Purpose and Community on Recovery Road - Clubhouse Int’l - Episode 30

Guest Joel Corcoran, Executive Director of Clubhouse International

WE are registered on Podchaser: 1JYHu8EZSiGN2dxr1Oz7

Clubhouse International:

A Clubhouse is an evidence-based-practice founded on the belief that even the most disabled can sufficiently recover and improve their lives with the help of a supportive community. The Clubhouse model provides pathways to meaningful social inclusion, work and wellbeing. First developed in New York in 1948 by a small group of former psychiatric hospital patients, the model has gained international recognition, scaling to more than 350 Clubhouses operating in 32 countries and growing.

“We help start and grow Clubhouses globally where people with mental illness can go to get their lives back.

There simply are not enough resources today for everyone with a mental illness who needs help. It’s a crisis situation and the numbers are growing.

Clubhouses powerfully demonstrate that people with mental illness can and do lead productive, happy lives. Each Clubhouse we open reaches +/- 500 

1. How does the Clubhouse program fit into the larger mental health system?
2. Sometimes the Clubhouse program is referred to as a peer led program. Is that accurate?
3. What kind of things does a Clubhouse do for someone living with mental illness?
4. What can a person joining a Clubhouse for the first time expect? 
5. Who is eligible for Clubhouse membership and what is expected of those who belong?
6. What is the long term vision of Clubhouse International?
7. How do Clubhouses get started?

Links:

https://clubhouse-intl.org/

Mindy talks about efforts to create a clubhouse in her state:
https://my.nicheacademy.com/rcladult/course/59353/lesson/169660

Who Are the 3 Moms?

Randye Kaye -Broadcaster, Actress, Voice Talent, Speaker, and Author (“Ben Behind his Voices”)

Miriam Feldman – Artist, Mom, Author “He Came in With It”

Mindy Greiling – member of the Minnesota House of Representatives for twenty years. Activist, Legislator, Author (“Fix What You Can“)

Transcript

Copy Transcript Copied

SPEAKER_01 0:01

Welcome to our podcast, Schizophrenia. Three moms in the trenches. From the place where schizophrenia and real life collide East Coast, West Coast, Middle America. With Miriam Feldman, Mindy Gryling, and Randy Kay. Our last episode was the Just Us episode, and I'm not sure how many solutions we've presented to dual diagnosis ladies at that time, but we did get a chance to vent, and a lot of listeners have gotten back to me to say they feel less alone, which is the purpose of those just us episodes. But tonight I really want to focus on solutions. And the clubhouse movement is something that I know Mindy, you and I have had experience with, and we'll talk to our guest in a moment. The title of this episode is Purpose and Community on Recovery Road, the Clubhouse International Movement. Because for my son, getting out of the hospital was barely getting out of the starting gate. And trying to get your life back is quite a journey. So that's what tonight is about. Anything new and exciting in your worlds before we bring on our guest?

SPEAKER_02 1:20

Yeah, a little snow Minnesota, but it's a little melting today.

SPEAKER_01 1:24

Okay, we saw our first holiday lights here in Connecticut. I think it was mid-November. It's time to do that.

SPEAKER_03 1:32

Lots of rain here. Lots and lots of rain.

SPEAKER_01 1:36

Well, I will say that we had a um my son came to visit last Sunday, and it was one of those delightful days that gives you hope. So just throw that out there. Take a good day when we get it, right? That's right. Always. So since we're about solutions, why don't we go straight on to the topic tonight? I've been wanting to talk on this podcast with Joel. You know, I'm gonna have to ask him how to pronounce his name. I think it's Corcoran, but when he comes on, we will ask him. He's the executive director of Clubhouse International. And what is the Clubhouse? I'll just read from their website and then bring Joel on. We help to start and grow clubhouses globally where people with mental illness can go to get their lives back. And again, straight off the website, I think we will agree, three moms, there simply are not enough resources today for everyone with a mental illness who needs help. It's a crisis situation. The numbers are growing, and clubhouses powerfully demonstrate that people with mental illness can and do lead productive, happy lives. So that sounds hopeful, right? So I would like to bring on our guest, Joel. Enter and sign in, please.

SPEAKER_00 2:58

Hello.

SPEAKER_01 3:00

I'm dating myself. First of all, tell me how to pronounce your last name.

SPEAKER_00 3:04

You got it exactly right, Randy. Joel Corcoran.

SPEAKER_01 3:07

I guess that's right. So, Joel, welcome. Um, I want us each to just take a minute and introduce ourselves to you. I believe you and I have met. Positive. It was 10 years ago when my ver when my book first came out. Did we meet at Fountainhouse?

SPEAKER_00 3:26

I think we met. It could have been at Fountain House, but I think we might have met at one of our breakfast briefings at the United Nations. Did you come there one time?

SPEAKER_01 3:35

I did not, but if there's another one, I'd love to come. With mask on now.

SPEAKER_00 3:40

It must have been at Fountain House.

