Fountain House

The FH program of treatment for people with serious mental illness has been helping people and influencing program development for over 60 years. The community model developed at Fountain House has been extensively replicated in the United States and around the world. It was a major influence in the psycho social rehabilitation movement and the clubhouse movement and it’s programs in advocacy, employment, education,wellness, housing and artistic creativity are state of the art. Fountain House is the 2014 Hilton This model has as its base an intentionally created working community in which in addition to case management services members belong, are needed, have the opportunity to build their self efficacy, motivation and relationships. In short Fountain House is a place in which a member at her own pace can build confidence and acquire the interpersonal and work skills necessary to find a sense of purpose and fulfillment in the general community. Yet no course on the Fountain House model or any of its practices exists in any university or college or department charged with teaching prospective social workers or psychiatric rehabilitation counselors or for that matter any prospective helping professional. The Why? is subject of this article.
To help discover an answer to this conundrum I posited the notion that the creation of the Fountain House model by John Henderson Beard was the result of his ability to think “out side of the box”. Thinking “out side of the box” in developing programs for people, means a focus on satisfying their real needs by incorporating new professional skills in the program plan or utilizing old professional skills practiced in a new way. Based on my forty five years in the field I have noted time and again the fact that the programs that most planners create to help any at risk client group including people with serious mental illness are usually the result of “in the box” thinking which utilizes professional skills that are consistent with graduate school training courses. I have further observed that these programs have the effect of creating a comfortable working environment for staff but do not always meet the comprehensive needs of the people they were intended to serve. Never the less, “out of the box” programs have problems too, since they require new ways of doing things, some professionals who work in these new models often experience some discomfort and even question the professionalism of their practices. Since the some of the practices in the new models are unfamiliar to professionals exposed to them they handle their skepticism by labeling the new “out of the box” program, as having adjunctive status. Adjunctive status label, quiets their concerns because it implies that there are other programs in existence, consistent with university training that represent the comprehensive or the major thrust in the effort to assist the seriously mentally ill in the community and that a program labeled as adjunctive is a semi professional supportive element of that effort. The result of the adjunctive program label is that although mentioned in graduate schools ” as adjunctive to the major treatment thrust,”the new professional skills and the theories underlying them are not taught in university departments.The new skill set that this new program requires is not taught, not only because the program is considered adjunctive, but also because there are no professors adequate trained in its methodology. As a result of this somewhat negative circularity these “out of the box” programs must develop extensive, expensive and time consuming in service training programs for new staff and depend on the word of mouth praise by the clients and their families for support, growth and development. Even, as in the case of Fountain House, when an out of the box program is successful in meeting the needs of a group of at risk people, has the praise of clients and family members and has its programs replicated in the US and around the world, the professional schools are still incapable of overcoming the erroneously assigned adjunctive status label and what is galling to me is that these academics somehow feel that they have the right to then criticize a program about which they know little about.
So far I have come to the conclusion that the Fountain House social practice has been excluded from academia because its methods and practices are not widely understood, they make professionals uncomfortable, question its professionalism and have led some to the belief that it is adjunctive to the major thrust in the treatment of seriously mentally ill adults. Never the less there still must be another reason for Fountain Houses exclusion. I have been thinking long and hard on this question and have come to the conclusion that regardless of the effectiveness question, any program that does not have an office or cubicle based one on one or group counseling process of some sort at the core of its design, will be forever considered adjunctive,because that is what’s taught, that is what is considered professional, that is what makes traditional workers comfortable and that is what many students aspire to do.