Fountain House and Recovery Centers

To the Editor: It is encouraging to read an article like Whitley and Siantz's Best Practices column in the January issue (1) that advocates for places in the community for people with mental illness. But it is equally discouraging that the authors felt a need to denigrate the source of many of the concepts for which they are advocating. Although Fountain House now describes its approach as a “working community,” the term “clubhouse” originated with us. Clearly, a network of recovery places is lacking in the current mental health system. The authors' attempt to misclassify clubhouses is harmful, especially given the dearth of any type of community programs for people with mental illness. Furthermore, it undermines the authors' expressed support for recovery centers.

Myths about and misinterpretations of our work are beyond our control, and we are the first to admit that many programs of dubious quality and fidelity to our practice call themselves clubhouses. In order to distill and disseminate our theory and methods, two Fountain House colleagues and I have written a book, forthcoming this year from Columbia University Press.

Accredited clubhouses are listed as an evidence-based practice on the National Registry of Evidence-based Programs and Practices maintained by the Substance Abuse and Mental Health Services Administration (nrepp.samhsa.gov), and some of the best recovery centers in the country refer to themselves as clubhouses: Genesis Club in Massachusetts, Gateway House in South Carolina, Magnolia House in Ohio, Independence Center in Missouri, and Grand Avenue Club in Wisconsin, to name a few. These high-quality centers offer extensive programs in supported education, supported employment, and supported housing, buttressed by a strong working community where members can develop a social network and a sense of purpose. Over the past five years alone, Fountain House has supported hundreds of people in colleges and universities. Like many similar programs, we continue to evolve and innovate, with a wellness center, an art collective that sold $100,000 in artwork last year, a youth initiative, and a local health home.

We have differed with some mental health planners and academics who advocate only for individualized services in vivo, because we know there is a need for places of support in the community. They are not just places of respite but communities with porous borders that promote reintegration of their membership. Individuals reach their fullest potential when they are a part of a community or group. We have great admiration for the housing-first approach, and we agree with many of their concepts. From our perspective, it is much more productive to work together to create more and better places of support for people with mental illness to engage in their communities.