SPEAKER_01 3:41

Yes. So I know then Fountain House is, I believe, the original clubhouse, but I'm going to let you tell all, you know, that whole story. So you know I'm the author of Ben Behind His Voices, which my son just told me this week. Why did you name it that, Mom? I don't hear voices. Why didn't you name it Ben Behind His Choices? So that was an interesting conversation. Um, anyway, just thought I'd throw that out. And I did have my son for a year in a clubhouse in Bridgeport, Connecticut. And it's spelled out in my book. And it was a very good year for him. He has refused to go back ever since. Maybe we'll talk about that more toward the end of the cast. But it was the first constructive thing he was able to do with his life after his five hospitalizations. And I'll be forever grateful for what the clubhouse did for him, which was to recognize his skills. And they made him editor of their literary magazine. And that was the first thing that he felt ever since his illness struck that used his talents. And he embraced that. And it was a really my first shining moment of pride in quite a while. So I'm a big fan of the clubhouse movement. So that's a bit of me. Me, uh Mimi, since I just said me, why don't you go next?

SPEAKER_03 5:03

Hi, I'm Mimi Miriam Felvin, and I've written a book too called He Came In With It, which is about our family's experience with my son, who is 35 and has schizophrenia. I have zero experience with clubhouses. The only, you know, I only know about it anecdotally, and we've never really had um an opportunity. Though my son right now is at a point where he's doing really well, and I'm thinking that it might be a good time to start looking into that.

SPEAKER_02 5:35

Okay, and Mindy. And uh thank you, Joel, for being here. I'm Mindy Greiling, and we have two uh clubhouses in Minnesota run by Vail Place. You may be familiar with them. Uh Jim was at Vale Place getting services at one time, but he did not participate in the clubhouses. But where he was for almost 10 years actually was um in our Minnesota version of the Fair Weather Lodge program, uh Tasks Unlimited that used many of the components that the clubhouses do, except that people actually live there or they live in lodges and then they get their services. But the idea of fellowship, um, making friends, living in a nice place, doing constructive things, working with the staff, not the staff working for you or to you. And um, and then empowerment, you know, that all the lodges are in charge of their own banking and their own cleaning and their own cooking and and all of that sort of thing. So I just I love the Fairweather Lodge model and the clubhouse model. Randy, I have to tell you, I went back today because you mentioned that uh, and I should say too, Joel, I like all of us, I've written a book. Mine is Fix What You Can, Schizophrenia and the Lawmaker's Fight for Her Son. I spent uh 20 years in the Minnesota legislature. Um, I went back, Randy, and um read your chapter today on Bridge House in Connecticut. And that was, I and I hadn't taken out your book since we first met, you know, virtually, but I was just um enthralled. I was looking at your book, and I when I read it, you know, 10 years ago, I had there's so many things I underlined and start. I hadn't started my book yet at that point, um, but I really um enjoyed your book at that time. And rereading that chapter reacquainted me with how important clubhouses are. So I'm so glad we have Joel here.

SPEAKER_01 7:30

Yeah, thank you. So, Joel, why don't you just, you know, give us your spiel? But you know, I know that it's very well practiced. I'd like to know how clubhouses began and what the model is, and a little bit about your story. Like, why are you involved? What got you into this work? So that's a lot of questions, but I know you can handle it.

SPEAKER_00 7:50

Well, you know, Randy, I appreciate it. I like I I do I mentioned a moment ago this is my favorite topic. It's so nice to meet the three of you and thank you for welcoming you here and having me here in this conversation. I love the idea of what you're doing with these uh podcasts and and the conversations I know are nothing but helpful. So it's um it's my pleasure to be here with you. I think I'll start with the second part of your question, which is is how did I get involved or how did I get here? I started working in the in the area of mental health in 1981. I was fresh out of college and I was um I was actually uh I had this job running a youth program in the city and I needed some extra money, and I took a job at night at a state hospital. And I had never really had a I did not have a lot of experience with uh people living with mental illness or the mental health system or any of those kind of things. And I was absolutely shocked by what I learned in my in my new job. I was shocked at how we as a society um treated people who had an illness. I was shocked at the conditions, the lack of hope, the lack of um of any kind of opportunity, and uh and the just sort of dismissing that I uh it seemed to me that we were doing in the name of healthcare to to people. And I became really motivated by by working there. And I I worked in the state hospital for a few years, and and then I got involved with a program that helped people move out of the state hospital. And as a few of you have mentioned tonight already, what I discovered as a young man is that you know, getting people, helping people to move out of the hospital was wonderful, but once it happened, there was nothing. There was literally nothing for people. I mean, uh the the support system, the healthcare system, the employment, the education, the acceptance of people as human beings, it just wasn't there. And I started working in a program that was um just you know try to help people come out and help people build their lives and regain some control over who they were as a human being. It was very, very hard. And it took, I did that for a number of years, working in um day programs and residential programs and case management and emergency services and all those kind of things.

SPEAKER_01 10:33

And this was New York City?

SPEAKER_00 10:35

No, this was um this was Rhode Island and Massachusetts.

SPEAKER_01 10:39

Okay, because I, you know, being from the Northeast, when we go the city where I live, it means New York. So the city you're talking about is the city I was in initially was Providence. Providence, okay.

SPEAKER_00 10:51

I worked in I worked throughout Rhode Island and and um and and southeastern Massachusetts.

SPEAKER_02 10:55

But it wasn't before you go on to your next part of the question. I just have to say there must be something about people who work in state hospitals that want to make things better, want people to have a chance to leave, but then want something to be there, because that's exactly how TASS Unlimited got started here in Minnesota, the Fair Weather Lodge program. It was started by people at the state hospital who first started an employment program. So people at the state hospital could work and have some meaning to their lives. But then when they got to doing so well because of that, they had nowhere to go. So that's when uh TAS Unlimited started in the community. So very similar to a journey.

