Fountain House

Fountain House: Creating Community in Mental Health Practice

ALAN DOYLE
JULIUS LANOIL
KENNETH J. DUDEK
Copyright Date: 2013
Pages: 216
https://www.jstor.org/stable/10.7312/doyl15710
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  • Book Info
    Fountain House
    Book Description:

    Often people with mental illness feel alone in society, with no place to go and little hope. Their isolation can be further perpetuated through typical approaches to treatment, such as case management and psychotherapy.

    Since 1948, the Fountain House "working community" has worked to address the isolation and social stigmatization faced by people with mental illness. This volume describes in detail its evidence-based, cost-effective, and replicable model, which produces substantive outcomes in employment, schooling, housing, and general wellness. Through an emphasis on personal choice, professional and patient collaboration, and, most important, "the need to be needed," Fountain House demonstrates that people with serious mental illness can not only live but also contribute and thrive in society.

    The authors also explore the evolution of Fountain House practice, which is grounded in social work and psychiatry and informs current strength-based and recovery methodologies. Its inherent humanity, social inclusivity, message of personal empowerment, and innovation -- a unique approach on behalf of people suffering from mental illness -- have led to the paradigm's worldwide adoption.

    eISBN: 978-0-231-53599-1
    Subjects: Psychology, Sociology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. FOREWORD
    (pp. ix-xii)
    EZRA S. SUSSER

    This book on the origins and stance of Fountain House is likely to become a classic. It illuminates the driving ideas behind one of the major movements in mental health care and advocacy. Although focused mainly on the original Fountain House in New York City, it portrays the source of what is now a global movement. I anticipate that it will be widely read and discussed. It could (and should) have a significant influence on future developments in mental health.

    One of the remarkable features of the book is that the authors find ways to express profound ideas in language...

  4. INTRODUCTION
    (pp. xiii-xxx)

    Fountain Houseis about an idea in psychiatric recovery whose time has come. Most people who know of Fountain House think of it as a place for people with psychiatric illnesses located on West 47th Street in New York City’s historic Hell’s Kitchen neighborhood. They associate its founding in 1948 with a group of ex-patients and their wealthy sponsors amid high hopes of helping one another to reenter society upon their discharge from a mental hospital. They may even be aware of the formative influence of John Beard, who labored for more than twenty-five years on the early design and...

  5. PART I Working Community
    • 1 INSIGHTS FROM ACTIVITY GROUP THERAPY
      (pp. 3-22)

      From 1950 to 1951, John Beard worked in Ward N-206 of the Wayne County General Hospital. The hospital was known locally as Eloise, as it was located in the Detroit suburb of the same name. The ward to which Beard was assigned was populated by about 250 male patients suffering from severe and chronic schizophrenia; no one thought any of them would ever recover. At the time Beard was a second-year graduate student in social work, doing his field placement assignment at the hospital. It was during his time at Eloise that he was introduced to a practice in psychiatric...

    • 2 REINVENTING FOUNTAIN HOUSE
      (pp. 23-42)

      Fountain House was established in 1948 amid high hopes of providing a supportive community for patients who had been discharged from mental hospitals. The board of directors was incorporated as the Fountain House Foundation and promptly put together a funding package to purchase an attractive building on West 47th Street in midtown Manhattan to house the new program. Those who participated at Fountain House were called members—no longer patients. The membership was organized under the Fellowship, which was separately incorporated, and operated as a social club typical of its time (Carmichael, 1959). The Fellowship provided mutual support for its...

    • 3 CORE PRINCIPLES OF A WORKING COMMUNITY
      (pp. 43-66)

      From its beginnings, Fountain House presented a different approach to aid in psychiatric recovery than its contemporaries did. It underscored this difference by employing special terms to describe itself that were indicative of its inner dynamics. It first adopted “club,” for “social club” (Carmichael, 1959), to announce to patients who were leaving mental hospitals what opportunities awaited them on West 47th Street in New York City, in supporting their return to society. Beard frequently used “day program” to refer to the sense of normalcy and doing things that he was introducing at Fountain House through the structure of a workplace...

  6. PART II Social Practice
    • 4 DEFINING SOCIAL PRACTICE
      (pp. 69-78)

      Staff workers at Fountain House, like practitioners everywhere, come to work thinking about what they have to accomplish that day. On Tuesdays, staff working in the horticulture unit know that they have to purchase fresh flowers for the house. If the meat order failed to arrive the previous day, then those working in the kitchen have to rethink a lunch menu that was otherwise planned. Materials may need to be copied in the clerical unit for an upcoming job fair. In the employment unit, staff who are scheduled to accompany members to an employment office must decide which tasks need...

    • 5 TRANSFORMATIONAL DESIGN
      (pp. 79-105)

      By 1962, the original building housing Fountain House could no longer accommodate its increasing membership. The moment was ripe to build a new and larger house. John Beard supervised every aspect of the building’s construction. He regularly reviewed the blueprints and contributed significantly to their specifications. Beard was eager to create the appearance of a non-institutional environment at Fountain House and wanted the membership to feel proud when attending it. Deinstitutionalizing the physical appearance of the building, however, was not enough. Beard’s environmental design was also guided by an overriding sense of restorative purpose. Beard was always clear that it...

    • 6 MOTIVATIONAL COACHING
      (pp. 106-124)

      Mark Glickman is a former member of Fountain House who now lives and works successfully in Southern California with his wife. His credits include a book,Fountain House: Portraits of Lives Reclaimed from Mental Illness(Flannery & Glickman, 1996), a documentary film on Fountain House, and a seat on the board of the International Center for Clubhouse Development. His life was not always this way. Glickman (2005) related that when he was twenty-four years old his father accompanied him to the front steps of Fountain House in New York City following his hospitalization for a mental breakdown. After an initial successful...

    • 7 ISSUES IN RELATIONSHIPS
      (pp. 125-136)

      Bob Jackson, a former staff worker at Fountain House and now a retired professor of social work, once recounted an incident that he considered illustrative of the nature of the member–staff relationship at Fountain House. While working in the dining room at Fountain House, he observed a member pacing back and forth, agitated and speaking in a loud voice. A staff worker standing nearby, who was anxious to clear the tables and reset them for the next lunch group, tapped the member on the shoulder and asked if he would give him some help. The member, regaining his composure,...

  7. AFTERWORD A PLACE FOR RECOVERY IN THE COMMUNITY
    (pp. 137-150)

    The idea of having a place, like the Fountain House working community, is what is needed and missing in the community mental health system of today. Despite decades since the acceptance of the idea that people with mental illness can live in the community, society has failed to provide anything near the range and depth of services needed so that they can live in a meaningful and productive way. As mental health policymakers and practitioners strive to design such a recovery system, it is becoming clear that a strictly medical approach of hospitalization and symptom reduction no longer offers an...

  8. ACKNOWLEDGMENTS
    (pp. 151-154)
  9. CHRONOLOGY
    (pp. 155-156)
  10. GLOSSARY
    (pp. 157-158)
  11. NOTES
    (pp. 159-164)
  12. REFERENCES
    (pp. 165-176)
  13. INDEX
    (pp. 177-186)