Measuring perceived outcomes from participating at a clubhouse for persons with mental illness: Psychometric properties and associated factors

Background: The clubhouses are part of a growing international movement concerned with providing work-oriented psychosocial rehabilitation for people with a history of mental illness. Instruments used for measuring outcomes from clubhouse participation is in a developing phase.

Aims: This study aimed to assess psychometric properties of an outcome survey tool used at a Norwegian clubhouse, and to explore factors associated with members’ perceived outcomes from participation at the clubhouse.

Methods: A cross-sectional design was used. The instrument’s factor structure was examined with Principal Components Analysis (PCA), and internal consistency was assessed with Cronbach’s α. Associations with the derived outcome scale score were examined with linear regression analysis.

Results: All scale items belonged to the same latent factor, and internal consistency of the items was α?=?0.81. Members, who used the clubhouse more frequently perceived the outcomes from participating to be better, compared to their counterparts.

Conclusion: The outcome scale was unidimensional and the items fit well together. Active members were likely to evaluate outcomes of clubhouse participation as more positive, compared to less active members.

Significance: The scale can be useful for exploring clubhouse members’ perceptions of the outcomes they relate to their participation at the clubhouse.     

The business of staying in business: North Carolina Clubhouse programs

Clubhouse Model Programs in North Carolina are threatened by significant local and state reimbursement mechanisms. The goal of this study was to examine the impact of diminished state resources and administrative changes on the ground, from the perspective of Clubhouse members and staff at two Clubhouses in North Carolina. The lead author conducted participant observation for five weeks at each site engaging in various daily activities with members and staff, conducting conversational interviews, and reviewing program administrative data to corroborate findings. Income lost to decreased Psychosocial Rehabilitation (PSR) rates, decreased billable hours, and an increased delivery of non-reimbursed services represented a significant net cost to the Clubhouses’ operations and finances. The impact of these costs varied between the two organizations largely due to differing policies enacted by their Local Management Entities (LMEs). The costs of forced budgetary changes at the state level created varying degrees of hardship between clubhouses and their service missions.     

精神康复会所模式对精神分裂症患者干预效果评价

目的：探索会所模式对精神分裂症患者的康复成效.方法：选取罗湖区慢性病防治院精神科门诊就诊的精神分裂症患者作为研究对象,根据其康复模式分为会员组和非会员组,分别进行为期12个月的会所模式和一般社区职业康复中心模式的康复训练观察,采用自身前后对照法进行效果评定.结果：经过康复训练,会员组LSIB得分由（10.23±4.35）上升至（13.23±3.21）,而非会员组由（8.56±4.60）上升至（9.77±4.57）,上升趋势具有统计学意义（F时间= 5.810,P〈0.05）,且会员组上升幅度明显高于非会员组（F时间＊会员=4.030,P〈0.05）;患者焦虑抑郁、缺乏活力、思维障碍、激活性和敌对情绪都明显减低,且具统计学意义（P均〈0.05）,且在＂思维障碍＂方面,会员组下降幅度大于非会员组（P〈0.05）.结论：康复训练有助于提高患者生活满意度,改善患者病情,提高患者自知力,且会所模式独有的康复特点对患者的后期康复效果优于一般社区职业康复中心.     

The effects of an arts intervention program in a community mental health setting: A collaborative approach

Throughout history, musical and visual arts have played positive roles in healing the human body, mind, and spirit. In traditional treatment settings, arts interventions offer opportunities for emotional expression and social interaction and have been shown to improve motivation, to increase personal empowerment and to relieve negative symptoms associated with mental illness. The purpose of the current project was to examine the effectiveness an arts program for individuals with chronic mental illness served by a community “Clubhouse”. Another goal was to develop a model for serving this population based on collaboration between a practitioner-based arts in healthcare program and a clinician-based music therapy program. Results showed that arts sessions improved feelings of well-being, and member-participants reported that sessions provided fun, relaxation, socialization, creativity and a sense of belonging. Improvements also were noted in the ability to manage self-care and in overall quality of life. Implications of the project's results and recommendations for future research also are discussed.