Fountain House’s model for supporting those living with serious mental illness

Serious mental illness (SMI) has moved to the top of the agenda for healthcare leaders, policymakers, and public health officials alike. SMI affects approximately 1 in 20 adults in the U.S. annually, and there is renewed urgency and interest in identifying and scaling solutions that work to help address the needs of people with SMI. For over 75 years, Fountain House has been a leader in treating those with serious mental illness. The organization pioneered the clubhouse model of psychosocial rehabilitation long before it became policy consensus, building the evidence base, developing a global network, and is now positioned as one of the most credible and scalable answers to meeting the complex health and social needs for those with SMI. Through its community-based approach – centered on membership, connection, and meaningful participation – it has established a globally recognized model for recovery and continues to advance frameworks that guide more effective, person-centered systems of care. At a time when leaders are searching for approaches that both transform lives and control costs, Fountain House offers a model. For example, the Fountain House Measures That Matter framework reflects a shift away from traditional clinical and utilization metrics toward outcomes that people with lived experience identify as most meaningful to recovery. These include quality of life, social connection, trust, and progress toward personal goals – domains that better capture the realities of living with and managing SMI. By elevating these priorities, the framework supports a move toward value-based, whole-person care that emphasizes long-term well-being over service volume. It offers a practical roadmap for health systems and payers to align measurement and accountability with what truly drives recovery, while remaining grounded in dignity, agency, and lived experience. According to Fountain House's Beyond Treatment report, clubhouse participation can save more than $11,000 per person, which translates to a national savings of nearly $700 million annually across the known 60,000 members served. The potential is even greater at scale: if clubhouses were appropriately resourced and expanded to serve just 5% of the 15.4 million adults in the U.S. living with SMI, the net societal savings would exceed $8.5 billion. These figures account not only for healthcare savings, but also for potential lost wages and productivity, disability benefits, repeated emergency room visits, and criminal justice impacts.