Unsung Hero Spotlight: Clubhouse International

Rarely does a mental health service provider's name invoke images of friends gathering—but that's exactly what the word "clubhouse" does, and Clubhouse International has seen its friendly and human-oriented approach help grow its reach to one that's now worldwide. The organization, which began as a single Clubhouse is now a network of several hundred.

Clubhouse International doesn't just provide the standard clinical services, either. Rather, they connect people with mental illness to housing, employment, friends, and community. In turn, they've shown that these expanded services help to drastically reduce hospitalizations, suicides, and incarcerations. They offer an improved quality of life to people who don't often have access to it.

We spoke to Clubhouse International's executive director & CEO, Joel D. Corcoran about the incredible growth this organization has seen, the significant impact of their work, and how they're able to offer so many services on a slim budget.

The Journey From One Clubhouse to 325

Known as Fountain House, the first Clubhouse was founded in 1948. Nearly 30 years later in 1977, it established a national training program, and in 1987 began its expansion. Presently, there are nearly 300 Clubhouses in 32 countries worldwide, and every Clubhouse serves approximately 500 people.

Along with individual Clubhouses throughout the world, there are a dozen training centers. Corcoran says that "the transition from one Training Center, Fountain House, in New York to currently 12 internationally authorized Training Centers was necessary due to the fast-growing demand for help replicating the Clubhouse model."

He adds that "Clubhouse International was created by Fountain House and several other Clubhouses to coordinate the expansion of training along with promoting the model and providing a quality assurance system."

Training centers for new Clubhouses are located everywhere from Australia to Hong Kong to Utah. Corcoran tells us that "Each year, more than 150 groups from new and veteran Clubhouses participate in Clubhouse Training," which ensures that existing Clubhouses can offer the best possible services.

A Bevy of Services Provided

Clubhouses are different than job centers or mental health medical clinics. By providing so many different services under one roof, they can utilize a holistic model that results in better outcomes.

Their job training program is three-tiered, inclusive of Transitional, Supported, and Independent Employment categories. This means that no matter where an individual is in terms of skill set, Clubhouse can help them.

Independent Employment is the most hands-off, where support is kept out of the place of employment and occurs only at the Clubhouse. For Supported Employment, Clubhouse places its staff on the job with the worker, helping to train them and acting as a liaison, then eventually shifting to the worker being there alone.

Transitional Employment is a vocational rehabilitation program in which members work part-time, 15-20 hours per week, and are fully supported by Clubhouse staff. The transitional placements aren't meant to be permanent but instead give someone the skills needed for a Supported or Independent position.

Their unique job service program, and the documented results of those who move through it, set Clubhouse apart from other providers. Let's look at how strong the impact has been.

The Impact of Jobs Placed and Kept

It isn't enough to help people get jobs; they need to be able to keep them for long-term change to be possible in their lives. Corcoran says that "over 40% of the average daily attendance in our accredited Clubhouses have their Clubhouse members working in paid jobs in the community," which he tells us is "more than double the average of people with a persistent mental illness gaining employment in their respective communities."

It makes perfect sense that more people who can keep their jobs correlates directly to fewer people hospitalized or incarcerated. Corcoran tells us that "criminal justice system involvement is substantially diminished during and after Clubhouse membership." One study notes that "the extent of criminal justice system involvement diminished substantially" during and after a person's Clubhouse membership. Occurrences of psychiatric hospitalization are also reduced after involvement.

For marginalized populations, the employment results through Clubhouse's job programs are even more profound. One study noted that before receiving assistance, Latino mental health patients in the United States "had lower levels of education and disability income, were less likely to have worked competitively over the previous five years, had more severe symptoms, and worse psychosocial functioning than the non-Latino African American or non-Latino White participants."

Once placed in jobs, the study states that the Latinos placed in supported employment had better outcomes than those only placed in psychosocial programs or standard services.

Why Less Is More for Staffing

With how successful the Clubhouse International training programs have been, one could easily assume that this is a high-cost service model. In fact, the opposite is true. Clubhouses operate at a fraction of the cost of other services, and about half the annual costs of Community Mental Health Centers.

Corcoran tells us that reduced staffing is key to keeping costs down, and that fewer staff also creates a more realistic environment to prepare for job placement. He tells us, "Clubhouses are intentionally staffed with a lower ratio of members to staff than other PSR programs in order to fully integrate members into the day-to-day operations and leadership opportunities in our Clubhouse network."

Along with a smaller support staff, Corcoran says that Clubhouse members help with the upkeep of the facilities. They choose where they want to get involved based on their interests, and interact with other members in their work. Corcoran says that's helpful because "working together as part of a community of people with shared interests is restorative and therapeutic."

Lastly, the fact that so many services are provided under one roof also aids in keeping costs low, especially when compared to facilities that provide singular services. Corcoran notes that beyond the most publicized services, Clubhouses also have health and wellness programs and activities, early intervention, skills development, and advocacy.

How to Learn More or Get Involved

The scope of Clubhouse's work couldn't be more impressive, and as it continues to expand throughout the world, there are ever more opportunities for involvement. In addition to the below resources, you can donate directly to Clubhouse International through their website.

For People With Mental Illness

If you or someone you know would benefit from being part of a Clubhouse, it's easy to get started. Clubhouse membership is voluntary, open to anyone with a history of mental illness, and community-oriented. Clients are often referred by hospitals or healthcare providers or by a service such as National Alliance on Mental Illness (NAMI) or National Council on Mental Well-being.

For Providers

Feeling inspired to start a Clubhouse in your community? You're certainly not alone, considering their rapid growth rate. Corcoran says that "starting a new Clubhouse in your community begins with a group of interested people coming together and sharing a common vision."

When founding your own Clubhouse, you'll be guided at each step through the proper training needed. Corcoran says that "Clubhouse International leads new groups through the steps to making the dream a reality, in our new Clubhouse Development training and ongoing mentoring programs."

Employers and Employees

If you hire people to work at your company, you can get involved with Clubhouse. Thanks to their three-tiered program, you're able to choose exactly how involved you and your organization are able to be with the placement of Clubhouse members. There are also positions available within the Clubhouse network, with career opportunities ranging from Executive Director to Rehabilitation Associate.