A social path to mental recovery

Mental health and the treatment of mental illnesses are difficult topics in all societies, regardless of their level of financial development. Debate ranges from how institutions should be funded to what sort of treatment should be favoured, and there are clearly and painfully no right answers. In a country like Argentina, where mental health can teeter dangerously close to a political football, like so many other issues, definitions are particularly murky.

However, a charity that has been finding its feet in Argentina after successful implementations around the world offers an entirely different approach. Founded in the United States in 1948, Fountain House establishes bases in communities to provide an outlet for individuals struggling with mental illnesses. The role of Fountain House is not to provide treatment, as its representatives are quick to stress, but to enable sufferers to participate in a productive environment.

The charity began in New York with a centre or “club house” dedicated to local sufferers, but has since expanded to 341 locations around the world. The Clubhouse Model, as described by Fountain House representatives, encourages persons suffering from mental health conditions to enter the clubhouse voluntarily, as a “member.”

“Within the clubhouses, we provide training in specialized units, focusing on providing our members with the means for living in the outside world,” said Beatrice Bergamasco, International Coordinator for Clubhouse Development, in a presentation given by Fountain House in Buenos Aires in August. According to Bergamasco, Fountain House now caters for over 100,000 members around the world.

A Fountain House member was able to recount hands-on experiences of how the clubhouses work. “We open our doors at 8.30am, and we close at 5pm. Nobody gets to stay the night. When you’re with us, we encourage work. If you don’t want to work, that’s OK, but we try to encourage that our members do something productive for the house, including cooking meals for other members,” said Mario Pinot, a member of the New York establishment.

In the US, Fountain House has seven areas in which members can work, or “units”, which range from Culinary to Horticultural, but also from Clerical to Educational, where members can participate in the education of their peers. The age limit for members is between 18-65, and Pinot stressed that the role of the clubhouses is not to provide treatment. “We are not doctors, and we do not focus on treatment. At the clubhouse, we treat everybody as an individual; it is not up to us to differentiate based on illness.”

The Buenos Aires event was designed to present the progress made by Fountain House in Argentina over the last five years, including the establishment of the first clubhouse: La Casa del Paraná, in Rosario, Santa Fe.

In the words of Viviana Romano, the director of Casa del Paraná, “the focus of what we do is on looking at how each person wants to recover. We work together, as a team, and we motivate each other’s growth.”

Casa del Paraná has a particular focus on participation: meetings with the relatives of members are held once a week, while volunteers from the Universidad de Rosario’s Political Sciences degree programME lend a hand to Romano and her colleagues. With less than 20 members, there is a waiting list of 110 suitable candidates but a lack of physical space is restricting the Casa del Paraná’s possibilities of growth.

INVESTING IN RECOVERY

One issue of particular relevance is the relationship that the charity has with the state, and Fountain House itself is no stranger to state support. Funding in the US is divided equally between public subsidies and private donations, although this does not make the charity immune to cuts, as with all mental health institutions.

“From where I live in New York State I used to be able to see three mental health hospitals. Over time, all have been closed,” said Alan Doyle, Director of Education for Fountain House. “We try to fill the gap that society is no longer capable of filling.”

In Argentina, at least for the time being, Casa del Paraná and its sibling in Gualeguaychu, Entre Ríos, are entirely dependent on private funding. Romano, who started working with Casa del Paraná on a part-time basis before devoting herself entirely to the project, admitted that in order for the charity to grow in Argentina, funding is required.

However, Romano was also able to articulate the positive impact that the charity had on the members who participated. Through working together with local businesses, the Casa director said that it had been possible to find work for members in the local community. “It’s really about preparing people who suffer from mental illnesses to enter the workplace. Our goal is to assist our members with their recovery and their re-integration into the community,” said Romano.