Opinion: New York needs mental health clubhouses, not just involuntary commitment

Recent high-profile tragedies involving people living with serious mental illness have drawn attention to an undeniable reality that both of us know all too well: our state’s patchwork system of care means more New Yorkers are grappling with visible mental health crises. 

You see, one of us, Arvind, lives with a schizoaffective disorder; the other, Dr. Tse, is a psychiatrist who has treated hundreds of individuals living with serious mental illness (including Arvind). From our unique vantage points, we know how the journey through the mental health care system can be anything other than straightforward. 

Fortunately, state and city leaders, including Gov. Kathy Hochul, state Attorney General Letitia James, and New York City Mayor Eric Adams have placed mental health at the forefront of their legislative agendas. We believe there is a real opportunity for New York state to lead the way in taking the safety of all New Yorkers seriously by investing in a nuanced and robust approach to care for those living with serious mental illness.

After 20 hospitalizations over the course of just a few years, and times when my bed was a subway car, I (Arvind) finally found stability through a clubhouse which provides a community-driven, restorative space that connects me and others living with serious mental illness with housing, employment, education, and crisis support. After first coming to Fountain House Bronx as a member, I have graduated from college and now am working at a national mental health nonprofit and serving on Fountain House’s board. 

Despite my current stability, I know that too many of the nearly 800,000 New Yorkers across the state living with serious mental illness are only accessing support or care when in crisis. In order to stop this cycle of short-term crisis response, we need opportunities for care at various entry points in our journeys – from community-led, voluntary programs like clubhouses, to housing and public health access that can prevent crises before they happen. 

At clubhouses, members are able to find meaningful connections and recovery through a model where community and shared work are the therapy. The importance of trusting relationships in supporting recovery cannot be overstated. Through clubhouse communities and other supportive networks like peer advocates or chosen families, people living with serious mental illness forge trusted relationships that can help with navigating the care system if and when crises do arise. Involuntary care, while sometimes necessary, can compromise that trust, which is why it needs to be avoided wherever possible, in favor of trust-building care teams.

Yet the reach of clubhouses is limited. Even with the recent, crucial investment by New York City to expand clubhouses across the five boroughs, there remains a great opportunity this legislative session for state leaders to scale up these services and extend their benefits across New York. For upstate regions more prone to social isolation, clubhouses will provide a proven, voluntary resource operated by and on behalf of members of each community in which they reside. 

And although we are two people who see the positive impact of clubhouses on people living with serious mental illness every day, we know that they aren’t a silver bullet, either. Without a stable living environment, recovery and healing become an uphill battle. Access to permanent and supportive housing is another essential piece of the puzzle if we are going to remove barriers to care and treatment for mental illness. 

Furthermore, we can build upon progress made shifting away from a police-led response to mental health emergencies and toward a public health response. As a psychiatrist who has worked on an Assertive Community Treatment team for 15 years, I (Dr. Tse) have seen firsthand how specialized crisis teams that include peers can de-escalate situations, promote safety, and support recovery. 

For my part, I (Arvind) haven't been hospitalized in five years, a testament to the power of a supportive, resourced community. If a crisis arises, I know I will be met with understanding and advocacy, not judgment. This is the future we should strive for – a system that uplifts, empowers and protects, while also easing the financial burden on emergency systems.

We appreciate the attention of our elected leaders to people living with serious mental illness and encourage them to prioritize holistic, evidence-based solutions over reactive measures meant to only address short-term crises. Investment in a comprehensive mental health infrastructure, alongside housing and public health access, will not only provide individuals with the tools to thrive, but also make our communities safer for all.