Last week was the final session in the Return to Balance series: a yoga, meditation, and massage class offered in the Wellness Unit. The team of teachers – Shoko, Elizabeth, Ruth, and our own, Anna - planned a wonderful celebration.

First, we set up for the class. Ruth led an introductory exercise with a ball; when a class member threw the ball to us, we had to share a thought about what we learned or how the class has helped us. I used Elizabeth’s basic quote, “Learn to listen to your body.” This activity was followed by a full class – from chairs to mats. After the class, Anna presented special cards to our guest teachers, and Ruth awarded a beautiful certificate to each participant. We whisked the mats and exercise balls away and moved the tables together. After all that work, we visited over a light, healthy dinner.

Being aware of your body is very helpful. Drink lots of water. Eat well. Exercise. Walk. Meditate. Breathe deeply. Stand straight. If you practice every day, your body will feel better and you will get stronger. We celebrated last week, but what we learned will not end with the class. 

Alice B. Chernick
Research Unit, Fountain House

Many mental health consumers have the financial resources to enjoy their weekend leisure time but cannot, because they lack the social opportunities to fully participate. The Consumer Dinner Club that I coordinate attempts to provide a chance for consumers to congregate and better enjoy their weekends by offering the one resource that they may lack – each other.

The Consumer Dinner Club started with a modest group of three - my girlfriend, my best guy friend, and me. All three of us had met as Fountain House members and were used to frequenting diners in the Hell’s Kitchen area. We wanted to embrace more members, and also the limited diner-restaurants in Hell’s Kitchen were becoming tiresome. I decided to ask other FH members if they would provide me with their emails and cell numbers so that I could invite them to a restaurant elsewhere in Manhattan. Almost everyone who I spoke to said that they wanted to come and gave me their contact information.

In the beginning, I relied on members’ suggestions of restaurants (now I do my research on yelp.com, a web site that posts astute restaurant reviews.) At the start of the week, I send out my email invitation. The invitation lists details about the restaurant, such as its name and location. I also include some anecdotal remarks, such as what menu items may be best and the approximate cost of the meal. If the restaurant takes reservations (I usually choose restaurants that offer reservations and are group-friendly), I make a tentative reservation at the restaurant immediately. I ask that people RSVP by the end of the week, so that I can call the restaurant with a more accurate count.

In previous FH gatherings outside the house, prior to the formation of the Consumer Dinner Club, we have had a number of issues. Sometimes members would come mainly to hang out and would either order too little or tip too low (often very low). Also some members would come and behave inappropriately and embarrass the group.

Therefore, I have a few rules with regard to the Consumer Dinner Club. Firstly, everyone who comes must order dinner and everyone must tip 20% on their pre-tax balance. As is common with people on fixed incomes, Fountain House members have been used to getting a separate check for each person, so that each individual could tip what he or she preferred. This is still a good method for impromptu gatherings, but I wanted to ensure that people tipped adequately, so that we could be appreciated by the restaurant wait staff and management. The group receives only one check and I calculate each individual’s or couple’s amount owed, which is based on what they order and a 20% tip (as well as sales tax.

Secondly, to limit behavioral problems, I maintain control over who may attend the Consumer Dinner Club events. Club members are told that any guests they wish to bring must be approved by me. Usually I know the members’ desired guests and can assess whether or not they would cause trouble. In general, a Dinner Club member’s significant other or good friend will be welcome. If an attendee causes a problem, that person will not receive an invite again. I try to be ethical in my decision-making; I am mindful that although I may not like a Dinner Club member, the member may not be a problem to the group and therefore is welcome at the events. If I am ever overly concerned that my approach is becoming draconian, I am mindful that even Fountain House has rules about who may attend at the Clubhouse.

Thus far the Dinner Club events have gone well and our attendance continues to rise. At our last dinner we had a group of thirteen. Those who attend are genuinely excited about the events and enjoy them. We usually go out to dinner at a Manhattan restaurant and also a café afterwards to chat further. I try to choose a new restaurant each time. Currently, I plan two dinners a month. The events can be a little pricey for some members, so I suggest that members with small incomes try to come occasionally.

