Fountain House’s Silver Center for Older Adults: It Takes a Village to “Live Long and Prosper” with Behavioral Health Challenges

What’s in a name? Just as age 60 is supposedly the new 40, the silver hair on older heads is now apparently worth its weight in gold.

However, the “silver” in Silver Center refers to the respect certain cultures, such as the Japanese, confer on their elders. So, when you read about the coming “silver tsunami” of baby boomers, don’t let this negative image fool you into thinking society would be better off if our older folks drowned before they overwhelm us with their needs for care.

A Silver Center activity: Greeting cards for psych inpatients

A Silver Center activity: Greeting cards for psych inpatients

And it just so happens that Fountain House, the original psycho-social clubhouse founded in midtown Manhattan in 1948, on which some 350 others are modeled worldwide, is undergoing a growth spurt at 76 years old, with a branch opened in the Bronx 11 years ago, a new Hollywood, CA location, and a West Harlem one in the making.

Once novel, psycho-social rehabilitation that is person-centered, recovery-oriented, strengths-based, trauma-informed, and culturally humble, with staff and members acting cooperatively in a voluntary and purposeful “work-ordered day,” is now widely accepted and more often practiced by such programs as intensive Psychiatric Rehabilitation Treatment (IPRT), Personalized Recovery-Oriented Services (PROS), Assertive Community Treatment (ACT), Intensive Case Management (ICM), Community-Oriented Recovery and Empowerment (CORE), and Crisis Respite Centers (CRC), as well as supported housing, education, and employment. (An acronym of care a day keeps the psych ward away!)

Fountain House

Such rehabilitation “can save more than $11,000 a person; when extrapolated to the current 60,000 people attending clubhouses (known as members), that amounts to a national savings of almost $700 million annually. This figure could be far higher if more of the 15 million people in the US living with serious mental illness had access to these programs.”1

When it comes to the allocation of scarce resources, the question is whose disability is more stigmatized: the “crazy,” the “demented,” or the “plain old”? Given that people with Alzheimer’s and the frail elderly are never accused of violence by politicians and the media, we in behavioral health care have an uphill road to climb.

Although locating the Silver Center in the basement of our senior residence might appear to be a “step down,” it amounts to a repurposing of what was once storage space and what could be more symbolic of lives that are worth more when not packed away in mothballs!

For the center is a beehive of such activities as meditation/relaxation, chair exercise, reach out, words with prompts, not alone project, Wayne’s movie club, literary magazine, board games, horticulture project, silver story club, standards study, joy of music, silver sports club, advocacy meeting, animal art, bingo and watercolor, newspaper meeting, plus silver jam. And this is just the fun stuff that promotes interdependence and makes for a super-charged senior center.

Silver Center participants also partake in all the Fountain House services that foster independence, such as housing, employment, education, insurance, and financial benefits. Eager beavers help run the clubhouse as part of the wellness, culinary, garden, communications, and research units.

Because “creativity” is essential for recovery, our art gallery and studio offer first-class exhibits and classes. And on our NJ farm, contrary to the notion that digging in the dirt is a reversion to childhood, learning to help plants grow is one of the best ways to recover from what may seem like personal dead ends. As for continuity of care, Fountain House partners with a nearby health home and community health center.

“At Fountain House, a third of our [1200 active] members are 55 and older, many of whom have been a vibrant part of our community for decades. In 2018, we opened the Silver Center to keep our older members supported and connected as they age and to address the ongoing concerns of isolation, physical illness and decline, inadequate housing, and poverty.

Interviewee Judy’sZoom self-portrait

Interviewee Judy’s
Zoom self-portrait

One of the more unique – and valuable – aspects of the clubhouse model for older adults is that they’re able to make meaningful social connections, not just with people their own age, but with younger adults. These intergenerational relationships can lead to powerful healing benefits. Numerous studies show that these kinds of relationships can improve physical health, quality of life, and cognitive function for older adults, while also providing young adults mentorship and greater self-esteem.”2

In other words, Fountain House, as a voluntary, intentional, intergenerational community with a sense of belonging and mutual support, appears to be a key to the well-being of our older members. With the support of staff, members care for each other and dare each other to do and be better.

Susan Lieblich, who has been a staffer on and off since 1980 and was the first program director of the Silver Center, credits Norman Feldman, a Fountain House member, with initiating “senior services” in the education unit. Said Lieblich, “Norman believed that being older was a time to grow and give back.” Out of his inspiration, the center was born!

