Imagine a place where any person with any mental health challenges can come, spend their time productively, make friends, and experience a time without any mental health stigma. This place is a house, but a place with no authorities, no clinicians and patients, where all people are equal, all people contribute to the running of the house, and all people are there voluntarily. No monitoring, no restraints, no hierarchies, no labels.
This may sound like something of a dream. But this dream has been captured, to a large extent, by a phenomenon called Clubhouses.
Clubhouses are community and member-based places where all people with mental health concerns are welcome to come and engage with each other and with meaningful activity without stigma. The idea is to provide people with a space for relationships and friendships to grow, where all people, including staff, are equal, where people can work productively on projects relevant to the house, where people are needed, and where people can work towards their recovery goals. Indeed, whilst staff may to some extent, guide activities, members and staff support each other’s recovery.
The idea driving the Clubhouse movement is for people with mental illness to work towards recovery in a strengths-based, non-clinical, and non-stigmatising environment. The research on Clubhouses suggests that this recovery is very often real and significant – with reduced hospitalisation, greater quality of life, increased integration with the community and other people, and reduced or fewer symptoms[1]. More research into employment outcomes for employment programs embedded at Clubhouses, and for health promotion activities at Clubhouses would be valued[2].
The Clubhouse model originated in 1948 in New York. It has been estimated that now over 370 Clubhouses exist around the world in 32 to 34 countries, including the United States, Great Britain, Canada, and Australia. The Clubhouse movement is centred around Clubhouse International, who represent a very significant number of Clubhouses around the world. Clubhouse International provides 37 Quality Standards towards which Clubhouses may aspire. The Standards are grouped into eight areas:
- Membership, which governs the access and opportunity to people with mental health challenges to access membership of Clubhouses;
- Relationships, which governs the egalitarian relationship between Clubhouse staff and members;
- Space, which ensures a “dignified, attractive environment” where meaningful activity is carried out;
- Work-Ordered Day, which governs the structure of meaningful, day-to-day activities;
- Employment, which ensures members have opportunities to move into meaningful, paid employment outside the Clubhouse;
- Education, which ensures members have opportunities to engage in education;
- Functions of the House, which ensures the House addresses “basic requirements for meeting members’ needs”;
- Funding, Governance and Administration, which lays out standards for managing Clubhouses.
These standards embody principles that ensure a safe and supportive community that supports recovery. A fundamental standard is that membership of the Clubhouse is entirely voluntary. There is no coercion, restraint, or prescription.
Natalie Krkovska, NDIS Complex Mental Health Support Worker at One Door, writes that:
“Attending the Clubhouse means stepping into a safe and supportive space. For many of our members living with mental illness, it becomes a place where they feel understood, respected, and valued.”
Clubhouses provide a sense of purpose and meaningful activity. One of the most important factors in the Clubhouse is the ‘Work-Ordered Day’. The Work-Ordered Day structures purposeful tasks undertaken by members around a 9-to-5 work cycle that mirrors conventional work outside the Clubhouse. The emphasis on the Work-Ordered Day is to help people living with mental health challenges to become accustomed to working in a conventional work environment. There is also generally a belief that productive, organised activity can help build a person’s self-esteem and help the person reach their recovery goals.
Jack Partridge, Program Manager for Frangipani House, Harmony House and Illawarra Clubhouse, describes some of the activities members engage in:
“Participants come in to engage socially with each other and the staff, using the groups as a chance to connect and build new friendships. We run discussion and support groups everyday which allow people to explore various topics around mental health, health and wellbeing, financial management and healthy relationships.”
Further to meaningful activity, Clubhouses often encourage members to acquire skills that may contribute to further employment and education. This includes ongoing availability of employment placements at the employer’s place of work and where members are paid the prevailing wage rate. The placements are part-time and time limited. Selection and training of members is done by the Clubhouse, not employers. Clubhouses also encourage members to develop skills and take part in educational opportunities in the community.
Another important standard lies in the policy that members and staff are equals. Staff help ensure that the Clubhouse is run safely and productively, involving all members. The staff are not clinicians, support workers, or counsellors. As noted above, staff are treated no differently, nor subject to different rules, than members of the Clubhouse. Members and staff work together, look after the Clubhouse together and make decisions together.
One Door Mental Health currently provides Pioneer Clubhouse in Balgowlah, Illawarra Clubhouse in Wollongong and Frangipani House in Harris Park. These Clubhouses require NDIS funding from the member. It is unclear whether this NDIS funding will be continued under pending changes to the NDIS. Pioneer receives some independent Federal government funding. One Door also runs Harmony House in Campbelltown. Each house caters to roughly 30-60 members.
Whilst the principles and realities of Clubhouses are appealing to people living with mental health challenges, and there is ample evidence of their positive impacts, there are unfortunately relatively very few Clubhouses in action in Australia; only six to eight Clubhouses operating nationally. Many of the functioning Clubhouses are only funded by individual participants using NDIS. This is, perhaps, a compromise of the spirit of Clubhouses, where group-based funding could be financing them for all interested parties. Whatever the funding source, Clubhouses are not a spending priority for State or Federal governments at the moment, leaving the less engaging option of individual funding through NDIS, which has its own sustainability concerns (as we are seeing). This is a particular challenge for group-based models like Clubhouses in an era of individualised funding from the NDIS. The implementation of Foundational Supports in the NDIS could be an opportunity for valuable programs like Clubhouses to attain sustainable funding.
Perhaps it is time for mental health advocates to support this movement, as reform in favour of Clubhouses promises to have real-life impact on the lives of people with mental health challenges, helping them achieve their recovery goals and beyond.
- McKay, C., Nugent, K.L., Johnsen, M., Eaton, W.W. and Lidz, C.W., 2018. A systematic review of evidence for the clubhouse model of psychosocial rehabilitation. Administration and Policy in Mental Health and Mental Health Services Research, 45(1), pp.28-47.
- Meyer, M.S., Agner, J., Botero, A. and Cha, T., 2023. Mapping community: A scoping review of clubhouse members’ social networks and their impact on recovery in mental illness. Psychiatric Rehabilitation Journal, 46(3), p.250.
- Hinchey, L.M., Pernice, F.M., Christian, J.N., Michon, A. and Rice, K., 2023. A contemporary review of the clubhouse model of psychosocial rehabilitation: Past, present, and emerging directions. Psychiatric Quarterly, 94(4), pp.569-604.
- Mutschler, C., McShane, K., Liebman, R. and Canadian Clubhouse Research Group Crossroads Fitzroy Centre, Notre Dame Place Oak Centre Potential Place Progress Place, 2024. Psychosocial Outcomes of Canadian Clubhouse Members: A Multi-Site Longitudinal Evaluation. Community Mental Health Journal, 60(8), pp.1464-1471.