SPEAKER_00 11:37

It's a very similar story to the to how many clubhouses get started as well. You know, for me, it just took a while before I um I discovered in my in my work and the opportunities I had to work and do things. I discovered Fountain House in New York City in 1986. So, and when I discovered Fountainhouse, um, you know, and I was not alone, I was introduced to Fountainhouse, is a better way to say it.

SPEAKER_01 12:03

Um it had been around for how I mean Fountain House is the original clubhouse model, correct?

SPEAKER_00 12:08

Fountainhouse is the original clubhouse in the world. Fountainhouse was the first, um, and it started in um bits of it, it started kind of evolved, but it really began and opened, you know, officially in 1948. But for me, you know, for me, I found a place that believed in people's potential that was focused on what they could do, not what they couldn't do, that gave people um a voice in their own uh care and um future, and which was so different in the mental health system that I had been working in, where people were focused on on what was wrong with individuals and mostly preventing them from doing things they shouldn't do. And no one talked really about the future and about goals. And the people that I knew um who were living with mental health have been told that they needed to they needed to adjust their goals, they needed to lower their expectations, they needed to recognize they were going to be on medication for the rest of their lives, and they were they were more than likely never going to work again, and they just needed to get used to that. And that was, and I just felt like that was the wrong way to go when I discovered Fountainhouse in New York and recognized that there were other clubhouses that were modeled after Fountainhouse, a place where people were first and foremost, whole human beings who had, you know, who had all the same rights and um as you know, as anybody else, and and the expectations at Fountainhouse is that people could live as full citizens in the community, right along with everybody else. And I became, just to finish my story, I became so captured by that that I um took a job opening the first clubhouse in Hyannis, Massachusetts, and I worked, and there were a number of people in Massachusetts who were working, family members and um mental health service providers and people living with mental illness who are working hard to bring clubhouses to Massachusetts. And there was a whole group that was doing that. That's how I got involved, and then worked to open uh two more clubhouses in Massachusetts, and then helped to support the development of clubhouses across Massachusetts. But all this time I was working with Fountainhouse, where I went to training and I learned, I learned the fundamentals of what a clubhouse is and how it operates. Fountainhouse, to come back to that, started um, you know, in the in the middle, late 1940s following World War II, where six men who had been discharged from a state psychiatric hospital back to Manhattan found themselves there with nothing. If you think about um think about the 1940s in Manhattan, there were no mental health systems. There were no um, you know, there wasn't a local mental health center. There wasn't very little in terms of outpatient treatment. And so these men um who had known each other in the hospital and part of a support group that started in the hospital got together and and and and said, why can't we recreate that experience supporting each other here in the community? And there's a lot of uh stories and mythology about meeting on the steps of the New York Public Library, which they did, and they met in coffee shops and other places where they could get and they began to support each other. And the way that I saw it was they recognized that they were stronger working together, try to be successful living outside the hospital in New York City than they would be alone. And they um they reached out to a to a volunteer from the hospital who was a wealthy woman in New York who helped with along with her friends, helped them create this group, start the group where they would support each other, but they also would write to people back in the hospital that they knew and said, when you get out, come and see us, join our group. They formed a society. They formed a society or a club that um was, as I understand it, loosely based on sort of the the university clubs and men's and women's clubs in New York City at the time. They didn't really want to be connected to um the mental health system and the stigma associated with that. So they called themselves the WANA Society, W-A-N-A, which was an acronym for we are not alone.

SPEAKER_02 16:24

Oh wow, that is the that's the motto for our NAMI Ramsey County affiliate. Well, it's you are not alone, but that is um that we have in our teachers, the group I'm in.

SPEAKER_00 16:35

Today that's still the um the sort of the driving force behind what a clubhouse is. You know, Fountain House um uh the was the first clubhouse and they began to um that began to uh draw other people to um to their group. And at first it was mostly social, but there was a board of directors and they formed a non-for-profit organization, they raised some money and they got a building that had a beautiful fountain in the backyard, and they changed their name to Fountainhouse.

SPEAKER_01 17:01

Oh Fountainhouse.

SPEAKER_00 17:03

So there were several books. You can look them up online to learn about Fountain House itself. But the um what they did is they formed this membership organization, and there was a board, and the board was supporting them, and eventually they hired staff, but probably not until about 1955. So they were operating without staff for all that time, just helping each other. They went through a couple of directors until the board found this um young social worker from Detroit, Michigan, named John Beard, who came and came to New York as their executive director. And he really um worked with the members and and staff that he had then to design what became known as the fountainhouse model, or later the clubhouse model. Um and it's you know, still pretty much today operates on the same basic principles. During the day, uh the the things that happen at a clubhouse are focused on work, taking care of the place, but also the work to support each other and rebuilding their lives, getting the services, the supports, and the opportunities they need to be successful, and to draw on the talents and strengths of the members themselves. And that environment in and of itself was therapeutic. Shared work, real relationships between members and staff. Um, and an important part of that of the clubhouse program is that what happens at a clubhouse is not designed to be treatment or clinical or service-oriented. Um, a clubhouse is a membership organization where the people who come who are to be eligible for a clubhouse, you need to be a person living with a history of mental illness. Okay, and if you are, um you can be a member of a clubhouse, and the people who come there use their talents and skills to help the organization, each other, and therefore themselves rebuild their lives in a way that's satisfying to them.

