San Antonio Clubhouse, a “beacon” of the growing Fountain House network

On a recent Friday, a visitor walked through the front door of a nondescript building off busy Fredericksburg Street. Noting the absence of a front desk attendant, she followed the sound of conversations in what appeared to be the main room.

“I’m looking for someone who works here,” the visitor asked a young woman.

“Well, everyone works here,” the woman replied with a smile.

She’s right. Everyone has worked at the San Antonio Clubhouse, which has provided its members – people living with mental health issues – a sense of community and volunteer opportunities for 19 years.

“People need to be needed,” said Eric Estrada, executive director of SA Clubhouse, of what the nonprofit provides. “When it doesn’t happen naturally in the community, [this is] a place where people can go where people care, they support you, you are precious and you can do meaningful things. We are creating this little microcosm to make this happen.

The local clubhouse is part of a nationwide network of centers organized under Fountain House, a New York-based nonprofit that aims to improve health, increase opportunity and end the social and economic isolation of people. people living with severe mental illness. There are over 300 clubs around the world, about two-thirds of which are in the United States.

As part of this network, SA Clubhouse has become the premier hub in Texas, training hundreds of mental health specialists and having recently embarked on public policy advocacy.

“The San Antonio Clubhouse is one of our flagship partners because it has a proven track record of innovation,” said Dr. Ashwin Vasan, President and CEO of Fountain House. “You have a very strong community in the San Antonio clubhouse who want to make their voice heard. “

The daily operations of the Clubhouse are provided by paid staff and volunteer members. Daily tasks include entering data, working from the cash register to the snack bar, cleaning the facility, running to the grocery store or bank, maintaining the hydroponic farm, organizing activities and meal preparation.

Staff also help members apply for paid jobs in the community, a key part of recovery, Estrada said. Many have become peer support specialists within the SA Clubhouse staff.

About 30 to 35 members visit the center each day; before the coronavirus pandemic, it was closer to 45, Estrada said. SA Clubhouse has approximately 2,900 members, of which approximately 1,200 are active. Membership lasts a lifetime, regardless of how often members stop. Another 600 people did not become members but received other services.

Anyone with a history of mental illness can register, as long as they are not a danger to others.

Lee Hernandez has been a member of the SA Clubhouse since it opened in 2003 as a program at Travis Park Church (then known as Travis Park United Methodist Church). It keeps coming back for one simple reason: people.

“I love teaching people new things to do… how not to isolate themselves,” he said. “We don’t get anything to isolate. “

For Michael, who joined in October, SA Clubhouse gave him a welcome respite from his struggles with depression.

“I used to have major depression and anxiety, but every time I walk in [here], it looks like I’m just leaving it out, ”he said. “Everyone is nice. “

An alternative approach to mental health emergencies

Earlier this year, SA Clubhouse participated in a national training program for alternative emergency responses to mental health calls that police have consistently responded to. He focused on models used in Eugene, Oregon and Denver that deploy physical and mental health clinicians rather than police officers for low-risk mental health 911 calls.

After this training, the clubhouse produced a report that recommends a similar policy for the San Antonio Police Department. For higher priority and higher risk calls, SA Clubhouse recommended increasing a team of police-ambulance-clinicians with a specialist who has direct experience with mental issues.

San Antonio’s multidisciplinary team approach, which is still in development, will likely include a police officer responding to all mental health calls, although activists are pushing to prevent it.

The clubhouse will serve as a neutral “Swiss” when it comes to such debates, said Estrada, but will always advocate for the well-being of its members and the wider community living with mental illness. “We want to provide the information and the space for these important conversations.”

Meanwhile, Fountain House wants to strengthen its capacity to give local clubs the tools they need to participate in public policy advocacy.

“It’s not that they don’t want to, it’s that they have other responsibilities” associated with operating a nonprofit, Vasan said. “So this is where we come in”, with technical assistance, connections to training programs and analysis of its national network.

Fountain House has a political advocacy team and will soon be establishing a nonprofit 501 (c) (4) political advocacy arm, he said.

“We have to start politicizing [mental health] … not in the horrible [way] to divide people, but to bring people together and empower them to develop good policies, ”he added. “This question may be one of the few or the last remaining bipartisan questions.”

Sticky notes with positive quotes fill a whiteboard at the SA Clubhouse on Wednesday. Credit: Nick Wagner / San Antonio Report

U.S. Senators John Cornyn (R-Texas) and Catherine Cortez Masto (D-Nevada) introduced a bill this summer that would fund an expansion of mental health services, shifting the burden on the police, Vasan noted.

Fountain House and Inseparable, another mental health advocacy organization, will lead a nationwide campaign to pass this bill, he said.

“Groups like San Antonio Clubhouse and other groups across the country are going to be a key part [of] raise their voices, ”he said.

Learn to “hold space”

While its recent work on emergency response was aimed at the public, the majority of SA Clubhouse’s most important initiatives take place on the second floor of its headquarters, called the Connection Center.

Cynthia Romo and Mary Tolle are waiting at the top of the stairs. They are mental health specialists who oversee other peer support specialists – people with first-hand experience with mental illness who have been trained to help others recover.

“We are not doctors, we are not counselors; However, we have this lived experience that we can actually understand and empathize with and be someone to talk to, ”Romo said. Existing and new members can come to them “and talk about whatever comes to their mind.”

Romo is recovering from drug and alcohol abuse and mental health issues. Years ago, she saw her children being taken away and serving time in prison.

“We have to give them a little snippet of our history,” she said. “Just to let them know that, hey, I know because I’ve been there, I did that.”

Peer specialists also connect members to resources such as housing or food aid, but most of the work is just listening to members, Tolle said. “We call it ‘stay in space’,” a term used in therapy to be physically, mentally and emotionally present for someone.

The Connection Center offers specialized weekly support groups, such as the Hearing Voices Network, suitable for people who report hearing voices or other extreme or unusual experiences.

SA Clubhouse recently received a federal grant of $ 1.4 million over four years that will provide $ 200,000 annually in stipends to those trained to become certified peer support specialists. The remainder of the funding will be used to increase its training capacity.

Once they have completed at least 44 hours of training and 250 hours of supervised peer support, specialists can receive state certification and find a job or internship, Tolle said. “We have just hired a few of our former interns to work here. “

Estrada wants to see peer support specialists working in the community beyond clubs and hospitals. “It shouldn’t be just the clinical setting. “

“I imagine that around the same time next year there will be a peer specialist in places that seem obvious in hindsight, but which we don’t think about now,” he said, as in housing programs, libraries and other places. social interaction.

Taking targeted approaches to mental health, such as peer support, outside of clinics and in the community can also help reduce the stigma associated with mental illness, Vasan said.

“We have over-medicated mental health,” Vasan said. “Mental health is ultimately social – it is about our social relationships. “

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