MICHEL MARTIN, HOST:
An exclusive new clubhouse is flourishing in Hollywood. Like all clubhouses, it offers members a place to hang out. But this club is unique. To join, a member must have a serious mental illness. Renee Montagne has the story about Fountain House Hollywood, and here is where I want to let you know that this piece contains a reference to suicide.
RENEE MONTAGNE, BYLINE: When I first visited the clubhouse, what struck me the most was the hum of activity.
UNIDENTIFIED PERSON #1: Hi, how are you doing?
UNIDENTIFIED PERSON #2: Good. How are you?
UNIDENTIFIED PERSON #1: All right. Here you go.
UNIDENTIFIED PERSON #2: Thank you.
UNIDENTIFIED PERSON #1: Thank you.
OK. Are we ready, folks?
UNIDENTIFIED PERSON #3: Let's do it.
UNIDENTIFIED PERSON #1: All right. Welcome to the Fountain House Hollywood meeting. Who will be the conversation wrangler?
MONTAGNE: Metings are important at Fountain House Hollywood because the members run the clubhouse. That means signing up for an array of jobs, cooking meals, shopping, organizing field trips. It's what Fountain House calls a work order day, and it brings structure, support and companionship, something that severe mental illness has stolen from them.
JILL SANTORO: It's three words - community is therapy. And it works.
MONTAGNE: Jill Santanero (ph) is the clubhouse director. She's one of a tiny support staff, just three altogether. They mingle comfortably with the more than 100 members who can come any day of the week. This clubhouse model of community-based mental health care was, in fact, started 75 years ago by a group of former patients in Manhattan. Over the years, hundreds of such clubhouses have spread worldwide. This morning, Fountain House Hollywood member Gennaro Simeon is giving me the tour.
GENNARO SIMEON: We have our newsletter here, Fountain House Times here that we print up from this area here. And this gentleman over here, Mark Logan, has made a book. He'd written a book about his personal life.
MARK LOGAN: It's called "Hard Pill To Swallow: My Manic Memoir."
MONTAGNE: Mark Logan has a vivid memory of the day his bipolar disorder emerged with a bang.
LOGAN: Yeah. Back in 1991, I stopped drinking alcohol, and six weeks later, found myself getting arrested in a bank wearing a black leather jock strap and a pink Easter bonnet.
MONTAGNE: Logan spent the next five weeks in a psych ward being treated for psychosis. His self-published memoir is a head-spinning tale of chaos - chronic homelessness, drugs, dozens of arrests, even another attempt at bank robbery, also in drag, this time landing Logan in prison. In the end, he destroyed virtually every relationship. My diagnosis, he writes, became a curse for the rest of my life.
LISA WONG: I'm Dr. Lisa Wong, and I am the director of mental health for the county of Los Angeles.
MONTAGNE: Her department services a quarter of a million residents, including more than 15,000 homeless who report that they are living with severe mental illness. Wong spent more than 20 years providing care on LA's Skid Row. Over and over, she says, the clinicians would observe that those outpatients who scored high for debilitating illnesses like schizophrenia and bipolar disorder did improve, yes, when provided with medication and shelter.
WONG: Which was great. That's what we were hoping for. But six months down the road, upon retesting, you see a different score spike, and that would be depression because now we're dealing with somebody who may have an amelioration of their psychotic symptoms but is finding themselves not connected, no meaningful activity, even if they have a roof over their head and food to eat.
MONTAGNE: So when Lisa Wong was named head of the Department of Mental Health two years ago, her first thought was to bring a Fountain House to Hollywood.
WONG: It doesn't, though, take the place of outpatient services like medication and therapy and case management and those kinds of things. But I think the clubhouse model is so essential in taking people to the next step to where they actually are entering into recovery and not just surviving.
GEORGETTE DARBY: They want you to be a success. They want you to be independent.
MONTAGNE: Georgette Darby was among a handful of original members who advised Fountain House in New York on its new Hollywood clubhouse. In her 50s, Darby lost her job as a legal secretary. Then a few years of couch surfing exhausted even her closest friends until finally...
DARBY: I became homeless, so I would be downtown, walking the streets downtown with my suitcase or either catch the bus and ride the bus all night. So I said to myself, I can't do this [expletive] no more. I can't. I just wanted to die.
MONTAGNE: Georgette Darby walked in front of an oncoming bus. That attempted suicide opened the door for a diagnosis and treatment of her major depressive disorder plus the supportive housing she was desperate for. Yet, it wasn't until she became part of the clubhouse that she started to flourish.
DARBY: Before Fountain House, I really wouldn't go out. I would just be at home. I look forward to coming here every day because it gives me a sense of purpose.
MONTAGNE: Karington Wallace is another member who has found a purpose at the clubhouse. His childhood was spent mostly in foster care. Then, a few years ago, in his mid-20s, the voices began.
KARINGTON WALLACE: That's the schizophrenia. That's schizoaffective disorder.
MONTAGNE: Wallace knows the voices he hears aren't real, but even his meds can't completely silence them.
WALLACE: I can't sleep at night sometimes because the air conditioner that I have on won't shut up. It'll keep talking and talking and talking and talking and talking and talking, and I can't cut it off.
MONTAGNE: At Fountain House, he's managed to overcome the noise within him to take on a job helping other members by answering calls.
WALLACE: It's a clubhouse model to have an open channel for a member to call in and talk about their problems or talk about what they're going through and whatever they want to talk about.
MONTAGNE: Mark Logan also has a part-time job, and he's learned how to cultivate the kind of supportive relationships that are key to maintaining mental health.
LOGAN: There is one person that I met here at the clubhouse, and we're very good friends now. And we both have the same diagnosis. We understand each other, and we know the warning signs before a full-blown manic episode or a psychotic episode.
MONTAGNE: For all of its members, there is one more feature of the clubhouse model that is key. Once you're a member, you're always a member. Karington Wallace says he'll never leave.
WALLACE: I love the fact that I'm here. I like the fact that I'm surrounded by peers. A lot of us have suffered from abuse. A lot of us has suffered from not having the community that we need. So I think that the fact we have our community now is why it's so precious.
MONTAGNE: Fountain House Hollywood aims to triple its membership in the next two years, and it won't be alone. The LA County Mental Health Department is investing Medicaid dollars into transforming six peer resource centers into full-fledged clubhouses. They will be run by and for their members in the classic clubhouse model. For NPR News, I'm Renee Montagne in Los Angeles.
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