I am gratified that I am able to provide a service that is truly needed. Dinner Club members are able to develop better friendships with each other outside of Fountain House. At present the major attendees are Fountain House people, but I am thinking about opening the program to the entire consumer community in New York City. 

Jonathan Brachman
Reception Unit, Fountain House  

The documentary, Kings Park, produced by Lucy Winer was shown on Wednesday June, 20th at the SVA Theater in New York City. More than 150 people attended this event, many of whom were Fountain House members, panel speakers, and supporters.

See photos from the event.

Kings Park, a psychiatric institution located on Long Island, was established in 1885 and closed in 1996.  At its peak in the 1950s, it housed over 9,000 patients. When the ward was open, it was a harbor for the people with mental illness who could not be taken care of outside of the institution. In the film, Lucy Winer interviews many of the patients and staff who used to work at Kings Park in order to show what psychiatric wards were like before de-institutionalization in the 1960's.

Kings Park was nothing like the hospitals we have today. In fact, few psychiatric facilities that resemble it remain open. In the documentary, the institution is depicted as a gruesome and disparaging space. As the facility was taped in its end stages with peeling wall paint, no furniture, and the absence of apparatuses, it may very well reflect the rooms as they truly were before closure. While revisiting the hospital, Lucy recalls that in the day room, there was nothing to enliven the place at all. The day room, she says, was just as bare as it appeared when she was filming.

In short, Kings Park was portrayed as a disaster, yet it was a necessity because patients had no other place to go. Some called it a safe haven, but the majority considered it to be worse than hell. Some patients stayed for many years while others, like Lucy Winer, were there only for a few months. As she delves into the past, she remembers being tormented by her stay on the hospital’s floor for violent women when she was 17 years old.

Lucy’s story is troubling and deeply concerning. She was diagnosed with schizophrenia and admitted to the hospital because of suicide attempts. Though revisiting Kings Park was deeply personal, she finds that there was more to say about Kings Park than just her own experience. Beyond this, Lucy finds a plethora of roles that the psychiatric facility played in society and mental health care.

She starts her journey by finding the providers who had her psychiatric medical records, and she soon realizes that, without the recollections of other people, she may never be able to tell the full story of Kings Park. As she interviews people, some patients remember awful experiences such as abuse, maltreatment, repeated and unnecessary restraint, and over usage of shock therapy.

Though the past of Kings Park may be irrelevant since few of these hospitals remain, the story’s ironic twist is that present-day facilities for many mentally ill people may be reverting back to resembling Kings Park. But this time, they are not psychiatric wards. Instead, these facilities are prisons, housing thousands of inmates, many of who have mental illness and are not receiving the services that they need.

The saddest part of the story is that it can truly be the luck of the draw that some mentally ill people gain access to places like Fountain House or Hands Along Long Island (HALI) clubhouse, which initially developed as a place for former patients from Kings Park psychiatric hospital. Throughout the panel discussion at the end, one psychiatrist who visited state prisons and administered psychiatric treatment to inmates discussed that there is hope for these people, but ultimately, the systematic criminalization of the mentally ill isn’t fair.

All in all, the film opened my eyes to the old realities of what hospital stays were like and makes me very grateful for not living in those days. In a time and place where Thorazine was the only dispensable medicine allowed and attendants were the only personnel in hospitals, many people were at a disadvantage and in a position to deeply fear assistance. Most of all, the film showed me how lucky I am to be at Fountain House, especially when so many people in the penal system are sentenced to time in prison, when all they may truly need is a community and some treatment to support them.

 

Marianna F.
Employment Unit, Fountain House


 

The strength-based approach to treatment originated in the writings of Aristotle, but its more modern development began in the 17^th century. Moral treatment, as it was called, was supported by John Locke and other early Humanists. Humanism - with its emphasis on the worth and dignity of all people, the commonality of all human experience, the rejection of inappropriate authority, and optimism about the capacity of people - can be seen as the first context in which a focus on human strength building occurred.