SPEAKER_01 18:50

So okay, so uh explain to Mimi what would happen to her son if she were to find a clubhouse where she lives. By the way, she's on the West Coast. I'm not exactly sure. Sometimes she's in California, sometimes she's in Oregon. I'm not sure. But I'm in Washington State and we're in a small town.

SPEAKER_03 19:10

The only there's a couple really great clubhouses in Seattle, but we're a good two hours or more from there. So it's that's a little prohibitive unfortunately.

SPEAKER_01 19:21

So theoretically then, it so it what what would happen? Let's say your loved one just got out of the hospital, they're done with the day program that insurance paid for or whatever, and now they don't know what to do with their days. What would happen in a clubhouse for someone like any of our sons?

SPEAKER_00 19:38

Great question. You know, the the the clubhouse model, you know, evolved from the 1950s today. And it it same principles, but it is a very specific way of working and it's evolved. It's just it's a sophisticated opportunity system. So someone who's um someone living with mental illness who comes to a clubhouse can first and foremost expect to be welcomed and to find people there who understand their experience, which may sound like just kind of a matter-of-fact thing, but it's really a it's really important part of what the clubhouse world is. The membership organization as a clubhouse is made up of people who understand what it's like to try to live in the world with a mental illness. And they are united to try to help each other. So the the clubhouse is meant to be a safe place, which a lot of times people living with mental illness don't have a safe place or don't have access to many safe places, and they're not welcomed or don't feel welcomed in a lot of places. So the clubhouse is a place that says, Yes, you belong here, come join us. We want you and we need you to be part of our community. And we have things here that you can help with, and that hopefully can help you. And so the what you find when you go to clubhouse first and foremost is just this welcome and this understanding. But shortly after that, after you're accepted for membership, which is usually a pretty easy process, you know, you have to want to be a member, nobody membership is voluntary, so you can't be court-ordered to a clubhouse, you can't be required to go to belong to a clubhouse by your residential program or or or by your doctor. You you go because you want to. So you find a voluntary environment. And the things that you do at the clubhouse are up to you. And how often you go to the clubhouse, how long you stay, um, whether you go away for a while and come back again, what you get involved with in terms of clubhouse, who you get involved with is all up to you. So you find an environment where you are empowered. You are empowered to make decisions about your life and to engage in a place that is usually rich with activity, that is a Usually a pretty routinized schedule of activities and opportunities throughout the day. And you find people who not only want you to be along with them, but are there willing to help you get involved and get engaged. So during the course of the day of the clubhouse, we call it the work order day. That time, usually eight hours, nine to five, or depending on the community and the culture you're in, the world, whatever the work day is. But Monday to Friday usually. During that time, the work of the clubhouse is done and it's organized into areas we often call units. And there's activity, and it involves things like taking care of the building. When you come have a lot of people coming together every day, you have to feed them. So there's food service work to do. There's also mental health advocacy. There's clerical work that has to be done whenever you're running an organization. There's money to exchange hands, and that has to be managed. There's planning for the future. There's helping new members get acquainted. And then there's work that is designed to help members reintegrate with the and participate in the larger community. So there's a robust employment program that has several components to it, that members have the opportunity to go to work at an employer's place of business for the prevailing wage and get the support necessary to be successful. There's opportunities to go back if you or start your education if you if you didn't um didn't finish your education at whatever level that is, and whether it's high school or adult community education or college or university or graduate work, if you want to pursue your education, there's opportunities to get the support and help to engage with um education again. If you need services like doctors or or or health care of any kind or housing or transportation, the work during the clubhouse is helping members get and sustain the kind of support they need there. In addition to that, there's an evening, weekend holiday program. Because at a clubhouse, the it's it's probably important for me to say that first and foremost, a clubhouse is a community of people. And whenever you have a community of people together, yes, there's important work to be done, and you want to draw on the strengths and talents of each other and you want to help each other learn new skills and new talents, but you also want to have fun. We think fun's an important part of um of recovery and of belonging and having a social network. So staff and members together on the evenings and weekends and holidays, there's social and recreational program that of course has to be organized and managed. So it might be something that's uh structured, like um, you know, uh going to a show or a ball game or an organized picnic, or it might be unstructured like pizza night in a movie at the clubhouse, or it might be um, you know, going uh going Christmas shopping or going to go to see the the holiday lights or um or doing a community project like helping uh join the neighborhood cleanup or those there might be things like that that go on, but lots of activities are normal for the community. So if you're a member coming to the clubhouse, you're going to find a sophisticated opportunity system that is very easy to engage with and you and no pressure for you to choose to do more than you want to. Oftentimes when people come to us, they're not at their best at a clubhouse. So we recognize that. So someone can come and just have a cup of coffee and watch for a while and and come back another day. What you will find though, and I'll take a breath here in a moment, but what you will find is that the clubhouse is going to try is is going to give you lots of opportunities to engage. You may not have a lot of confidence in yourself, you may be skeptical, you may be um, you you may not be that interested, but when you come to the clubhouse, people are going to say, Hey, do you want to join? Do you want to do this with me? I could use your help because I can.

