How Clubhouses Work

Clubhouses offer people living with mental illness hope and opportunities to reach their full potential. They operate on proven Standards which have been developed by Clubhouse International over two decades and which are effective in over 320 Clubhouses worldwide. The basic components of successful Clubhouses are:

The Basic Components of a Clubhouse

A Work-Ordered Day

The daily activity of a Clubhouse is organized around a structured system known as the work-ordered day. The work-ordered day is an eight-hour period, typically Monday through Friday, which parallels the typical business hours of the working community where the Clubhouse is located. Members and staff work side by side, as colleagues to perform the work that is important to their community. All of the work in the Clubhouse is for the Clubhouse and not for any outside agency or business. There are no clinical therapies or treatment-oriented programs in the Clubhouse. Members volunteer to participate as they feel ready and according to their individual interests.

Employment Programs

As a right of membership, Clubhouses provide members with opportunities to return to paid employment in integrated work settings through both Transitional Employment and Independent Employment programs.

Transitional Employment is a highly structured program for members returning to work in local business and industry. Transitional Employment placements are at the employer’s place of business, are part-time (15-20 hours per week), and include a lot of on-the-job and off-site support from Clubhouse staff and other members. These placements generally last from six to nine months. Members can then try another placement or move on to independent employment. Transitional Employment is specifically designed as a vocational rehabilitation program where a member can gain or re-gain the skills and confidence necessary to have a job while he or she is employed in a “real world” position. The only requirement for the member to participate in Transitional Employment is the expressed desire to work.

Independent Employment is a program of the Clubhouse through which members, when ready, are broadly helped by the Clubhouse to seek and obtain a job of their own. The Clubhouse then provides ongoing support and encouragement for the members as long as they remain employed and want assistance. There is no on-site support at the place of business for members in Independent Employment; all support takes place at the Clubhouse, or in the community.

Evening, Weekend and Holiday Activities

In addition to work opportunities, Clubhouses provide evening, weekend, and holiday social and recreational programming. Members and staff together organize structured and non-structured social activities. These activities are scheduled outside of the work-ordered day. Holidays are celebrated on the day on which they fall. Activities are scheduled both at the Clubhouse and in the community.

Community Support

People living with mental illness often require a variety of social and medical services. Through the work-ordered day at the Clubhouse, members are given help in accessing the best quality services in their community. Help is given to members in acquiring and keeping affordable and dignified housing, psychiatric and general medical services, government disability benefits and any other needed services. Members and staff from the Clubhouse ensure all such support and assistance.

Reach-out

Part of the daily work of the Clubhouse involves keeping in contact with all active members. When a member does not attend the Clubhouse or is in the hospital a “reach-out” telephone call or visit is made. Each member is reminded that he or she is missed, and welcome and needed at the Clubhouse. This process not only encourages members to participate, but it is also an early warning system for members who are experiencing difficulties and may need extra help.

Education

Many Clubhouse members have had to interrupt their educational plans because of their mental illness. Some have not finished secondary school, while others had to curtail their university studies. The Clubhouse offers educational opportunities for members to complete or start certificate and degree programs at academic institutions and adult education providers. The Clubhouse also utilizes the talents and skills of members and staff to provide educational opportunities in the Clubhouse, particularly in areas related to literacy.

Housing

Safe, decent, dignified housing is a right of all members. The Clubhouse helps members to access quality housing. If there is none available for members the Clubhouse seeks funding and creates its own housing program.

Decision-Making and Governance

Decision-making and governance are an important part of the Clubhouse work. Members and staff meet in open forums to discuss policy issues and future planning for the Clubhouse. Clubhouses also have an independent board of directors or advisory board that is charged with oversight management, fundraising, public relations and helping to develop employment opportunities for members.

Summary

Although Fountain House started more than fifty years ago and has been replicated more than four hundred times around the world, the Clubhouse concept is still a radically different way of working in the field of community mental health. Most program models still focus on assessing a person’s level of disability and limiting the expectations based on that assessment. Most use teaching or treatment as the vehicle for providing rehabilitation. In a Clubhouse the expectations are high and mutual work, mutual relationships, and meaningful opportunities in the community are the vehicles of choice.

References
  • Anderson, S. B. (1998), “We Are Not Alone: Fountain House and the Development of Clubhouse Culture,” New York, New York, Fountain House.
  • Beard, J. H., Propst, R., and Malamud, T. (1982), “The Fountain House Model of Psychiatric Rehabilitation,” Psychiatric Rehabilitation Journal, 5, 47-53, Boston, MA.
  • ICCD, (2002), “The International Standards for Clubhouse Programs,” New York, New York.
  • Vorspan, R., (1986), “Attitudes and Structure in the Clubhouse Model,” The Fountain House Annual, Vol. 4, New York, New York