Integration: Its Evolution in the History of the Clubhouse Movement

by Mark Glickman

I believe that integration is the driving force of the clubhouse culture. Not racial integration, but the integration of members and staff in clubhouses. The greatest dilemma for people who have suffered from mental illness is isolation and lack of opportunity. Our isolation is sometimes self imposed because of the terrible inner torment we experience, and sometimes results from being rejected by other people.

Clubhouses bring people out of their isolation and into opportunity in the clubhouse and eventually in the community. We are integrated together, members and staff, like people are in no other program. We work together and share responsibilities together, not in tidy little batches, but in long stretches, without closed doors and carefully defined roles. We are integrated together in a dignified and profoundly human way. We share the same goals in our clubhouse communities, and our lives are greatly enriched.

We have had great success in our clubhouse world. Today, at this Seminar, there are almost eight hundred of us, members and staff , board members, consumers and family members. We come from a clubhouse world of about 265 clubhouses, speaking about eleven different languages, and located in seventeen different countries. We are a movement which has revolutionized the mental health world.

We have come a long, long way. When I first came to Fountain House in 1973, though, there were only a handful of clubhouses in the world. When I first walked through the door of Fountain House, I was reeling from an illness which had left me with no confidence, feeling completely shattered and hopeless. When I walked up West 47th Street to Fountain House, up to that big green door for the first time, Fountain House stood almost alone in the world. Today, twenty three years later we have an International Center for Clubhouse Development, a set of Standards, a consultation and certification process, a Faculty of members and staff , and a growing body of literature and research. So, we have come very far and have much of which to be proud.

Yet, we are aware of three very sobering facts. First, good clubhouse programs are not available to all who could benefit from them. In California, where my wife and I have been living for the past three years -- a state of 22 million -- we have only four clubhouses. Second, there is the sword which hangs over all our budgets, and the managed care systems which threaten to overwhelm us with a wave of mergers. And finally, although we have codified our values into our Standards, we all have much further to go in truly living and practicing those Standards each day. We live with the danger of our blending in and disappearing amongst programs which are based on very different philosophies.

What distinguishes us the most from these other programs, I believe, is integration and opportunity. Our clubhouse model is based on these two pillars. One does not stand without the other. John Beard, visionary, and director of Fountain House

from 1956 to 1982, once said that the future of clubhouses depended on whether members would be allowed to share crucial functions and not just routine ones.

The most important growth I have seen in the clubhouse movement, through my years of affiliation both as a member and a staff, has been around that issue. In looking back, it seems clear to me that this sharing of critical responsibilities accelerated with the start of the National Training Program at Fountain House.

The National Training Program began in 1978, and with it the spread of clubhouses around theworld. That was a critical time, as it paved the way for members to take on new and exciting roles in their clubhouses. The Training Program was an enormous success, with many people being trained and many new clubhouses opening. But there was one glaring omission. Only staff came to Fountain House for training in those early years.

In about 1980 Fountain House received another grant, this time to train members from clubhouses around the country. This program lasted for about a year and a half. Each of the training sessions had about six members, who stayed at Fountain House for two weeks, not three, as the staff did. Other than that, the member training and the staff training looked pretty much the same. The members worked in units just as the staff colleagues did.

I remember how exciting it was when the first group of members came for training. However, it soon became clear that something was missing. The truth was that the program lacked a sense of purpose and was not taken very seriously. Often, members who came for the training felt lost and ended up going home early.

Looking back, I think the problem was obvious, but we weren't ready to see it. The staff training and the member training programs were segregated. And as the Supreme Court of the United States has said in regard to school integration, separate is NOT equal.

Towards the tail end of the member training program, Rudyard Propst had come to work at Fountain House. The member training grant ran its course, and once again there was only staff training. Rudyard saw the issue clearly, and had the courage to make a decision which dramatically speeded up the evolution of the clubhouse movement. He integrated members into the staff training program.

Looking back, it is hard to believe that at first there was a good deal of resistance to this integration of the training program. Some people said the members might not be up to the three weeks of training. Others worried that the staff might not share their true feelings, if members were present. But Rudyard believed that segregated training was inconsistent with our values. He had faith that members could meet the challenges of the three week training.

The integration of members into all aspects of training was an immediate success. There wasn't a part of the training which didn't benefit enormously from the presence of members. This was true in the units, in the meeting rooms, and in the guest house. Including members in training programs has greatly enriched us, and propelled our movement forward.

This change in the training program led into another important moment in our history, which was when clubhouse members and staff, together, wrote the Standards for Clubhouses Programs. About nine years ago, an international group of members and staff met up at the Fountain House farm in High Point, New Jersey. It was a magnificent time. Sixteen of us, members and staff, shouting and arguing, debating, sometimes all talking at the same time, and forging a draft document of the Standards. Then in St. Louis at the International Seminar in 1989, over 600 members and staff meeting in about twelve groups simultaneously, reached consensus on these Standards. We reached that consensus with a breathtaking sense of like-mindedness. It was an unforgettable moment.

It is interesting to note that of the 35 original Standards the one which caused the most controversy was number 7, which states that there will be no formal member or staff only meetings. Here was the standard which spoke about integration and power at the same time, and it caused quite an uproar. The issue most often raised about this standard was confidentiality, which was really a non-issue. If a sensitive matter is involved, we all know that it can be dealt with informally, including only those who need to know. The real issue was, and is, can we all share the same important agenda.