SPEAKER_01 25:52

And they they do need to that's that's key. I know again, and and I will tell you that after his year was up, my son was like, Well, I don't have a mental illness, I don't need to go back with the, you know, but for the year that he was there, what really helped him in my estimation was we need you. We need you to he ran the cash register in the lunchroom. But oh, I hope you come to work today. I I think a big problem for my son, I'm gonna speak for him, which is is the only thing I can do at this moment, is it feels useless a lot of times. And what Bridge House gave him was being needed to the skill, and even when and when they said, Oh, you're a poet, you know what? We need an editor for the for our literary magazine. That is the first thing that made him feel special in a long time. And I know even for myself, like there are organizations I belong to that I'm like, eh, I don't feel like going tonight. But if they go, oh, you're emceeing the meeting, well, I have to show them, right? So we all need to be needed. And to me, that was a big part of it, just to see somebody get a purpose back.

SPEAKER_00 27:08

So I well, you know, you're right, Randy. You know, in a clubhouse, uh these, you know, a clubhouse is a partnership model. It's not a staff run organization, it's not a peer-run organization. It is a partnership model, but there's a small professional staff, yes, that has some bottom line responsibilities, yes. But the way the place comes alive, the way the work gets determined and decided, and the things that are focused on um are by the people who come, the membership, the people who come and make up that community. The staffing is kept intentionally low at a clubhouse because the we want to create that environment. We do create that environment where the people who come as members are not only wanted, but they are in fact needed to get the work done. So the staff, the staff role is not to treat or serve or impart wisdom to members, it's to be working colleagues, but talent scouts and cheerleaders, problem solvers. And and and and you know, and and just like you know, sometimes people ask me, well, why do you call that club? What do we mean by club? What do you mean by that? I say, well, think about any membership organization you belong to. Like if you belong to a health club, okay, you you join a health club in your community. There's all kinds of opportunities in a health club, right? You can lift weights, you can do cardio, you can go to the juice bar, you can sometimes you go to a steam room, sometimes you can get involved in classes, you can get personal um attention for your own rehabilitation needs, whatever. You pick and choose when you join the club what you want to be part of. And a big part of a health club are the other people who are there, the people who you know you might engage with, you choose some and not others. Um, but there's a small professional staff who have some bottom line responsibilities for things they have to do. But the actual health club is all the people who come and do the things. It's not different in a clubhouse for people living with mental illness. The difference is is the eligibility requirement. You have to be a person living with a mental illness. And second, the things that we're focused on in a clubhouse are those things that are important to people living with a mental illness. So, what you know, things like we talked about a place to belong, opportunities to have friendship, to be needed, have something to do, opportunities to improve your circumstances, something to do on a Friday night. I mean, those are the kind of things we all want, right? And so the clubhouse does that. But it's um, you know, it's you know, it's it's it's more the it's not a place of vicarious learning. It's not a place you just come and hang out. There are real things going on in the clubhouse. If you come, you're gonna see activity going on and you're gonna be you're gonna be encouraged to participate and to join. You don't have to, and though maybe inspired.

SPEAKER_01 29:52

Maybe inspired maybe inspired when I when I toured Fountain House. I was just everybody from the person who gave me the tour to someone who was explaining how Fountain House helped them to get housing, which not all of them do, just everybody was very impressive and meant to be their best. Believe it or not, we only have about 10 minutes left. So I want to make sure that you know Mimi gets a chance to, if you have any, I know you're just listening because this is a new concept for you and you may not have it, but I just want to see if you guys have any questions or anything you want to add to the conversation because I know we do want to cover what do we do if our loved ones are reluctant to go? What can families do to help you? What can people what can our listeners do to find a clubhouse? I mean, there's so many. So I have tons of questions, but I'll let Mimi go first since she's new to clubhouses and muted and she's muted.

SPEAKER_03 30:46

I don't have that much experience with it, so I really don't have that much limits. So go ahead.

SPEAKER_02 30:52

Okay, well, thank you. I just I have I will limit myself to a couple of questions at this moment, but I'm wondering about the involvement of families or if it's a philosophy that this is a place just for the people with mental illness and not the families. Um excuse me, and maybe her in the Randy's book, she wrote about speaking at some event and um so that it was family involvement. But just generally speaking, I know when Jim was um intense and limited. One of the things I loved about it was he and all his needs been there, and we could just be the family. You know, he when he came to visit, um, he was so happy to see it, and he was also just couldn't wait to get back, you know, to his friends and to his productive life. And it was more the relationship we have with our adult daughter, who we see her occasionally, but she doesn't, we aren't her main support, you know, as an adult. And so what is the family involvement? And then my second question is um, knowing that I'm guessing a lot of people you have are people with schizophrenia or serious bipolar woman. And I know for my son, when he comes into a place, if there are too many people or it's too big or it's too loud, you know, he won't he will retreat. So family involvement, and then what is the environment when people are there? Is it quiet? Is it separate little groups, or how does that go?

