Jay McGill didn’t think he could answer the phone. He wouldn’t be good at it: He was quiet and shy, far from the self-assured type who could hold a conversation with a stranger without a second thought. He said as much to the team at Fountain House—a support and recovery community he’d recently joined—after being asked to take on phone duty. But the other members and staff were determined to see him push through his nerves.
“They said, ‘Well, you know, we’ll help you . . . . It’s nothing to be ashamed of,” says McGill. “So, somehow, I persevered, and I got through it. And I think everyone was so proud to say, ‘Oh, Jay, you did it!’ And I was like ‘Yeah, I know! I don’t know how I did it, but I did.’ ”
By the time McGill became a Fountain House member in 2023, he’d been trying to persevere for much of his life. He’d lost a parent in childhood, and experienced homelessness as a teenager. He struggled to cope with mental health challenges, and had spent time in clinical treatment programs before arriving at Fountain House. When he first walked into the Bronx location to pick up a membership application, he recalls, he was shocked to find that the person who greeted him wasn’t staff, but a member of the program.
“I was like, ‘That’s kind of unusual,’ ” says McGill. “Because at the program I came from, you were just a client. They told you, ‘OK, you take these pills; you have this diagnosis. We don’t expect much of you . . . . We’ll tell you what to do, and when to do it.’ ”
Fountain House’s history dates back to 1943, when a group of psychiatric patients at New York’s Rockland State Hospital formed a “self-help” club, where they socialized and offered one another emotional support. After being released from the hospital, a handful of the group’s original members continued organizing meetings under the name WANA—short for “We Are Not Alone.” The group expanded as more ex-Rockland patients began attending meetings, and eventually, with the help of a Rockland volunteer named Elizabeth Schermerhorn, they secured a permanent location: a brownstone in the Hell’s Kitchen neighborhood of New York City, which came with a garden that had its own fountain.
Since its official incorporation in 1948, Fountain House has pioneered a type of psychosocial rehabilitation now known as the “clubhouse model”—a nonresidential community-led space where people living with serious mental health challenges can not only access services like care referrals, transitional employment placements, and educational support, but can also find social community through the collective work of operating the club and its facilities. It now serves more than 2,500 people across all of its clubhouses, including three New York City locations—in Hell’s Kitchen, Harlem, and the Bronx—and a new clubhouse in Hollywood, California. The model has been taken up by other organizations across the world; Clubhouse International, a global network of clubhouses, lists more than 370 member clubhouses across thirty-two countries, including more than 250 in the United States.
Fountain House’s flagship clubhouse occupies a large building nestled away between 9th and 10th Avenues in Midtown Manhattan, just across the street from the brownstone where the organization first began nearly eighty years ago. When I searched the address on my way to tour their facilities a few months ago, the Google Maps result labeled it as a “mental health clinic.” But inside the brick façade lay an environment entirely unlike anything I would even think to describe as “clinical.”
The clubhouse is labyrinthine: six and one-half floors, a sprawling procession of rooms unfolding like a chain of handkerchiefs, and large common areas with tall windows that cast long columns of bright midday light throughout the space. Every room bustles with the collective purpose of an ant colony. Some spaces, like the reception area, basement cafeteria, and mailroom, echo with chatter. Others, like the upstairs gym, library, or backyard garden, are quieter. Some members sit placidly outside by themselves, surrounded by the lush plant life in the garden, or do puzzles together in a common area.
But most move through the space with a brisk confidence. There’s work to be done: They have mail to sort, phones to answer, carrots to chop, newcomers to show around. Still, no one seems too busy to greet one another as they pass through the halls. Everyone seems to know everyone else’s name—a tall order given how many people pass in and out of the clubhouse each day. When I point this out to Yusselffy Denizé, a veteran staff member of more than two decades who now directs the Bronx clubhouse, she laughs, and replies, “We’re all like Norm from Cheers!”
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Two Fountain House members sit in the terrace garden at the Hell's Kitchen clubhouse.
To help run the clubhouse, members are assigned to one of several “units,” where they have a hands-on role in the community’s day-to-day operations and decision-making. In the communications unit, members work on their weekly newspaper, The Fountain House Times, as well as The Fountain Pen, a quarterly literary magazine that features members’ poetry, short prose, and visual art. The communications headquarters houses a publication archive that stretches back decades—as I pass through on my tour, a member tells me they’re in the process of digitizing all of it.
Meanwhile, at the culinary unit, members are busy sorting and prepping vegetables for the kitchen team to use in the day’s meals. The produce comes from Fountain House’s sustainable in Montague, New Jersey, roughly seventy-five miles outside New York City, where visiting members grow food and tend to the chickens, goats, and other livestock. A member of the horticulture unit tackles wilting leaves in the “plant hospital” near the windows; an employment unit member updates the list of current openings in Fountain House’s transitional employment program, which matches members with temporary outside job placements through partner organizations. Bulletin boards in the common areas advertise this week’s social events and activities, which include an open mic, a scavenger hunt, and a paint and sip. As I wander through the facilities, each person I encounter is eager to tell me what they’re up to and why. It’s hard to differentiate the members from the staff; no one wears a uniform, or anything else that would identify them one way or another.
