Small NYC mental health ‘clubhouses’ facing evictions and may be in crisis: experts

Politics

by Haley Brown

New York City’s small mental health day centers are being replaced by larger, less personal ones, a move that’s backed by top city officials but worries some experts.

For the past two decades, New Yorkers with mental illness have relied on up to 16 city-funded “clubhouses” — day centers that connect them to community, art therapy and sometimes work.

But nine of the existing clubhouses in the five boroughs will lose funding in July because of the Adams administration’s plan to consolidate services into 13 larger clubhouses by the fall.

“I, like many others, am skeptical of larger clubhouses,” Joel Corcoran, executive director of Clubhouse International, a clubhouse accreditation organization, told The Washington Post. “We haven’t concluded that bigger is better.”

This questionable policy shift will limit access to $30 million in funding to cover the costs of these centers to locations that can serve more than 300 members daily.

“I’ve spoken to (the city) about it, and the city’s commitment is to reach more people living with mental illness through licensed clubhouses,” Corcoran said. “Obviously, I’m concerned about the impact on the smaller clubhouses that didn’t get the contract and the people involved with them.”

The Department of Health estimates that approximately 5,000 New Yorkers with mental illness benefit from these clubhouses every day, and their consolidation into larger community centers will increase the clubhouse’s reach by an additional 3,750 people.

But Corcoran is also troubled by the city’s ambitious timeline for implementing the new contract.

At least six of the 13 contracts have been awarded to providers whose locations have yet to be determined, two people familiar with the contracting RFP process who requested anonymity told The Washington Post.

“We are concerned about implementation because the numbers are so large and the time frame is so short,” Corcoran said.

Director-General of Health Dr. Ashwin Vasan said the Department of Health and Mental Hygiene is working with existing members who will lose their clubhouses.

“We have assured all organisations that we will support each and every member in every way possible, be it metro cards, transport or communication,” Vasan said.

A ministry source told The Washington Post that the HHS would work with health care providers to compile a roster of active members and “determine a plan to ensure continuity of engagement.”

Lawrence Fowler, executive director of Rainbow Clubhouse, which boasts 150 members and did not sign a new contract, said some members are too ill to easily switch clubhouses.

“Inherent within these diagnoses are people who tend to be withdrawn, who are uncomfortable in large spaces and who are trying to reinvent themselves so they can participate in the larger community,” Fowler told the Post.

“From a government perspective, there may be a belief that bigger is better,” Fowler said.

“But I feel like they want to eliminate the community aspect of the clubhouse and just build a bunch of giant houses and put it in a shopping mall-like environment.”

Some Clubhouse advocates expressed concern to The Washington Post that Vasan was relying too much on his past experience at Fountain House, the city’s largest Clubhouse provider, where he served as CEO from September 2019 to January 2022.

At a City Council hearing in March, Vasan denied having any involvement with the request for proposals the department put out last fall, but many clubhouse advocates still blame the commissioner for the city’s shift in focus to larger clubhouses at the expense of smaller ones.

“It’s a conflict of interest,” said Dice Cooper, director of LifeLinks Clubhouse in Queens, one of nine small clubhouses whose contracts were not renewed.

“They said we needed more than 300 members. Who would benefit from that? Fountain House,” Cooper told the Post. “What (Vasan) doesn’t realize is there are 349 clubhouses in the world. Only three have more than 300 members,” Cooper said.

“It’s kind of surprising that someone who worked at Fountain House would take a position that there’s any value in getting rid of the clubhouse,” Fowler said.

Two people who worked with Vasan at Fountain House – one current employee and one former employee – said the commissioner never embraced Fountain House’s programs and therefore doesn’t understand the clubhouse model.

“He was not a very sociable person,” one longtime Fountain House employee told The Post. “He would always run away when he saw members or staff.”

Because the Clubhouse model is based on community, members allege that they invited Vasan to community meetings, raffles and Christmas parties during the two years he worked there, but he never showed up.

“The members were asking him to come talk to them because they needed a connection,” the employee said. “He had no idea what we were doing there and didn’t want to get involved.”

The members and staff had spent weeks preparing a skit just for Vasan, but shortly after the skit began, Vasan answered a phone call and left.

“Not even 10 minutes had passed, I had just started my presentation and he said, ‘Sorry, but I have a very important call, a very important meeting,’ and then he walked away and never came back. He does that all the time.”

“Everyone was devastated. We were constantly begging him to get involved.”

Vasan told The Post that the arrival of the COVID-19 pandemic just months after he took office meant he wasn’t able to engage with Fountain House members in person.

“It’s very difficult. When you have a community that thrives on people coming together physically and you can’t do that because of the pandemic, it’s very hard on the community,” Vasan said.

During his tenure, Vasan was tasked with expanding Fountain House into other states through an initiative called Fountain House America, according to the same employee and another former Fountain House employee.

That effort was halted after Vasan left, employees said, but Fountain House has continued to expand under the name Fountain House United. The mental health giant has inked a deal with Los Angeles County to open a clubhouse in Hollywood this summer.

“I was primarily hired by the board to scale this model, and we’ve been very successful in that regard,” Vasan said.

Jonathan Glass, 50, has been with Fountain House for 24 years and said the institution has become less community-focused both during Vasan’s tenure and since.

“It’s very cold and not the clubhouse I was in for 24 years,” Glass told the Post. “The more time I’ve been there, the more I’ve grown tired of the sense of distance between people.”

Vasan declined to speak to members directly but told The Washington Post that “things happen within the community and are usually dealt with within the community.”

Vasan said he still remembers two members from his time at Fountain House, one who greets people at the front door and one who gives tours.

Vasan said the reason for removing parts of the clubhouse was to improve the system.

“The whole intention here is not to take away from any particular community or hinder anyone’s recovery, but to make sure everyone has access to this amazing model,” Vasan said.

“It doesn’t matter if it’s big or small, it’s about the capacity and resources to provide the range of rehabilitation services required for a clubhouse,” Vasan said.

Vasan said Clubhouses with more resources will be able to collect stronger data on their members and improve the Clubhouse model.

“Unless there is compelling data on how the Clubhouse model is transforming our mental health system, other sources of funding, support and policies will continue to treat the Clubhouse model as a cute afterthought,” Vasan said.

But while the city is focused on collecting data, Cooper is concerned about the thousands of members who stand to be left without a home after the nine clubhouses lost city funding.

“If all of these services were taken away completely, it would be a total disaster. We would see an increase in homelessness in the subway and in our neighborhoods. We would see people going back to the hospital. It would be really, really devastating for people who have nowhere to go and no one is paying attention to them,” Cooper said.

Ruben Fernandez, 61, describes himself as a “regular guy.” A former Marine, he started going to LifeLinks three years ago after heart failure prevented him from working his longtime job at a New York University facility, but he didn’t get a contract.

Now Fernandez worries that the things that helped her recover will be taken away from her.

“I went from having a six-figure salary at NYU to having heart failure, which left me severely depressed and isolated. That’s when I discovered Clubhouse, and it helped me in so many ways,” said Fernandez, who now attends Yankees games with his teammates.

“Clubhouse is the glue that holds a lot of people together,” Fernandez said. “If Clubhouse closes, a lot of people will be left displaced and without a place to be.”

“This is not the end, it is the beginning. The Ministry of Health is working closely with Clubhouse providers to develop as seamless a transition plan as possible for current members,” the ministry’s statement read.