SPEAKER_00 32:32

Those are two great questions. And so thank you for asking them. You know, the um family involvement in clubhouses, um, I you're right, the clubhouse is designed to be a place where um members, people who come and belong, uh, a place where they're not a patient or they're not someone who needs is receiving care there, and it's their place. It's their clubhouse. So there's not a lot of family involvement in the day-to-day activity in the clubhouse. Having said that, though, across the United States and really throughout the world, family members have been instrumental in getting clubhouses started, helping to support clubhouses, advocacy for support for clubhouses, serving on boards of directors, and getting involved in projects that help the clubhouse um go and grow. So families um sort of naturally have become an important part of clubhouses. Many clubhouses in the United States were started by either um people NAMI members or NAMI chapters or those kinds of things that get involved there. But um most families are on the periphery of the clubhouse. There's not a lot of involvement in the day-to-day activities because it's a place that belongs to the members and it's for them. Um, and so there isn't a lot of volunteer work, like people don't come in to volunteer to cook or to or to um or do the books or do it because all that work is part of the therapeutic environment that is the club. So the work um is is broken down into small tasks when it needs to be, or big task if people have the talents and skills to do those things, like um, you know, creating a website or a video or going and advocating for mental health at the state house or those kind of things. Or it can be small, like answering a telephone or helping to chop the potatoes. And that kind of leads to your second question, which is um, you know, the experience for people maybe who don't want to be in a crowded, busy, noisy environment. Um, most clubhouses are going to have a fair amount of activity going on every day, but the activity is also divided into um into different what we call units or departments or sections of the clubhouse. And people can choose where they want to be involved at the clubhouse. So somebody who wants to be in an active environment might choose the kitchen, you know, where there's gonna be a lot of big stuff going on. Somebody who who's maybe less likely may want to get involved with the literary magazine, maybe wants to be involved with one or two other people and work on the literary magazine. Somebody might be um, you know, somebody might be in interested in um driving the van, being the person who helps members go to their employment or go to school and picks them up every day. Because clubhouse runs a trans, some clubhouses run transportation systems. Another person might be interested in, you know, take care of the outside of the building. Somebody might be interested in the bankings or the those kind of people get a chance to use their talents or learn new ones. Um, clubhouses vary based on their the size in the city. The average clubhouse has about 150 active members, meaning people who use the clubhouse on a regular basis, um, with an average daily attendance of about 60, 65 people. But the largest clubhouses, the few largest ones have 300 people coming a day. There are smaller clubhouses that have 15 people coming a day. So it depends on where you live. Now, somebody mentioned finding a clubhouse. You know, if you look on our website, there's a there's a directory there, it says find a clubhouse near you, and you can search a map by scrolling over it, or you can put a name in or a city in and look up where the clubhouse is and all the contact information, and many times a hyperlink website so you can go see that clubhouse and see what it's about in your community. There are over there about 210 clubhouses in the United States. There are 325 in the world, and so it's you can um it's pretty easy to find a clubhouse. If you can't find one, call us, we'll help you find one.

SPEAKER_01 36:29

So and this is to uh to be clear, is there a membership fee or is this all club?

SPEAKER_00 36:37

There is no membership fee at clubhouses. Clubhouses are free. Some clubhouses have instituted a uh, you know, uh the clubhouse members and staff themselves institute some fees to think, but that's very rare. Usually clubhouses are are just are free to members and again entirely voluntary. And another important feature of a clubhouse is um we talk about the some basic rights of membership: a place to belong, a place to build meaningful relationships, a place to find meaningful work and education, things to do, but also there's a right of membership, a right to return. So if you go away for some reason, you you lose interest, or you um or you um are or you're hospitalized or you get a job and you work for a long time, but time in your life comes back, and you need to you want want to or need to come back to the clubhouse, you're always welcome. You're just back as a member. You don't have to go through some process or anything, you're just back as a member. And that's important to a lot of people because you can't get too sick to be a member, you can't get too healthy to be a member. Membership is for life.

SPEAKER_02 37:40

Um, and the rest of the mental health system uh feel about clubhouses. There was a little bit of backlash um against Hassan Limited in Minnesota, you know, that they were doing enclave and employment when the going thing was was um you should be working in competitive employment by yourself. They were having people live together four to eight people per lodge, and the coming thing was you should be set up in your lonely apartment by yourself, et cetera. But how does the rest of the mental health system in general view clubhouses?

SPEAKER_00 38:16

I think the mental health system's come a long way in the last 20 years and have begun to recognize mostly because the evidence is published. There's a ton of research that demonstrates the effectiveness of clubhouses. Outcomes are there. But I think that, you know, when you think about um something like employment, and I said employment is a foundational piece of the clubhouse model. About 49%, 42% of the average daily tenants at clubhouses are working out in employers' place of businesses, in um in prevailing wage jobs that are integrated into the community, you know, that. But the clubhouse doesn't take um, you know, that harsh a view about you know this model, that model. Clubhouse has sort of three approaches to employment transitional employment, supported employment, and independent employment. And they're all all designed to meet members where they're at. Transitional employment is unique to clubhouses, it's an over-the-top support system where the clubhouse partners with an employer and provides a vocational rehabilitation experience that's designed to help people rebuild routines, rebuild self-confidence, build references and jobs. And the clubhouse goes to great lengths to make sure that people are successful in those jobs, up to and including absentee coverage. If the member has to be away for a day or two or whatever, the staff person who's assigned that will go in and work that job. And that's a partnership agreement with the employer. The employer becomes a partner in the rehabilitation process. Supported employment is also supporting the employer some, but mostly helping members go and work in jobs that are out there in the community and providing a lot of support on and off-site at the members' discretion to be successful at those jobs. Those jobs belong to the members. So transitional jobs belong to the clubhouse, and members stay on those for their time limited, and you move on from one another until you're ready to go and get your own job, and you'll get support to it. Independent employment is members who clubhouse helps members, if they want it, get their own job and provides the support back at the clubhouse before and after work that members might need to be successful on their job. And there's no real relationship with the employer there, just with a member. But that array of employment provides lots of opportunities for members. And there are group placements in the transitional employment program where that can work really well for some people. There are individual placements. Um, so the clubhouse is designed, you know, to meet people where they are. And we recognize that things change for people. Somebody might need a lot of support this year and not so much support next year, and the year after that, they may need a lot of support again. And so if you're part of the clubhouse, you can go there and during the day, you know, part of the structure of the clubhouse is people get asked, is there any is there anything you need help with today? And that usually happens a couple times a day in unit meetings. And if people want help, they can say, Yeah, I need to talk to somebody about my housing, or I need to talk to somebody about my job, and they get help with those things. And something really important to remember about a clubhouse is the longer a clubhouse is in a community, the more knowledge and expertise that that place, that community develops about how to successfully live in this community, even though you have a mental illness.

