The Pipeline

Community-based care model offers mental health patients sense of belonging and recovery


Shruti Tiwari

A novel approach to providing care for mental health patients—called the clubhouse model—has been found to improve patients’ recovery, reduce rehospitalizations, and provide a sense of belonging.

Following a set of standards established by the International Center for Clubhouse Development, more than 300 clubhouses around the world have been set up based on the belief that recovery from a serious mental illness requires a community-based and culturally-sensitive approach. In addition to the clinical benefits they provide, these clubhouses have been found to have cost-saving implications.

These clubhouses, or community centers, provide the care and treatment that patients need while also involving the patient as a partner in recovery. Members are responsible participants in the upkeep of the club, while the club provides them with temporary employment through partnership with local businesses. These transitional roles provide club members with the skills and confidence they need to eventually graduate to independent employment elsewhere.

The clubhouse model has provided clinical and financial benefits for the club members involved. Studies have shown that rehospitalization rates for patients with severe mental illness can be up to 40% after six months and 75% after five years of the initial acute event. In 2011, Threshold Clubhouse in Durham, N.C. had a rehospitalization rate of 7%.

The clubhouse model has also been found to be cost-effective. At Threshold Clubhouse, the Medicaid cost of six months of care neared $10,412 in 2011, which was less than the price of only eight days of psychiatric treatment at a nearby hospital.

As managing psychiatric conditions and co-morbidities become increasingly important in an accountable care environment, a community-based approach provides mentally ill individuals with the social support needed to be productive and healthy contributors to society while providing patients with a place to go. Being labeled as “club members,” instead of “patients” or “clients,” also removes stigma and adds a comfortable sense of dignity, belonging, and member value.

As hospitals work toward further developing their continuum of behavioral health services, identifying and partnering with area clubhouses will be an important strategy. After stabilizing an acute event, hospitals will find it clinically and financially advantageous to partner with these community centers to ensure ongoing care and manage chronic conditions. Severely mentally ill patients will be given a safe-haven where they can actively live and work toward overcoming their debilitating conditions.