“There’s these nonhierarchical relationships,” says McGill. “Everyone is side by side. It promotes this egalitarianness that you probably won’t find anywhere else. And it took me a while to get adjusted to that, because I had become so used to being the person with the diagnosis, who doesn’t do anything, who thinks he can’t amount to anything.”
Since joining Fountain House, McGill has completed his bachelor’s degree in sociology, and is now a master’s student at the University at Buffalo. On top of his studies, he serves as a community advocate for Fountain House, helping the organization stay abreast of federal and state mental health policy, educate mental health care professionals about clubhouses, and respond with member input to issues that affect the community. Looking back to his first day answering the phones, he says, “I’m actually doing things I never thought I would be doing before.”
As the oldest and largest clubhouse organization in the country, Fountain House occupies a unique position within the mental health care landscape. But the tenets of the clubhouse model—of social community and collective self-determination as a foundation for recovery from mental illness—belong to a long tradition of radical healing communities thriving in times of political and economic turmoil. During World War II, while psychiatric patients at many French institutions were dying en masse from starvation and illness, one rural hospital at Saint-Alban became a thriving “asylum-village,” where psychiatric patients lived and worked communally alongside Jews and anti-fascists who sought refuge there. The Italian psychiatrist Franco Basaglia found similar success in the 1960s and 1970s with his implementation of the “Trieste model,” which transformed state mental hospitals from sites of torture and neglect to vital communities in which the hierarchy between staff and patients broke down as they ran the institution collaboratively.
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Fountain House Silver Center members participating in a chair dancing session.
These institutions were in many ways unabashedly political projects, helmed by radical psychiatrists who located the primary causes of mental illness in society rather than an individual’s biology or moral character. By integrating patients into purpose-driven social relationships with others who had faced similar struggles in the outside world, these communities offered patients refuge from a social order that had deemed them broken and afflicted, and invited them to instead see themselves—perhaps for the first time—as capable, respected, and valued. Fountain House is in some ways a very different operation—it’s nonresidential and located in the middle of the city rather than a secluded area far from the outside world. But its members describe a similar impact on their sense of self.
“I became part of a community that understood what I was all about, without me having to go into a lengthy explanation and talk about the illness,” says Cyrus Daniel Napolitano, a Fountain House member of seventeen years who now serves as the co-director of the New York Clubhouse Coalition. “I define myself through the relationships that I’ve been able to develop since I became part of the community, and also the work that I do. That’s what I see when I look in the mirror—I don’t get up in the morning and say, ‘Oh, Cyrus has X, Y, and Z.’ ”
At a time when serious mental health challenges are becoming more prevalent and homelessness is at an all-time high, many city and state governments have sought to expand their power and capacity to involuntarily institutionalize people living with severe mental illness, particularly those who are unhoused and sheltering in public. The Trump Administration has eagerly embraced this strategy, calling for “maximally flexible civil commitment” in a July 2025 Executive Order titled “Ending Crime and Disorder on America’s Streets.”
McGill and Denizé tell me that many Fountain House members have experienced the vicious cycle of institutionalization and abandonment, bouncing between involuntary hospitalizations, the criminal justice system, and homelessness. Without social supports in place, Denizé says, hospitalizations are just another step in the cycle, rather than an intervention against it. “You can hospitalize folks for a number of weeks, a number of months,” she says. “It’s going to cost much more money, then you’re going to put them back in the streets. And then what?”
As a mental health counselor who has seen many members find their place in the community, Denizé says she believes that social ties are the key to breaking traumatic cycles. “I remember meeting with a nurse a couple of years ago who used to work in a shelter,” she says, “and she mentioned how she had a lot of her clients who, once they move on into their own apartment, would end up coming back. And she asked them why, and they said, because they had a community in the shelter, you know, they’d made friends. They were able to make connections with people, whereas when they moved into their apartment, they were by themselves. I think that’s a huge aspect that’s lost a lot of times: Everybody wants to be a part of something. Everybody wants to be a part of a community where they’re wanted and needed.”
For radical asylum communities such as Trieste and Saint-Alban, the ultimate goal was not simply to return patients to the broader society, but rather, to transform the broader society to better resemble the one they’d created within the hospital. In this same spirit, Fountain House has found ways to embed itself in the surrounding community through what it calls “social enterprise”—ways to engage with the general public and make money for the organization while also supporting the members. Since 2019, it has operated a brand called Fountain House & Body, which sells candles, essential oils, soaps, and other home goods made in-house. Its storefront is housed in a coffee shop two blocks from the Hell’s Kitchen clubhouse, and staffed by Fountain House members; but to customers, it’s just a regular café along 10th Avenue.
