At this Hollywood clubhouse, people with mental illness find purpose and belonging
When Georgette Darby has one of her bad days, she knows what will rouse her from her Hollywood apartment.
"Get your butt up and go to the clubhouse," Darby tells herself.
At Fountain House Hollywood, the 61-year-old has a job to do. Lunch is served Monday through Friday, and Darby, who has strong opinions about making a meal, is part of the crew that prepares it. So she gets dressed — "you can’t just be walking around here in an old funky T-shirt," she tells herself — and heads to an unusual hangout tucked into a Sunset Boulevard office building.
Behind its glassy doors is something rare: A community run by people with serious mental health conditions such as schizophrenia, bipolar disorder and major depressive disorder. Above the front desk at Fountain House Hollywood are emblazoned the words: "You Are Not Alone."
Whiteboards abound listing a flurry of needed tasks. Besides her duties in the kitchen, where onions and meatballs were sizzling on the stovetop on a recent Wednesday, Darby is also on a team focused on mental health advocacy. Others volunteer to water plants, write a weekly newsletter, launder aprons, check on members who haven’t shown up in a while, and shoulder other tasks needed to keep the clubhouse humming.
Darby is free to come and go as she chooses, but she comes at least four days a week.
"I do what I do," she said, "because I don’t want anybody to go through what I went through. I'll say this — I caught hell with a catcher’s mitt, honey."
Such clubhouses are far from a new idea. They were born more than 75 years ago as a way for people leaving psychiatric hospitals in New York to find community. Researchers say they offer connection for people whose social ties may have been broken from the fallout of mental illness. Hundreds now exist worldwide. .
Yet the clubhouse model has not taken off in California as much as in other parts of the U.S., said Dr. Thomas Insel, former director of the National Institute of Mental Health.
"In California we focus a lot on housing and making sure that people have a safe environment to be in," said Insel, who sits on the board of Fountain House, the New York-based organization that helped start the Hollywood site. "But what happens often, for people with serious mental illness, is they get housing and then they’re isolated all day, just looking at the walls."
Local officials said the new site that opened in July, Fountain House Hollywood, is the only one of its kind in Los Angeles — one built on the "Clubhouse International" model pioneered at Fountain House.
It's an idea that had long interested Lisa Wong, director of the Los Angeles County Department of Mental Health. In her years working on Skid Row, Wong said, she saw that newly housed clients might see their symptoms of paranoia or schizophrenia subside only to suffer a new bout of depression.
"They're dealing with loss. They're dealing with trauma. They're dealing with broken connections with previous relationships and with family. It's not enough to just give them the means to stabilize," Wong said. "They really want to have a life beyond that."
Clubhouses, she said, can offer people a sense of meaning and purpose. "You take part in building something."
At a morning meeting at Fountain House Hollywood, members rated how they were feeling on a scale from 1 to 5 and answered a randomly selected question — "If you could relive one day from your past, which day would you choose and why?" — then went through announcements, upcoming events and birthdays. A board was spangled with Polaroids of its members, who numbered more than two dozen as of October.
Clubhouse director Jillian Santoro sees her job as working side-by-side with members, not running the place for them. Members helped vet Santoro for the job, and they review applications for new members.
When Darby and other clubhouse members got their food handler certifications, it was their idea, not hers. When a member needed disability benefits, Santoro said, "I'm not gonna do this for you, but I'll go with you."
That can be a radical change for clubhouse members — and an empowering one. People who have grappled with serious mental illness are often "told where they have to be, when they have to be there, what time, and everything's done for them," Santoro said.
Darby said she had endured trauma as a child that was left unaddressed in her youth. As an adult, her life was upended when budget cuts cost her a longtime job at a law firm. She soon lost her home and car as well.
Darby ended up in downtown L.A., where she was looking for shelter one afternoon before an impending storm. Feeling she was out of options, she walked in front of a bus.
The driver slammed on the brakes and cursed her out. Shaken, Darby sought help, first at a police station and then at a Department of Mental Health office, and ended up in a hospital psychiatric ward.
She began to stabilize, she said, with medication and care. But Darby recalled that at many mental health programs, if you didn't show up or do what you were told, "you lost your place. You had to start all over again."
At Fountain House Hollywood, "you're not forced to do anything," she said. "Once you're a member, you're always a member."
Another clubhouse member, Mark Logan, said Fountain House has given him "a whole new circle of friends."
"And I get to use skills that I'm familiar with and share with other people," said Logan, 61, who has written a memoir about living with bipolar disorder.
He is part of the membership team at Fountain House Hollywood that gives tours, orients new members and writes a regular newsletter, among other duties. When clubhouse members have been hospitalized, Santoro said, the team has gone to visit them and even stopped at their homes to feed their pets.
"They say if you want self-esteem, do esteemable acts. And that's what I try to do," Logan said.
Fountain House says its clubhouses save money by avoiding costs for preventable hospitalizations, unemployment and tangles with the justice system that people suffer without such support. Its researchers estimated such savings at over $11,000 a person.
New York University researchers also calculated its savings to the Medicaid program, comparing Medicaid expenses for people coping with mental health conditions who did and didn't enroll in Fountain House. Their analysis found a cost reduction of 11% from being involved with the clubhouses, although researchers cautioned that the sample size was small.
Yet experts said money has been one of the biggest obstacles to expanding the clubhouses, which tend to flourish where there is steady funding — Michigan, for instance, pays them through its Medicaid program — but such programs have often had to scramble for donations to survive.
In L.A. County, Fountain House Hollywood is receiving $1 million annually under a county contract, with payments hinging on meeting goals such as the number of members the clubhouse serves, Wong said. That money comes from the Mental Health Services Act, funded through an income tax on the wealthy approved by Californians.
The Hollywood clubhouse is also being funded by the Conrad N. Hilton Foundation. And as California pushes for federal approval to fund clubhouses under its Medicaid program, Wong said L.A. County hopes to tap that funding in the future as the Hollywood program grows.
Santoro is also eager for Fountain House Hollywood to move into new digs: a bigger space near the Hollywood Forever Cemetery with an outdoor garden to grow vegetables. Members are already brainstorming possible names for its future cafe. Maybe "Buzz and Banter," or "Fountain Flow."
"When you think of traditional mental health, people are going in and getting fixed," said Francesca Pernice, a Wayne State University College of Education professor of educational psychology who has studied clubhouses.
But at a clubhouse, "they're saying, 'You belong here. You have something to contribute to society, and we're here to work with you,'" Pernice said.
Santoro, listening to Darby recount her story that Wednesday, told her she was thankful that the bus hadn't hit her.
"Because I wouldn't have been able to meet you. And I love you — you know that. And you are a huge part of this community. It would not run like this if you weren't here."
"I just hope I'm able to make a change," Darby replied.
"You already are," Santoro said. "Every day."
This story originally appeared in Los Angeles Times.
