the issue of abusers when u hear of them all the time it makes me wonder would i have acted as irrationally to even the help i use with cognition now. but u guarantee death if a person says i had one panic in mylife mi get it no first u wonder its ur health then it becomes the quest to find it with a great doc it took 1 year but if u describe it as sudden change people who are not studying the field of medicine believe u but my friend did when therapist said all in ur head when its not its adrenline and only caffeine makes it worse. I would not be advocating xnax use all way around but worry about addiction when the dose never rises but in anti depressent rises and no one blinks and dealt a withdrawl of twitches after being told no dependence when in fact even slowing xanax is easier and i take 15 mg of effexor i tryed more i tryed every reuptake and mood stabilizer gave movement and had to show articles and feeling like no one gets me except few and if u dont have it u dont understand and in fact this diease must be treated especially with people have suicide ra u mean well but if the patient is at that point say have u tryed it saying something in the same category vs saying well this pohysical symptoms are making u worse lets try this and if u go up a small amount its ok and why make it where if they do reduce 1 a day they scrutnize u as addict vs u f--ing tryed because u finially actually can brreathre ok and i was so fearful and u ge to the point if they go to suiccide clinic one immediately aftre institution he was so bad believe these other cause no issues when they do i get the opther dose but its how u represent to the patient. not blaming there in in actuate thought again not intentiona l. But if they want to die truly listen they came to help themselves not told how they even thought poorly if u were told that not in exact words but ur depression and going to diff physcian and everytime they worry about mental when i had mental problems with other ssri treatments they can help but the credit its too much the fact i type this shows u i care and most fear treatment due being called addict but are u not addict if u cant stop the other snri tratment and if they run low or spill it not having to provre it went into the toliet and then sating 1 sentence later ativan which is in the smae category with 3 specialist telling my general doc telling me try and countinue the effexor when i had not just mental issues but physical and says i ingrained that no its because each time i defend it i forgot totally i take it 2 times a day rarely 3 and called abuse but if someone raised 50mg on antidepressent and in fact i couldnt leave my house after i stop after i felt below decent is euphoria finially not passing out after 30 min episode of believing u have gone mad dont know what is treatment what is panic. but if my situation happen which it did 2 oother friends and iwas called alcoholic due to the fact i started drinking a shot whenmy heart rate rose 180 i just thought u should calm downji didnt think being out of it! if u said the same fore the other i bet the mental asscostion would change the episode a panic disorder has "is not pychotic" in fact increasing like seroquel which i heard people abused and is a ntisczio so why do 3 alcholics represent all alcohol i get 3 treatments but 7 f--ing ridiculous told all in ur head i dont even fear panic and the few times i try and fight it have surpressed tacycardia 20 men if that is not tring get and epipen keeep giving it to the point of the person feeling near death u are a pretentious ***** if u had it "somewhat" and the other friend accused doc shopping and wasnt after u stop anything crazy and was there for them and never said they will die anyway i was there so know i am not critizing but if u treat a person with what they believe vs cognition like especiaslly scziophrenia how canu argue what they feel or see doesnt exist to them. but u guys mean well just my comment is trying to help and to punish it would truely sadden me it may not apply to all but attacking there cognition doesnt always go to plan. I just hope my comment saves a life offered some advise... i mean well i study pharmacology and medicine. and forgive the grammar i really want u to save a life and u cant believeu are write people especially panic read u like a book and even standing while patient sits in front and they seemdelusional.. is it delusion from fearor proven ways like panic and schizophrenia. many people who would go to medically field say what are u talking about and leave sadder than whwn they left and for the 5 min it happens how does a modern doc see ignoring the nurse justifying i am more qualified than her. The last criticism wasnt from me but my fatherwho changed cardiac surgey. i apolgize poor grammar but want to help but being critical of what i know and i can know my own blood pressure and heart rate due tonick is *****ing scary. Scary isnt even an understaement its fear to a point of craziness. In fact even if u disagree i would never wish these attacks on u and doing this explaining what many want to save i sbeyond brave they arent doing sketchy things just they fear more judgement. Suicide and telling them life is good when u feel no joy is failure and spiral gureendtede i never dedicate this time just suicide is important to me iam as down to earth and one said i took xanax it amazing stop it said i cant have it again and began drug testing me and i thought she didnt judge and cryed. Judging hurts anyone but i have adhd and they said adhd doesnt really exist. and reading last comment giving up is so sad i cryed at that. yea it may feel tiresome but being ther is important working with schizophrenics and ask if u can help due to saying i understand u percieve a reality that is differnent from mine and doint want to discount yours just i know what u feel is unqiue please give me a call if u want to discuss few would just stare at the wall then attack but few true empathy as in saying i know whats right to asking what have they done before and what u feel is best is crucial. lastly ask if they followed u showing them . like if u never said xanax was abusable i literally wouldnt even thought of it but it did when i got 1 day earlier when i did antidepressent halfway thru the month. what wrong here. u discrimate the point of scarying people who want help. please dont take this personal i dont mean that just its cliche to think what the ideal . Sorry poor grammar i wish i could check i hope u ask them how they feel vs nowwe are going try a b and c or tell what lifestyle and not even write it down because responsibility is too the patient not to our biases or expectation its aving thems from extreme scarey sad. Please i beg of u at least take something from this please.. i am tearing up i went to panic group i talk about they agrred

