Op-Ed: Eight Weeks to Recovery From a Mental Health Crisis

Fountain House, a unique program in New York City, helps young adults living with mental disorders like depression, bipolar disorder, and schizophrenia get their lives back.

Fountain House offers help for young adults dealing with depression, schizophrenia, bipolar disorder, and other mental illnesses.

A new report found that 20 percent of adults ages 18 to 25 were dealing with a mental health condition like depression or schizophrenia in the last year. Of those, over one million had trouble functioning day to day. Fountain House, in New York City, helps young adults get back on track in a unique eight-week recovery program. (Getty Images/LeoGrand)

Elliott Madison leads Fountain House's Horticulture Unit and holds advanced degrees in anthropology.

Maybe you caught the news this week from the Substance Abuse and Mental Health Services Administration (SAMHSA) that a staggering 20 percent of young adults (defined as those ages 18 to 25) were dealing with a mental health condition in the last year. Of those, some 1.3 million had a disorder so serious that they had trouble functioning day to day. This is good news in that young adults are now being diagnosed earlier so they can start treatment before losing too much time to the illness. Over the last 20 years, I’ve been impressed with the success of early diagnostics for these young people.

What has largely been missing, though, is an intervention to help these young people get back on track (what we in this field call social rehabilitation). I’ve worked at Fountain House, a leading recovery center in New York City for people with mental illness, for 14 years as a program developer and supervisor. Fountain House has always been at the forefront of innovative community mental health initiatives, so it was only natural that we would try to fill this pressing need. It is distressing to see young people 16 to 25 who are just starting their adult lives get derailed, demoralized, and stigmatized by the onset of mental illness.

Most psychiatric disorders first manifest during this important transitional phase, seriously disrupting people’s lives. Many young adults are forced to interrupt their education, lose their social networks, and are faced with the fear of being diagnosed with a mental illness and living with the stigma it carries. It is easy for these young people at the beginning of their adult lives to become discouraged, hopeless, and isolated.

Young adults experiencing mental illness for the first time have many obstacles to overcome in seeking support from traditional mental health programs. First, they often lack needed benefits to afford effective mental healthcare (e.g., clinical services like regularly seeing a counselor). Second, young people frequently receive incorrect and/or multiple diagnoses, so they may not even be eligible to participate in programs designed to help people with mental illness. Adolescence is a transitional period, and it can be difficult to tease out an emerging illness from other behavioral or adjustment problems. Lastly, they are often isolated and ashamed of their illness, so reaching out for help becomes very difficult. 

Young people frequently receive incorrect or multiple diagnoses, and often lack benefits to afford effective mental healthcare.

The new UNITY (Understanding, Networking and Integrating Transitional Youth) project came out of Fountain House’s commitment to providing effective recovery for youth with depression, bipolar disorder, and schizophrenia. This new program specifically caters to young people who have recently experienced a mental health crisis. The UNITY project was created to reach out to these young adults and help them connect to resources and support to continue on to achieve their goals.

When we created UNITY, we made it a point to lower the threshold to admittance so young adults could easily and quickly begin to receive much-needed support. We don’t use a complex and lengthy intake process; the online application is so simple that young adults can fill it out themselves in 30 seconds. Rolling admission allows applicants to start the program within a few days of completing the application, thus getting them connected before they change their minds or become discouraged. Fountain House funds the project entirely, so participants don’t need to have any health insurance to join the free program.

We also know that lengthy programs don’t work for young adults who are eager to move on with their lives as soon as possible; thus the UNITY Project is only eight weeks long. Much can be accomplished in this short but intense timeframe. The goal is to connect every participant to a support system that can be accessed throughout recovery. For some, this might be membership to a program like Fountain House; for others it might be getting back to school and enrolling with the mental health services provided on campus; while other people might be best served by finding a suitable mental health residential program. The goals are generated by the participants with an eye toward realistic, short-term interventions that can have lasting results.

For example, one young woman, Isabella (not her real name), 19, came to Fountain House's UNITY program through her foster care residence. She wasn’t receiving proper treatment because she had been given several different diagnoses in her mid- teens, due to a substance abuse problem at that time. Additionally, she wanted to go to college, but she only had an IEP diploma, a diploma granted in a variety of special-needs situations but that isn’t recognized by colleges and universities. While in the UNITY program, we connected her to good clinical care at The Sidney Baer Center, where she was diagnosed with schizophrenia and prescribed medication that alleviated her psychiatric symptoms. We also referred her to an alternative high school, where she could complete the course work she was lacking for college admittance. At a recent UNITY reunion Isabella told us that she would finish high school this June and that she has already been accepted as a freshman at LaGuardia Community College for the fall.

More than 300 programs around the world have been modeled on Fountain House's unique clubhouse approach.

Fountain House's UNITY is unique in that it’s a hybrid of professional mental health services and peer support. Participants have ready access to trained social workers and clinical services from psychiatrists. Each participant is also assigned a peer-mentor—another young person who has successfully managed their own mental illness; these peers meet weekly with participants to provide support, inspiration, and guidance through the entire eight-week program.

UNITY is not only one-on-one support; it creates a social network for the participants. By socializing, cooking, and eating dinner together before meeting with their mentors or social workers, they can build friendships with people who understand and face the same challenges. During their eight weeks with UNITY, they work to reach their goals, become integrated into a social and understanding community, and connect to the support they will need to further their recovery and life’s ambitions.

More than 300 programs around the world have been modeled on Fountain House’s unique clubhouse approach, 195 of them located in the United States. We envision that, as awareness of the UNITY Project grows, these organizations will develop similar initiatives to help young adults more easily access the support they need to build healthy, productive lives.  

What sort of support or other resources do you think young people with mental health disorders need most? 


Elliott Madison has worked as a social worker at Fountain House for 14 years. He is a program developer and supervisor, and currently leads Fountain House's Horticulture Unit. Elliott previously worked as a researcher at the National Institute of Mental Health. He holds advanced degrees in anthropology. TakePart.com


These are solely the author's opinions and do not represent those of TakePart, LLC or its affiliates.


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