In the world of mental illness, moral treatment - represented by, William Battie, William Tuke, Benjamin Rush and Philippe Pinel - was the first approach created on the belief that patients had skills and abilities that could be utilized in their treatment. For example, in England, William Tuke founded York Retreat where he created a family-style ethos. Patients performed chores to give them a sense of contribution, and there was a daily routine of both work and leisure. In the United States in the late 18^th century, Benjamin Rush, eminent physician and humanitarian, developed humane approaches to treatment. He required hospitals to hire intelligent and sensitive attendants to work closely with patients, reading and talking to them and taking them for walks.

The 1920s saw the development of the residential living and learning communities such as Father Flanagan’s Boys’ Town in the USA, Homer Lane in England, and Aicorn in Austria. In England, these programs for disadvantaged youth were called Q Camps (for Quest and Query) and practiced “Planned Environmental Therapy” developed by the psychiatrist Marjorie Franklin. This therapy was based on identifying the healthy aspects of a person in an attempt at restructuring attitudes and functioning in a residential social and community environment. (Wills, W. D., The Hawkspur Experiment, London, George Allen & Urivin, 1941).

Also in the 1920s, the settlement house movement in the USA was another strength-based movement that influenced the Fountain House treatment approach. Similar to Fountain House-model programs, it related to the concrete needs of people in the local communities. Its emphasis on helping people fulfill the American dream through self-help, empowerment, family, community, support, training, social services and recreational activities had a powerful effect on John Beard through his social work training.

In 1945, in order to treat the so-called shell-shocked soldiers who had served in World War II, two hospitals were set up in England – Northfield Hospital in Birmingham and Mill Hill in London. Under the leadership of Dr. Main at Northfield and Dr. Maxwell Jones at Mill Hill, the strength-based ideas embodied in these hospital-based therapeutic communities gained full expression.

Stuart Whitely summarizes some of the tenets of this treatment in his article The Evolution of The Therapeutic Community. (Italics mine.) “When the leader interacts at the level of the group, his power can be magnified rather than dissipated.” At Fountain House, we call this working side by side. “It is not so much the occupation of the group but the participation in the group activity which is the curative factor.” It’s not the work but the therapeutic processes the work engenders. “Responsibility-sharing and mutual self-help lead to a decrease in passivity and dependence and to the abandonment of the sick role.” Members are asked to help themselves and others and to make choices. “Negative sanctions are less effective than positive reward in changing behavior.” 

Read more about the strength-based approach at Fountain House.

Unfortunately, the ideas developed in the therapeutic community movement failed to gain full realization because of conflicts between proponents of a strength-based treatment approach and the proponents of the psychotherapeutic treatment approach. Later, an offshoot of the therapeutic community, called milieu therapy, would have a powerful effect on Dr. Arthur Peirce - John Beard’s supervisor at Wayne County hospital in Eloise, Michigan. There, in 1950, they practiced AGT, the immediate forerunner of the Fountain House strength-based treatment approach.

The next element in this series looks at the influence of the Humanist Psychologists of the 1950s on the evolution of the Fountain House strength-based treatment approach.

Julius Lanoil
Consultant, Education and Wellness Consultant, Fountain House
 

I have been in Weight Wise, which meets on Tuesdays and Thursdays at 3 pm, for four weeks. I decided to go to Weight Wise to try to lose some weight. I have tried to lose weight many times using different programs and crash diets. None of it worked.

I think Weight Wise is different in that it teaches healthy eating, which is really important. The physical activity has been the hardest part for me, but I am getting better and taking the stairs at my house. I have been losing weight every week and feeling healthier.

I have earned over 100 Weight Wise points and expect to go to the next level in 3 weeks. This is very exciting to see something actually work for me. I find support from the other people, especially Louis, who was the first to get to Level 2, very inspirational. I look forward to continuing my healthy eating and doing more exercise.

Dawn Jackson
Wellness Unit, Fountain House