In the face of significant stressors occasioned by the needs of people with chronic mental illness and the ideological structure at Fountain House, staff members at Fountain House, a psychiatric rehabilitation facility in New York, have long tenures and display fewer symptoms of burnout than other providers. This study identified staff methods for adapting to stress; methods for reframing stressors as positive features are presented. This study describes the processes generated by the ideological structure which create staff commitment to the model and to the mentally ill, and which produce a sense of personal accomplishment and satisfaction. Implications of these findings and needs for further research are discussed.

Deinstitutionalization has guided mental health and mental retardation services for nearly 30 years. Historically, the mentally ill and the mentally retarded were grouped together, but recent trends have separated legislation, services, and funding, to the detriment of mental health. Deinstitutionalization policies in the mental retardation system, based on developmental, psychoeducational philosophies, seem to have been more successful than the more medically based mental health policies. Adoption of a psychosocial rehabilitation model of services, modelled upon the mental retardation system, might improve service efficiency, reduce hospital readmissions, enhance public attitudes toward the mentally ill, and increase productive family involvement.