SPEAKER_02 41:27

Having been an elected official for 20 years, I can say that employment piece is huge for getting support from everybody. That's a bipartisanly supported component of the mental health system. The idea that people couldn't work, they were told not to work, and now they can and they do and they are, that gets huge political bipartisan support, and I bet community support as well. Not to mention that it's evidence-based and good for the person themselves.

SPEAKER_00 41:57

You know, employment's important in a clubhouse because it's employment to people who are members of clubhouses. If you talk to people who are members of clubhouses and you have more than just sort of a cursory exchange with them, you'll find that the vast majority of people living with mental illness want to be employed. They want to have a job, they want to have a place where they can go and contribute and be compensated for what they do. They want to be part of that community. And so the clubhouse prioritizes it. Not every clubhouse member wants to go back to work. Some are retired, some aren't ready yet, but the vast majority do. So clubhouses prioritize employment, and it's always been that way. You know, I want to get this in before we go too far because I know I've run out of time. But the clubhouse um is organized around 37 best practice standards that have been developed over the years by members and staff and board members of clubhouses. And the clubhouse, um the clubhouse model is a very specific way of working. And it has, you know, I barely touched on most of the things here tonight, but these standards describe how that program is. You can find them on our website. And clubhouses hold each other, the clubhouses themselves, and the members and staff hold each other accountable to these standards that involve empowering members to make choices in their own lives, creating this kind of opportunity system I've talked about. But we we have a very sophisticated training program also that uh we have 12 training bases across the world that provide intensive training. There are conferences and seminars and papers and courses you can take and clubhouses and get involved in the way that they want to. But we also have a quality assurance program. There's a formal accreditation program for a clubhouse. If you're looking at an organization and it's calling itself a clubhouse, you should ask Are you an accredited clubhouse? Because there's a difference. Accredited clubhouses have far better outcomes in all the areas we talked about tonight. You know, uh good hours of service, opportunities for members, employment, education, all of those evening, week, and holiday programs, empowering members, um, all That stuff is all in our standards, and clubhouses are accredited. And so you know, to and the accreditation process is really it's uh it's an objective peer review where the people who are doing the accreditation are member staff teams.

SPEAKER_02 44:13

Are the ones on your website all accredited?

SPEAKER_00 44:15

Um, almost all of them are to to to be a member of Clubhouse International. We you have to achieve accreditation within four years of joining and then sustain that accreditation thereafter. And accreditation is is is um it it's is awarded three-year um segments. So you get an accreditation for three years, but after three years, you have to go through the accreditation process again. And it's designed to keep people focused on those things that are most important to members and to make sure that opportunity system is there and really to help clubhouses continue to get stronger every year.

SPEAKER_01 44:49

So uh we've talked about the website, and obviously I'll put it in the description, but the website is it's www.clubhouse or rg. Clubhouse.in since we are running out of time, but it's a little flexible, what are the most important things we haven't asked you yet that you want our listeners to know?

SPEAKER_00 45:18

Well, you know, I think when you started, Randy, you talked about the clubhouse movement, which is a word we use a lot. We've talked about it as kind of a social movement, creating these um these very special caring communities for people living with mental illness that are rich with opportunities. But um, you know, it's it's more than that now. It's a network. There's a network of clubhouses across the world that are supporting each other, um, reaching more than 100,000 people a year now. But we have this vision in the clubhouse world that one day clubhouses will be as commonplace in the community as YMCAs and boys and girls clubs and senior centers, because we think that's where that kind of support for fellow human beings who are struggling with an illness, that's where that belongs in in sort of our society. Every community should be taking care of each other. Um, and so we we we our mission is to try and help communities get clubhouses started and then to grow and sustain those clubhouses. Clubhouse International, that's our only mission. We're not trying to be a big not-for-profit organization. We work to help club help communities create and sustain clubhouses. So, one of the questions I wish you'd ask me was how do we get a clubhouse started in our community?

SPEAKER_01 46:31

How do we get a clubhouse started in our community? Because Mimi wants to do it. Yeah.

