by Tom Malamud
The Seabiscuit Project at Fountain House in New York City is based on the premise that adults with serious and persistent mental illness can be employed in jobs earning at least the nation's median income salary. Too often wages are much less than the $41,386 reported for males by the Census Bureau for 2005. For Fountain House Clubhouse members, adults suffering from schizophrenia or major affective disorders, the median income in 2006 was approximately $10,000, or one-quarter of the nation's.
Evidence supports the premise that people with a major mental illness can work, earn, and contribute. An NIMH-funded project, the Vermont-Maine Project, which compared extremely chronic and disabled persons who received vocational rehabilitation to those who did not, illustrated this more than a decade ago. Their findings revealed that people who received those services, had significantly better work outcomes - more sustained and higher level employment.
Boston University also surveyed 500 people who had major mental illness such as bipolar disorders, schizophrenia, major depression, and Post Traumatic Stress Disorder (PTSD). Sixty-four percent had been hospitalized more than three times; thirty-four percent were once enrolled in SSI/SSDI. But all respondents went on to managerial and high paying jobs. Twenty percent earned over $50,000 and 69%had increased responsibilities at the time of the survey in 1999.
Another BU study found that many popularly held assumptions about people with mental illness unable to work were superficial. They found, for example, that 1) diagnosis does not predict work ability; 2) hospitalization does not predict work ability; 3) symptoms do not predict work ability; and 4) training in an institutional setting does not predict the ability to work in a vocational setting. Clubhouses have known this information for a long time.
The project described below shows that it is possible to provide substantial work opportunities for individuals with severe mental illnesses, and to make a substantial contribution, not only to the lives involved, but also to the understanding of what is really possible. Called the Seabiscuit Project, it is named after the remarkable racehorse. Although he was the product of a great heritage (the grandson of Man of War), Seabiscuit was not expected to be a winner. He just didn't measure up. His awkward gait, ungraceful appearance, small size and anger worked against him. He slept all the time (very unusual for a horse), ate enormous amounts of food, had knobby knees, and was highly temperamental - scaring most people. He, therefore, was used to help other horses learn to win, by running with them and being pulled back, thus learning to be a failure.
At this point three people entered his life to make a difference. Charles Howard was rebounding from the death of his only child and a lost marriage. After losing most of his money in the Great Depression, he turned to horse racing as an emotional release. Tom Smith, a trainer who was better suited for the horse whispering days of 19th century Montana, prevailed upon Howard to buy Seabiscuit, saying "he is so beat up it is hard to tell what he's like. They got him so screwed up riding in a circle; he's forgotten what he was born to do. He just needs to learn to be a horse again." He also said: "You don't throw away a life away just because it's banged up a little." Then they hired a jockey, Red Pollard, who matched the horse's angry temperament; he was too tall, weighed too much, and had one blind eye.
Of course, Seabiscuit fooled all the doubters with hard work and the determined people around him. He was provided with decent food and housing, peer support from another horse, maximum latitude, kindness, respect, persistent retraining, and the chance to find himself again. His team and the horse kept trying. All rose above their individual circumstances and habits. Against all odds, everyone ended up with spectacular successes including winning "the race of the century" against War Admiral, who was "built like a battleship" and America's premier racer. Together, they provided encouragement for a whole nation bogged down in the Great Depression.
As narrator of the film version of this story, historian David McCullough commented: "It is a very American idea, that hidden inside you is huge potential, that is untapped or that is undiscovered, if only people had the understanding to explore it or to nurture it a little."
Applying the metaphor to this project, clubhouse members, of course, are the Seabiscuits, the clubhouse is the owner, the staff worker is the jockey, and the psychiatrist is the trainer. Project participants (Seabiscuits) either have previous successful careers to which they can return (medicine, law, nursing or education are just a few), or they can acquire the training, certification, or credentialing necessary to commence a new career.
A couple of examples from Fountain House illustrate the promise of Seabiscuit. George S. is currently working with a VESID-sponsored placement agency as a welder in New York City. He had been a homeless young man with a long-term history of mental illness. After completing job training and successful placements at Fountain House, he obtained a scholarship to become a welder. He now earns the union minimum of $50,000. Another example is Bob S. After some years as a Fountain House member, and completing several part-time supported employment placements, obtained a job as a residence counselor for a NYC mental health agency. He has since been accepted to graduate school where he will work toward an MSW degree. Following graduation, he plans to become a professional social worker.
The unique and innovative pilot project at Fountain House is designed to discover the "huge potential" of many clubhouse members, people like Bob S. and George S. with serious mental illness, and to provide them access to "good" jobs. These jobs are career-based and would include standard company benefits. The methods used in the Seabiscuit Project are those of Clubhouse support: access to excellent psychiatric and medical services and "head-hunting;" tapping the resources of retired highly placed businessmen, who are excited about using their existing networks to find and place project participants in high-paying, career-oriented jobs.
Collateral benefits expected from the Seabiscuit Project include: 1) combating the stigma associated with serious mental illness, particularly the belief that people with serious mental illness are unable to hold down good jobs, let alone careers; 2) restoring dedicated, skilled workers to the American workplace and; 3) saving taxpayer dollars (through reduction in government benefits and increase in payroll tax deductions).
The Seabiscuit Project uses the principles of Clubhouse support. It operates on the basic premise that when necessary and cost-effective, community supports are provided to persons with a severe mental illness. The expense of their medical and psychiatric care will decrease while the quality of their lives increases.
Fountain House pioneered and developed extensive programs for facilitating the social and vocational adjustment of men and women after they left mental hospitals. It is based on a Clubhouse model of voluntary participation and membership which has served over 17,000 individuals through a comprehensive array of accessible, integrated and long-term systems of care. The Seabiscuit Project is the latest of these. Based on the evidence about the potential for employment, it is Seabiscuit's premise that 400 people (about half of those participating in Fountain House programs each month) could and should be eligible for jobs paying more than last year's median income of $41,386. This would be a vast improvement over the median income currently earned by Clubhouse adults with serious mental illness.
Tom Malamud retired from Fountain House, in New York City, in 2006 after spending 42 years creating and directing programs to assist people with mental illness live independently in the community. He now directs Special Projects at New York's Center for Reintegration where he expands outreach, program development, and assesses service needs.