NOV, 01, 2015 01:51:52 AM
Jana Villalba
Is there a clubhouse in the Austin Texas area ?

OCT, 14, 2015 05:06:49 PM
Is there a clubhouse in Arizona ?

OCT, 14, 2015 10:39:55 AM
Ava Martinez
I belonged to Yahara House in Madison, WI for many years. They helped me get my life back on track. I work full time for NAMI Dane County now. Clubhouse WORKS

OCT, 01, 2015 12:38:58 PM
Lynne Hamilton
I am VERY interested in the Clubhouse arena. We live in SoCal, and I will investigate the "Clubhouse" scene in this area.

OCT, 01, 2015 12:35:17 PM
Call the Mississippi Department of Mental Health Consumer Supports at 1-877-210-8513. They should be able to give you some options. I work at Central Mississippi Residential Center in Newton. We are a transitional facility (6 months - 12 months based on individual needs) that helps seriously mentally ill individuals to prepare for placement in the community. We assist with appropriate placement (personal care homes, etc.) once clients have met maximum therapeutic benefits here. The Admissions Director is Tina Bailey and she can be reached at 601-683-4260 if you would like more information about our program.

OCT, 01, 2015 05:12:27 AM
Debbie Blair
Are there any expected to open in the LA area of California?

SEP, 30, 2015 10:49:52 PM
Frank Tavella
Here in Suffolk County New York, we have the Club House of Suffolk in Ronkonkoma

SEP, 30, 2015 08:45:45 PM
Linda Hayes Burns
I am a graduate student in mental health counseling and will be graduating next year. I am wondering how I would go about getting a Clubhouse started in my home town. Anyone with some advise.

SEP, 30, 2015 06:32:15 PM
Why doesn't every State have Clubhouses? Colorado has nothing

SEP, 30, 2015 06:22:48 PM

SEP, 28, 2015 04:33:27 PM
Kyle Lloyd
Just Advocating, Several clubhouse programs I am aware of are struggling to get adequate funding to remain operational... Are there grant-makers willing to come forward and help pitch in for these operations to keep going?

SEP, 22, 2015 10:56:58 PM
Mike Chang
Hey Loretta palmer give Fountain House NYC a call. And ask them your inquiries. 212-582-0340.

SEP, 14, 2015 07:50:18 PM
Loretta Palmer
I have a great niece, Kaley Palmer, age 21, who is schizophrenic and she needs long term help. We are in Mississippi and we do not have family to take of her. Does anyone know any facilities to help. We are to the end of our rope.

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