Sadly, Norman died of COVID, but he would have been proud of the way the center rose to the challenge of the pandemic with online programming and continues to promote a robust digital presence by a third of its members who are unable to attend in person. Of the 164 Fountain House members who used the center in 2023, 100 participated at least once a month.

In addition to all the activities offered, members meet with staff twice a day to decide on the administrative work needed to sustain the center. The enthusiasm generated powers a cooperation that was evident in several members’ responses to this reporter’s questions:

Carl: How long have you been a Fountain House/Silver Center member? Has your participation changed over that time?

Judy (age 68): Member since 2019. Was inactive until pandemic when I got Slack and Zoom. Became very active, attending daily virtually.

Jerry (63): 2018. Online during the pandemic was better than isolation. Now I come here five days a week to reach out to members in nursing homes or alone at home. Feel productive.

Carmen (65): 13 years. Every day for 4-5 years. Recently too much trauma. Only twice a week.

Carl: How’s your recovery? What part is due to Fountain House/Silver Center and what to other factors?

Judy: Doing well and love my time virtually with Zoom meetings. Silver scene, standards study. Used to like current events. Love the go-around [check-in]. Have friends.

Jerry: Not being stuck at home and doing fun things. Music, books on tape, and helping my older sister.

Carl: What activities and services at Fountain House/Silver Center are most helpful for your wellness?

Judy: Art and training and advocacy. Love it all. And technology.

Jerry: Board games and writing stories with prompts. When we had a sports club, going bowling and softball batting.

Carmen: I became a peer specialist during my Fountain House years. Then took over the Double Trouble in Recovery group. Many of our older members died or relapsed during COVID. I got a Zoom room so people wouldn’t feel isolated and could talk about their substance abuse recovery. While in the Silver Center, I organize mailings, enter data, make get-well cards, call members, and help run the chair exercise group.

Carl: What do you like best/least about Fountain House/Silver Center?

Judy: Love virtual. Don’t like to miss out if in-person only. Miss current events.

Jerry: Reach Out and heart healthy food, but the portions are too small and often cold.

Carmen: How the community works together. Fountain House lets you do what you want and gives you lots of choices. Doesn’t force you. Some members don’t realize how much Fountain House offers.

Carl: How has Fountain House/Silver Center changed during your time here?

Judy: Improved especially virtually

Jerry: Not at all. Always very nice people.

Carmen: Had to be young adult to be admitted. Now open to all ages.

Carl: How does Fountain House/Silver Center compare to other mental health and/or substance use programs you (have) participate(d) in?

Judy: Great that it’s combination mental health advocacy and senior love

Jerry: The place I went to on Long Island before Fountain House shut during COVID.

Carmen: When I got out of the hospital 30 years ago, the Post-Graduate Center and Fountain House were considered the two best programs for housing. Unfortunately, Fountain House was only accepting people up to age 35 and I was 42, so I went to PostGrad. I really wanted to go to Fountain House. I kept applying until they accepted me about 13 years ago.

Carl: How does the Silver Center compare to other older adult programs you (have) participate(d) in?

Judy: Hybrid and virtual interaction and karaoke is better than senior center with no virtual, no mental health. I am welcome. No stigma. Informative. Helpful. Advocacy.

Jerry: No other place like it. Where I went before, mental illness and aging made people worse.

Carmen: Haven’t tried others.

Carl: How would you like the center to improve?

Judy: More virtual. Improve virtual.

Jerry: Bring back the sports club and expand the center.

Carmen: Need more room for big events. More senior housing and job opportunities for seniors to earn money taking care of our seniors who are less able.

Carl: Anything else you would like to share about your Fountain House/Silver Center experiences?

Judy: My art is on artsy.com.

Jerry: No

Carmen: I have a lot to give.

A 73-year-old CORE peer specialist at Fountain House and journalist for 50 years, Carl Blumenthal can be contacted at carl.blumenthal@fountainhouse.org or (929) 715-2700.

Footnotes

  1. Usman, PhD and Joshua Seidman, PhD, “Beyond Treatment: How Clubhouses for People Living with Serious Mental Illness Transform Lives and Save Money,” Fountain House, February 2024 (https://www.fountainhouse.org/reports/beyond-treatment)
  2. https://www.fountainhouse.org/news/being-around-younger-people-can-feel-rejuvenating-fountain-house-members-discuss-the-healing-benefits-of-intergenerational-relationships, April 13, 2023

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