Mental health clubhouses praised for offering members structure

Mental health clubhouses praised for offering members structure

By Matthew E. Milliken : The Herald-Sun
mmilliken@heraldsun.com
Sep 21, 2008

DURHAM -- Richard Hudson has struggled with paranoid schizophrenia for more than half his life.

Hudson was first diagnosed with the disease in 1977. Now 61, he lives in a group home but is hoping to move into his own apartment soon.

He credits part of his readiness to live independently to the Threshold Clubhouse, a 33-year-old Durham agency. Hudson, who joined Threshold about three years ago, spends at least 25 hours there on weekdays and visits on occasional Saturdays, too.

"It gives me some structure -- tasks to do each day," Hudson said. "It helps my self-esteem. Right away when I first joined my self-esteem started to come up. I'm needed here and I'm expected to be here, and the work I do is very useful."

Clubhouses offer a variety of employment, educational and recreational programs. All members who are able are expected to work alongside staff.
Hudson, who serves on Threshold's board of directors, handles office work, cleaning and cooking; he prides himself on his Texas chili.

Recently Hudson has been asking clubhouses elsewhere -- in 2006, there were 220 certified clubhouses in North America and about 100 on other continents
-- how they run their employment programs. Threshold wants to see if it can get more outside jobs for members by restructuring.

The Mental Health Association in North Carolina, a care-giving and advocacy group, runs some of the state's clubhouses, which are considered psychosocial rehabilitation programs.

"I think one of the intriguing parts of psychosocial rehab is that it really is designed to look at the whole person and not just their mental illness,"
said John Tote, the association's director.

Clubhouses earn the lowest adult Medicaid mental health payments, about $12 an hour. But members benefit tremendously from clubhouses, argued the director of Shelby's Adventure House.

They won't need as much community support or hospitalization if they attend clubhouses regularly, said Tommy Gunn.

"If they start having problems we're going recognize it sooner and get them to the attention of a physician."

That's exactly what happened to Hudson recently. Threshold staff saw that he needed a medication adjustment and arranged for a doctor's appointment.

"We see a member here every day, and we know what their baseline behavior is like," Hudson said.

"And if they're having a bad day, we're the first to recognize it, and the first to get them some help when they need it."

The Durham Center, the local mental-health management agency, recently named Threshold a provider of excellence.

"Threshold is a wonderful program, and they have been a long-standing agency in our community, and we support them 100 percent," said Ellen Holliman, the Durham Center's director.
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