SPEAKER_00 46:37

What we do, we work right now, we're working with a little over 60 groups across the world right now, um, help working to get a clubhouse started in their community. It starts with a few motivated people. It rarely starts with um, you know, um somebody coming, somebody parachuting in and saying, I'm gonna open a clubhouse now. It starts with people who have roots in that community and have people they care about or that are living with a mental illness, and they begin to organize. We work, we're available to work with organizations and people in any community who want to learn what a clubhouse is, how it works. And when you're ready to start a clubhouse, um, we have we we have lots of opportunities for you to learn the details of it. We have a very short two-day workshop kind of program where we we teach a small startup group those things that are necessary if they need to know it. You know, how to get an organization started, how to become a not-for-profit, how to create a board, how to build support in your community for a clubhouse. Where do you find the money? What kind of building do you need? How do you hire the director? We help you build an action plan to get that started. And we we we help communities work and get that going. We give you a mentor or a coach for a year to work with you to help keep that going, and then connect you with the rest of the community because club one thing clubhouses love to do is help other clubhouses get started and get stronger. And each clubhouse is this cadre of people who are willing and able and experienced to help. And so there within our network, there are lots of people who are ready and willing and volunteer to help you get your clubhouse started. And once you get up and running, there's a whole training program and the accreditation program and standards and a network of support. So, really, you just have to learn a little bit about it. Look at our webpage, go visit a clubhouse. Clubhouses love to give tours. Go visit a clubhouse. And if it's what you think you want in your community, contact us and we'll help you get started.

SPEAKER_01 48:31

Awesome. Well, we I will just um close with a quick story. That in my community, there's something called happiness clubs, and they're all over the world. But the guy who started them in our community, his name is Lionel, and he started one at Bridge House. He went to them and said, you know, can I? And I went to one of those meetings. And as much as the supported employment and supported education programs gave me hope to see the men and women in that group bonded together with happiness just because they were together. And saying how this happiness club, because I'm just glad I'm here with all my friends, that gave me more hope for my son's future than anything else, because the thing he was lacking most at that time was friends. And so that is kind of the, you know, the icing on the cake, really, and the reason the way it started, let's help each other. So, you know, we talk about the four pillars of recovery and purpose, structure, community, and treatment. And at least three of those are found in a clubhouse. So I just thank you so much for joining us and for your work and your passion for this. Clubhouse-intl.org.

SPEAKER_00 49:58

And there's all come to visit a clubhouse. I hope your listeners will will take a time to get to know us and come visit because community is really what it's all about. And the mission of Clubhouse International is to end social and economic isolation for people living with mental illness. That's what we do. That's what a clubhouse is designed for. And I'm sorry, but you know, clubhouses work in cooperation with the the rest of the mental health system too. So we we're connected to that fourth pillar as well, because we help people get the best treatment available in their community.

SPEAKER_02 50:30

You've inspired me. I don't know about Mimi, but I want to start one. I'm finishing up my term, my two-year term as president of my NAMI County affiliate this spring. I've been wondering, what am I going to do next? And um there's a lot of people on our board who are people with mental illness, and then we have the family members. And I think it's a common thing that there just aren't enough places. There's not enough the employment help that we get through the professional people isn't geared to people with mental illness. And this maybe this will be my next mission. So I have one question and then I'll get the rest from that coach for a year. But do you ever get government money or is it privately raised?

SPEAKER_00 51:12

Oh, that's a great question. You know, clubhouses um in the United States, probably about 95% of the funding comes from state, city, county, municipal funding. When you first get started, you have to work to usually there's very little money in the mental health system. So you have to convince, you know, to show them it's worth. So clubhouses all do private fundraising as well. And sometimes getting started, you really have to raise that money privately. But we can we can help you look at how to do that and tell you what's been successful in other places. You should go talk to the people at Vail Place because they are very interested right now in seeing more clubhouses get started in Minnesota. And I think they'd be eager to help you.

SPEAKER_03 51:47

I'm gonna do that. Mimi, what about you? Well, you know what? As I'm sitting here listening to all of this, I'm remembering that there actually is a clubhouse here in Centralia in our small town. And uh Nick's involved, Nick has an act team, and she's brought him over there and he and he didn't want anything to do with it. But after this conversation, uh I think I'll go over there with him and check it out another time. Uh, you know, I like the whole idea of the family not being involved and it being his thing. One of the things that I run into a lot is he only wants to do things when I do them with him. And he's a grown man. And I think it would be so great for him to move away from that and have something of his own. So I'm gonna get involved in getting him involved.

SPEAKER_00 52:36

I would I'd encourage you to talk to the folks at Hero House Northwest. And they are the they are the Seattle uh collection of clubhouses there, but they are also on a mission to bring clubhouses to the rest of the state of Washington. They are they're working and they're they're they're gathering people now who want to do that.

SPEAKER_03 52:53

I'll do that. Because it already exists now, here it is here. They have a storefront, they have a place. You know, I it's not it's not accredited or involved with your group, but you know, maybe I can help steer them towards that.

SPEAKER_00 53:06

That'd be great. We'd love to talk with them about it too. Right. You know, their their clubhouses, um, you know, they're I've said it all, you know, it's it's a wonderful, caring community, and that's um, and and and people find a place where they can belong, and you know, and they build those trust relationships that make them want to be with other people as well.

SPEAKER_03 53:26

Well, you'll be getting a call from our local person soon.

SPEAKER_01 53:29

So there you go. So, you know, we we always like to have a show that has hope and solutions, and I love the idea of ending social isolation. So, Joel Corcoran, thank you so much for joining us.

SPEAKER_00 53:45

Thank you. Thank you, Elizabeth. My pleasure.

SPEAKER_01 53:48

Hey, thanks for joining us for this episode of Schizophrenia Three Moms in the Trenches with Randy K, Mindy Gryling, and Miriam Feldman. To get in touch with us or to learn more about our books, please visit our websites at MiriamHyfenfeldman.com, MindyGryling.com, or randyk.com.