A Response to "Expert Interview With Stephen R. Marder, MD"
To the Editor:
I read with great interest the interview of Stephen R. Marder, MD, with Medscape. I am in particular agreement and support with Dr. Marder's view on how "psychiatrists may be underestimating the ability of people with schizophrenia to function in the community" and that "patients are asking to be able to return to work, to return to school."
I was, however, somewhat taken aback by the statement that Dr. Marder made, in response to the question, "Do you know of any community or country where a recovery model has been successfully implemented?" -- "No, I don't." I believe, as do many of my colleagues, that a number of successful recovery models have been established, particularly in the United States. There are, for example, The Assertive Community Treatment Model (nationwide); The Village (California); Thresholds in Chicago; and the Fountain House Model (national and international).
I would like to focus on Fountain House, which is located in New York City and has sister programs throughout the world, including Great Britain, Scandinavia, Europe, and now Asia. A brief summary of the Fountain House Model follows:
Fountain House is a community-based, comprehensive support system established in 1948 by patients and volunteers from Rockland (NY) State Hospital. The first program of its kind in the United States, the Fountain House's innovative and consumer-centered model for recovery has been replicated throughout the United States (with financing from the National Institute for Mental Health, which to this day considers this replication to be the most successful ever funded by them) and abroad. Since 1948, Fountain House has pioneered and developed extensive programs for facilitating the social and vocational adjustment of men and women following hospitalization in public and private mental hospitals and has served over 17,000 individuals through a comprehensive array of accessible, integrated, and long-term systems of care.
Over 40 New York City businesses and industrial firms provide part-time work opportunities for more than 140 participants each day through the Fountain House Transitional Employment Program. Participants earn the going wage rate on all jobs, which in all instances is higher than the minimum wage, ranging up to $14.29 an hour. There is a clear correspondence between participating in the Transitional Employment Program and: (1) obtaining independent employment; and (2) maintaining independent employment. At the end of the 42 months of the research project, 36% of the 527 persons with mental illness were independently employed, while an additional 7% were employed through Transitional Employment, for a 43% employment rate.
Fountain House also provides housing services for over 450 members, with almost 50% of them living in independent (supported) housing.
In terms of success, track record, and recognition, Fountain House has, over the years, been the recipient of many awards for excellence in the field of psychiatric rehabilitation. Perhaps the most relevant to this constituency is the 1999 American Psychiatric Association Gold Achievement Award.
To the Editor:
I read with great interest the interview of Stephen R. Marder, MD, with Medscape. I am in particular agreement and support with Dr. Marder's view on how "psychiatrists may be underestimating the ability of people with schizophrenia to function in the community" and that "patients are asking to be able to return to work, to return to school."
I was, however, somewhat taken aback by the statement that Dr. Marder made, in response to the question, "Do you know of any community or country where a recovery model has been successfully implemented?" -- "No, I don't." I believe, as do many of my colleagues, that a number of successful recovery models have been established, particularly in the United States. There are, for example, The Assertive Community Treatment Model (nationwide); The Village (California); Thresholds in Chicago; and the Fountain House Model (national and international).
I would like to focus on Fountain House, which is located in New York City and has sister programs throughout the world, including Great Britain, Scandinavia, Europe, and now Asia. A brief summary of the Fountain House Model follows:
Fountain House is a community-based, comprehensive support system established in 1948 by patients and volunteers from Rockland (NY) State Hospital. The first program of its kind in the United States, the Fountain House's innovative and consumer-centered model for recovery has been replicated throughout the United States (with financing from the National Institute for Mental Health, which to this day considers this replication to be the most successful ever funded by them) and abroad. Since 1948, Fountain House has pioneered and developed extensive programs for facilitating the social and vocational adjustment of men and women following hospitalization in public and private mental hospitals and has served over 17,000 individuals through a comprehensive array of accessible, integrated, and long-term systems of care.
Over 40 New York City businesses and industrial firms provide part-time work opportunities for more than 140 participants each day through the Fountain House Transitional Employment Program. Participants earn the going wage rate on all jobs, which in all instances is higher than the minimum wage, ranging up to $14.29 an hour. There is a clear correspondence between participating in the Transitional Employment Program and: (1) obtaining independent employment; and (2) maintaining independent employment. At the end of the 42 months of the research project, 36% of the 527 persons with mental illness were independently employed, while an additional 7% were employed through Transitional Employment, for a 43% employment rate.
Fountain House also provides housing services for over 450 members, with almost 50% of them living in independent (supported) housing.
In terms of success, track record, and recognition, Fountain House has, over the years, been the recipient of many awards for excellence in the field of psychiatric rehabilitation. Perhaps the most relevant to this constituency is the 1999 American Psychiatric Association Gold Achievement Award.