Even in the wealthiest country in the world, mental health care is hard to come by for millions of Americans, who, in the age of COVID, have never been more beset by mental health challenges.
Nowhere is the need more acute than in the Bronxwhich has the highest rate of psychiatric hospitalizations in the five boroughs, as well as the highest proportion of people in serious psychological distress.
As lifelong residents of the Bronx who have experienced mental health crises firsthand, we’ve seen how our beloved community has been chronically denied the comprehensive mental health care it both needs and deserves. Much of the Bronx remains a mental health care desert: a staggering 91% of the Medicaid-insured population in the Bronx lives in a designated Mental Health Professional Shortage Area. In the Bronx and elsewhere in America, mental illness continues to be overcriminalized and undertreated.
I (Ritchie) know firsthand what it’s like to struggle with mental illness with few options for care. I dropped out of college after experiencing a downward spiral into major depressive disorder. There were moments when I attempted suicide because I felt as if the world around me had collapsed. I lost hope.
I would not be alive today—much less a member of Congress—were it not for the power of mental health care. I have long been a proponent of both psychiatry and psychotherapy, but neither one, on its own or even together, is a cure-all. The isolation that life often imposes can be every bit as corrosive as mental illness itself.
Belonging to a community, buoyed by a strong support system, is the simple but often overlooked key to easing the hardship of mental illness. Clubhouses can fill the human gap left by isolation and can provide a loving supportive community where none might exist.
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One of us (Arvind) has been hospitalized more than 20 times, experienced one mental health crisis after the next, and been forced to travel hours out of the Bronx just to access basic mental health care. But I have also managed to turn my life around to become a leader, put myself through college, excel academically, manage a political campaign, become stably housed and avoid hospitalizations — all on the strength of community-based care.
Reimagining mental health care need not be an insurmountable challenge. Community-based mental health care providers, like Fountain House Bronx, have long shown that there exists a cost-effective and culturally competent approach to serving people with serious mental health challenges — a model of mental health care that has delivered life-changing results for decades. Members of Fountain House, both here in the Bronx and in Hell’s Kitchen, have greater access to stable housing, employment and education — as well as lower health-care costs and recidivism rates — than most people struggling with serious mental illness.
The clubhouse model, pioneered by Fountain House since its founding in 1948 and present in more than 200 clubhouses across the country, offers not only a more humane but also a less costly alternative to the failed approach that the government has traditionally taken in response to mental illness. Instead of warehousing the mentally ill in jails, prisons and institutions, as the government has done historically, clubhouses afford people the human dignity of remaining rooted in and connected to their own communities.
Clubhouses are local organizations that allow people living with mental illness to stay in community, rather than be exiled against their will to institutions or worse, jails — and must be expanded to meet the growing demand for services and support.
The clubhouse model offers a comprehensive support system that connects members to free resources that build long-term independence, like job training and housing support, and empowers members to make the decisions that will impact their care and recovery. At a time when mental illness has been sensationalized by the mediaand the only solution lawmakers can seem to muster is forced treatmentFountain House Bronx has shown we can engage people before they’re in crisis while drastically improving outcomes and saving taxpayers millions in the process.
By creating a safe space for people with mental illness, Fountain House Bronx has managed to lift up those whose lives have historically been torn down by a system more concerned with criminalizing than caring for the vulnerable.
Torres represents the South Bronx in the US House of Representatives. Sooknanan is a community mental health advocate and member of Fountain House Bronx who also serves on Fountain House’s board of directors.