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A Fountain House member stands in front of a memorial wall at the Hell's Kitchen clubhouse.
Just two blocks in the opposite direction is the Fountain House Gallery, an exhibition space for artwork created by Fountain House members. It operates much like any other small Manhattan gallery, mounting several curated shows each year for the public, with a portion of works for sale benefiting the organization. When I visited in August, the gallery had recently opened a show with a party theme; the walls were filled with bright colors, twisted silhouettes of bodies in motion, and depictions of discos and birthday balloons. I gravitated toward a striking tribute to Prince by the artist Susan Spangenberg, who sews cloth “Asylum Dolls” depicting real and fictional mentally ill people, with their own words emblazoned across the torsos or limbs. Her craft, she writes in the exhibition text, is an act of “taking my life back” from an abusive parent who disapproved of her creativity.
Art and creative expression have been central to the radical healing communities of generations past—including the asylum-village at Saint-Alban, which nurtured the outsider art tradition now known as art brut. The art and writing on display in the Fountain House Gallery, and in The Fountain Pen, is richly varied; throughout the members’ work, profound meditations on loss, redemption, and rediscovery sit just beneath the surface of everyday observations. In one poem published in the Spring 2025 issue titled “The Girl in the Paper Dress,” poet “Elizabeth Levine, M.A., M.P.H., M.F.A., describes a South Florida jail cell with an epic rage that gradually simmers to a devastating final image of a fellow inmate on suicide watch: “I offer her my warm back / in the shape of a silver spoon / stronger than her confession / keeps the fire lit within us.”
For many people living with significant mental health challenges, it can be difficult to maintain a stable sense of identity and self-expression—the mental health care system is often quick to pathologize, and patients frequently face pressure from clinicians to avoid being seen as “noncompliant.” In this regard, the day-to-day life of the clubhouse itself feels like a collaborative act of self-expression. At one point during our conversation, Napolitano tangentially describes the clubhouse’s evergreen task—to build and maintain the clubhouse’s many functions, while also convincing others in the mental health care world of its radical potential—as akin to Michelangelo sculpting David out of marble. “In all his naked glory!” he says, with a booming laugh. “Just chiseling away, and creating a masterpiece.”
But as much as clubhouses may feel like outposts of a radical future, they are tethered, like everything else, to the myriad political and economic threats of the current moment. The Trump Administration’s continual attacks on the social safety net, including SNAP benefits, Medicaid, and housing support, pose an existential threat for Fountain House’s vulnerable members—and its threats to slash federal support for mental health and substance treatment programs has left the entire sector in a state of uncertainty.
“I think all of this uncertainty and this anxiety and fear is only going to exacerbate the problem,” says Napolitano, “and create a never-ending cycle of people moving in and out of an institution, whether it’s a hospital, or a jail, or a prison, or a psych ward, or being on the street. You have to have a social safety net; you have to create a pathway to success. Right now they’re pulling that pathway out from under the feet of tens of millions of people.”
But amid the Trump Administration’s grim vision to replace the country’s collapsing mental health care infrastructure with a return to the era of mass institutionalization, Fountain House has benefitted from city- and state-level efforts to fund preventive and community-based mental health programs. Under Democratic Governor Kathy Hochul, New York State increased funding for mental health care by $1 billion in its 2024 budget, including funding for clubhouses. That same year, New York City awarded Fountain House a $106 million, ten-year contract—though the move coincided with consolidation cuts for some smaller clubhouses in the city. In November 2025, newly elected New York City Mayor Zohran Mamdani—who referenced Fountain House during his campaign as a model for addressing the needs of New Yorkers with serious mental illness—appointed its chief executive officer, Ken Zimmerman, to his transition team.
Napolitano says it is imperative that clubhouses expand to meet the rising demand, and educate mental health care providers and the general public about the clubhouse model. “We want to show [clubhouses] to the world,” he says, “including to the psychiatrists and other mental health professionals who think that, for people with schizophrenia and bipolar disorder in particular, recovery is impossible. [We] show them a place where it actually happens, and you see their eyes go”—as his eyes pop wide open—“like this!”
But for all of the uncertainty—good and bad—it’s business as usual at the flagship clubhouse on West 47th Street, where I left my tour carrying several copies of The Fountain House Times and The Fountain Pen to peruse on the subway. In a short prose piece from last year titled “Small Changes at Fountain House,” a member named Joshua Horwitz describes the complicated feelings that accompany gradual progress. Once, he says, the walk from his bedroom to the living room felt overwhelming—now, he’s doing better, but must navigate what sustained growth and healing will look like in the long term.
“I wonder what will become of me here,” Horwitz writes, “and I have to be OK with not knowing. I have to trust that magic is happening here every day, or else I’m back to sarcasm and a slow death. For all this, I’m deeply grateful.”