The Center on Substance Abuse and Mental Illness (S.A.M.I.)

The Clubhouse Approach

While Minnes and Tracy are investigating experiences of substance abuse, SAMI Center Co-Director David Biegel, PhD, is investigating experiences of severe mental illness. He is the principal investigator of a two-year study, titled “Strengthening the Social Networks of Clubhouse Members,” which is funded by the Woodruff Foundation of Cleveland and The Cleveland Foundation.

Biegel’s study is being conducted at the Magnolia Clubhouse, a community-based program of psychosocial rehabilitation located in Cleveland. It primarily serves people diagnosed with schizophrenia, bipolar spectrum disorder, and major depression. It currently serves approximately 380 people (members), with an average of 80 people attending each day. Psychosocial rehabilitation is important, because symptoms of severe mental illness often impair a person’s cognition (e.g., memory, thinking) and social cognition (e.g., ability to interpret social cues accurately and to respond appropriately), making them more vulnerable to social isolation and loneliness.

Magnolia is one of only 200 Clubhouses in the United States accredited by the International Center for Clubhouse Development Model. The Clubhouse model was recently recognized by the Substance Abuse and Mental Health Services Administration (SAMHSA) as an evidence-based practice.

Research shows that social networks and social connectedness are important for helping individuals maintain physical health and mental health and for recovering from episodes of illness. Biegel’s study is filling a gap in the research literature, because there have been few studies of the impact of the Clubhouse model upon members’ social networks and social isolation. The study looks closely at the following:

• Size, composition, and quality (e.g., amount of social support) of social networks of Clubhouse member
• Relationship between social network size, quality, and composition to Clubhouse members’ quality of life, recovery, social functioning, and loneliness
• Relationship of Clubhouse participation to members’ social networks, quality of life, functioning, and loneliness

The research team recently finished interviews with 135 members of Magnolia and will soon conduct qualitative interviews with relatives of Clubhouse members. The team is also conducting a national survey of Clubhouses throughout the country to examine the role and degree of family involvement in Clubhouse activities and operations. Analyses of current data have revealed these preliminary results:

• Average age of participants in the study is 44.2 years
• Over half are African American (53.8 percent) and predominately male (70 percent).
• Almost three-fifths (58.8 percent) have a diagnosis of schizophrenia.
• Higher number of Clubhouse visits is associated with lower levels of loneliness (social isolation).
• Higher satisfaction with relationships is also associated with lower levels of loneliness (social isolation).

Biegel explains that previous studies have shown that Clubhouses can positively impact members’ employment status and recovery. This study’s preliminary data suggests that participation in the socially-oriented Clubhouse model can be a helpful resource to reduce loneliness and social isolation.

“The Clubhouse model has been an important resource in Cleveland and communities throughout the nation for a long time,” Biegel says. “We anticipate this project will provide valuable information to help shape its course for the future.”

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