Mentalhealthbooks.net interviews Dr. Alan Doyle of Fountain House

Fountain HouseWilliam Jiang: Hi Dr. Doyle, Thank you for coming today. Who are you and what is Fountain House?

Alan DoyleWill, thank you very much for inviting me to speak with you today about Fountain House. I am the Director of Education at Fountain House. It’s an opportune moment for me because of where Fountain House is in its history — for almost seventy years Fountain House has been at the center of defining a model of community mental health, not only in New York City, but especially now as the recipient the Hilton Humanitarian Prize globally. Fountain House is considered a model for community mental health world-wide and as policy on how we should proceed over the next decades  in terms of the structure and care for those with severe mental illness.

William Jiang:  it is really interesting that you brought up the Hilton Humanitarian Award. I wanted to ask you about that because I heard the Fountain House won it recently. Can you say more about the importance of this award?

Alan Doyle:  Yes. Every year the Conrad N. Hilton Foundation Identifies a charitable, non-governmental organization that has made extraordinary contributions toward alleviating human suffering. In 2014, when it considered the suffering caused by mental illness, it decided that Fountain House and those clubhouses throughout the world that follow its practice offer a real solution for families, for governments, for mental health professionals, and for people living with severe mental illness. We did not come to this award easily. We were nominated for the prize for more than ten years. It was only at the point where the Hilton Foundation learned that the crisis in mental health care had reached such global proportions that mental illness was a topic that needed to be addressed. It chose to shine its light on Fountain House to meet this great humanitarian need and the suffering it causes. Fountain House  is now also working with the World Health Organization for the same purpose.

William Jiang: Can you speak about Fountain House’s work with the World Health Organization?

Alan Doyle: Yes. The pervasive impact of mental illness cannot be understated. It should not only be considered in terms of individual human suffering alone but the impact it has on a nation’s economy, especially in those areas of the world at the lower end of the scale of wealth. So that the seriousness of this illness not only pertains to individual people, but also at the national and international levels. Fountain House has teamed up with the WHO  by jointly publishing a clinical study on the premature death faced by people with mental illness. It is currently writing source materials for government officials and public health practitioners addressing the impact of this condition in terms of solutions.

William Jiang: That is very interesting. As a reminder, this is http://www.mentalhealthbooks.net. I understand Fountain House has two books out. Can you please talk about them as well as where Fountain House is going in the future?

Alan Doyle:  The idea for a book on Fountain House (Fountain House: Creating Community in Mental Health Practice) came to me about 7 or 8 years ago. It became apparent to us that practitioners and policy makers were not clearly understanding our methodology. We call Fountain House a working community. We are located on 47th Street in New York City in the old Hell’s Kitchen neighborhood of the City. People come each day to Fountain House: both staff and the members — “members” is how we refer to those individuals within our community who suffer from severe mental illness. And we do what everybody else does. From Monday to Friday from 9 to 5, we have a work day here where we address together the issues faced by people living with mental illness in the community. That is the project  we work on. That’s why we are here today. And for some reason the idea that the normality of the way that we approach treatment for people with serious mental illness is considered not important or not intellectual enough for many academics or mental health practitioners was the reason for wiring the book. this perception is changing with the recognition of the WHO and The Hilton Foundation. We believe that many in the academic community have overlooked the importance of the opportunity for meaningful work that has always played a part in recovery for serious mental illness–for centuries back to the 19th century Paris, France and the   method morale of  Philippe Pinel.  Fountain House taps into these rich social traditions and practices them as a way of helping our members live outside the hospital and in society. So, what the book did then was tap into these rich academic traditions coming out of Psychiatry with Freud and group theory and integrated with Social Work and the Settlement House movement. Fountain House is a settlement house for those living with serious mental illness.

William Jiang: Like Hull House?

Alan Doyle: Like Hull house, exactly! But we practice our services for those with severe mental illness in contrast to Hull House which worked with immigrant populations.

William Jiang: Exciting!

Allan Doyle: We follow the evolution of this thought as to how we tapped into these traditions taking it out of a medical environment into an everyday work environment like our clubhouse here at 47th Street.

William Jiang: Did you want to say anything else?

Alan Doyle: I think there is a serious issue on the horizon that I would like to personally work on and bring to your attention. As we look upon our traditions and  the recognition by the World Health Organization and the Hilton Foundation,  what started to emerge that supports the effectiveness of the intervention of the clubhouse model. That of the original dream in our origins.  Fountain House was never just a program here at 47th Street: Fountain House was an idea in community mental health care with worldwide ramifications. What we’re looking at and challenged by now is how we scale our idea from where we started with one clubhouse in 1948 and then in the nineteen-eighties started the training program which resulted in over 300 clubhouses over score of years later.

William Jiang: Under Mr. Beard?

Alan Doyle: it started with John Beard and then was furthered by his protege Rudyard Propst into a worldwide movement involving hundreds of clubhouses practicing the approach that the was founded here at Fountain House. But for the last 15 years we’ve been stuck at 315 or so clubhouses worldwide. So it is an issue of scale that we are now faced with. I personally have been looking at how we can use education as an intervention to break through this barrier and reopen the gates of expansion that occurred between 1980 and 2000 when we grew to over 300 clubhouses. We need to look at a whole new approach to how we think about replication — in a way that is fiscally responsible for a solitary place in New York City. We want to keep in mind our global mission and how we can in a very practical dollars-and-cents way, think about how to expand community mental health around the world using the clubhouse model of Fountain House,

William Jiang:  That sounds exciting.

Alan Doyle: And yet we can reach out to a larger community. We are looking forward to coordinating with training for others and share our methodologies. We now have video conferencing–it allows us to give our traditional training in a way that we can do it without walls and recreate that early group who brought  the message of Fountain House to other parts of the world and use it to support and re-energize groups to go into areas like South America.

William Jiang: South America?
Alan Doyle: South America only has one or two clubhouses: two in Argentina and also one in Mexico. Think about it- all of South America is going through deinstitutionalization right now, like we did here in the states  in the 1960’s and 70’s. They will have an increasing number of people in the jails who are there not for any criminal activities but because of their mental illness. Also, there will be increased rates of drug addiction and homelessness on the streets. These are all the impacts that the World Health Organization is looking to Fountain House to mitigate. And that’s why we need to find a way of thinking about how we can bring this issue of mental health to the fore for countries at a reasonable cost.

William Jiang: This was an exciting and very interesting  overview of what Fountain House has one and will do in the very near future, hopefully. Thank you so much for talking to me today, Alan.

Alan Doyle: Thank you, Will.