Part of the mission of the National Clubhouse Expansion Project was the forming of a consulting Faculty of members and staff from clubhouses around the country. These people were experienced members and staff who had the skill and ability to go out as consultants to other clubhouses. At the end of that time the member and staff consultants suggested ways the clubhouse they were visiting could become stronger.

I believe the result of the composite experience of creating Standards, forming a Faculty, and making consultations, was much greater than the sum of its parts. Those who were privileged to take part in this process saw the birth of a new clubhouse movement. As a result, we are now more than a network of clubhouses. We are a movement of people dedicated to creating a better world, for those who have suffered the agonies of mental illness.

As a faculty member I made many consultation visits, the most enlightening of which was also the most painful. I was visiting a large clubhouse, the name of which I will not mention. There were many things wrong. For example, a huge volley ball net and a giant TV screen were the first things we noticed in the clubhouse. There was little important work going on. The members spent most of their time practicing how to type, or wandering around, not knowing what to do. The workday ended at noon, and the afternoon was only for recreation.

But the most striking feature of this clubhouse was that it had a whole separate building for administration. Members only went into this building to empty the trash. It was like apartheid. The staff did their paperwork in little cubicles, in a maze of offices, isolated from each other and the members. It was a glaring case of segregation. We have come a long way from places like that.

To have great clubhouses requires a commitment to quality in relationships and opportunities. We all agree that clubhouses must be integrated, with members and staff working side by side. But is working side by side enough? Must we not also

consider the quality of our relationships? Integration has to be more than a logistical reality. Togetherness has to go deeper than standing side by side.

During some of the consultations I had the privilege to make, I saw morning meetings in which I felt something very important was missing. Sometimes these meetings were consumed with reviewing a list of things to be done that day, and often this was done in a mechanical way. It seemed to me that neither members nor staff took the chance to talk even briefly about themselves, or to express concerns about those who needed to be reached out to. We have to also consider the quality of our relationships, and take the time to share our goals, our dreams, and our visions for the future.

In short, check lists do not equal relationships. We need to look up from our lists and take the time to ask what is happening in peoples' lives. We need to take the time to hear the good and the bad. We need to take the time to expose our humanity to each other. Doing that builds community as much as the cleaning, cooking, news letter writing, researching and attendance taking.

There were two other important policy decisions which enormously influenced the evolution of clubhouse integration. Back in 1985 the call went out for ideas for workshops for our international seminar in New York. Many clubhouses submitted ideas for panels which did not include members. As a result, at the next international seminar in Seattle in 1987, the expectation that members would be included in panels was made abundantly clear. Today, members here comprise more than half of the delegates to our seminar and make up a least half of the seminar presenters.

A similar precedent has been established for those occasions when clubhouses are called upon to make presentations in other forums. Today, there is an absolute expectation in our clubhouse culture that when we present, both members and staff will be doing it.

Which brings me to the last milestone in clubhouse evolution I'd like to talk about today. The evolution of the policy meeting, pioneered in Worcester, Massachusetts, at Genesis Club. At these meetings members and staff and the director discuss important and often controversial issues. This process is not about voting, but about consensus. It takes the important issues once reserved for a handful of people and spreads out the decision making. These discussions and debates become a chance for people to strengthen their confidence, their courage and their spirit while building a stronger clubhouse for all. So if we move ahead into the future sharing the same important agenda, work, and sense of mission, we are bound to succeed.

There are pitfalls in our journey toward greater and greater integration of staff and members in the clubhouse. And some of them are subtle. The clubhouse works best with staff who are generalists. But it is tempting indeed, is it not, to become a specialist. We all like to feel we do one thing especially well. We all like to have a title. But if we become too specialized, we take a risk. We risk segregating ourselves from the heart of the clubhouse world.

Sharing is hard. I find it hard to share. Because I want it done right. I want it done my way. I want it done as soon as possible. It's very hard to share. But the truest judge of how we are doing in the clubhouse is how many people are involved with us, and

what is the quality of that involvement. Yes we must pursue excellence. But we must pursue it together.

Overcoming the stigma of mental illness is an enormous challenge. It is a long term challenge, akin to the great struggle of overcoming the racial divisions which plague this country. In the clubhouse, this challenge requires the constant integration of members and staff and the dedication to building a sophisticated opportunity system. Together we can build more arenas where profound human change and recovery is possible.

We don't have to achieve our Standards to the point of perfection, today. But we must inspire ourselves to increasingly move toward them so that men and women who have suffered so much from mental illness can have the kind of places they deserve, where they can rebuild themselves and achieve more dignified, productive and satisfying lives.

We have much to do. We must sustain our funding and nurture the growth of new clubhouses around the world. We can have phenomenal growth if we keep our eyes on the prize, which are clubhouses dedicated to excellence in both relationships and opportunities. Sharing the same important agenda, we can bond together, moving toward greater and greater integration between clubhouse members and staff throughout the worldwide network of clubhouses.

Mark Glickman is a member of Fountain House, now living in San Diego, California. He is also a member of the ICCD Board of Directors.