by Jeanyung Chey
Department of Psychology, Seoul National University
On a snowy day last February, I visited Fountain House in New York City to meet Jeff Aron, Director of External Affairs. I am a clinical psychologist from Seoul, Korea, and this was my second visit to Fountain House. Although my first visit in 2014 was motivated more by my research interest in rehabilitation programs for individuals with serious mental illness, I had been impressed with how members' need for care and structure was well balanced with their pursuit of individual interest and freedom. So on this visit, partly due to my new responsibility as a Secretary of External Affairs of the Korean Psychological Association, I wanted to learn more about the Fountain House community-based model, since South Korea’s mental health system is faced with pressures to deinstitutionalize.
According to the Organization for Economic Co-operation and Development (OECD) reports, South Korea is one of the countries that heavily relies on hospitalization for the care of people with serious mental illness. Despite passing of a law in 2016 to make forced hospitalization more difficult, the number of hospitalized individuals with mental illness has not decreased. Most tragically, however, on New Year’s Eve, a dedicated psychiatrist was killed by his patient during a follow-up session in an outpatient clinic in Seoul which was preceded by a lengthy period of no contact. This has ignited a debate, perhaps controversial, on the need and methods of enforced hospitalization and treatment in South Korea, mainly to ensure a safer environment for both mental health professionals and patients. Forced hospitalization and treatment is not being welcomed by individuals with mental illness as well as mental health professionals who wish the country would go forward in the direction of deinstitutionalization.
Upon arrival at 10:30am at the lobby of Fountain House, a member greeted me with enthusiasm and took me on a very informative tour of the house for an hour. Our first stop was the kitchen run by both members and staff, serving lunch during weekdays and dinner on weekends, a great source of well-being physically as well as psychologically, I thought. As we moved from one unit to another, I found myself enjoying the paintings and art pieces done by members, hung on walls and displayed on tables throughout the house. Having studied fine arts in youth, I could imagine how art activities in the Fountain House studio could serve as a great resource to the members who can express their feelings and thoughts through arts and crafts. And the separate gallery nearby Fountain House that exhibits art works done by the members, I thought, is a great way to express and communicate members’ inner stories with others, especially with residents of the larger community.
The wellness center, where members can learn to cook, join groups for walking, running, yoga, meditation, and smoking cessation, was very impressive, and offered much needed skills to lead a healthy lifestyle for people who might have had their lives interrupted by serious mental illness for a significant portion of their early adulthood. I was, however, most impressed with how collaborative the house was run by both members and staff.
My meeting with Jeff after the tour, was blessed with drop-in short discussions with Program Director Elliott Madison and President Kenn Dudek, whom I met four years ago, to discuss the common denominators for a successful community-based mental health care system and what is unique about Fountain House that made it so popular around the world. The leadership explained the Fountain House model as a community-based network for people with serious mental illness that puts collaboration between members and staff as the cornerstone of its existence and success. This enables the members to grow their various potentials in a safe environment that allows them to be an active participant in programs and further leaves room for development of rehabilitation and training programs that would suit members’ needs. The community-vibe of the place was another feature, I thought, would be important for a successful community-based mental health care system. This was best-capture by Elliott’s analogy of Fountain House being a safe harbor for people with mental illness, which would ease the process for members transitioning into the larger community.
As a mental health professional and a teacher in South Korea, longing to see successful deinstitutionalization in our country, I will share this visit with my students, colleagues, and policy makers, so that we, as a country, can reassess our priorities and resources in mental health system in order to make meaningful progress toward deinstitutionalization, which would better serve people with mental illness in the end.