Changing Lives: Changing Mental Health

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Clubhouse Model and Its Impact on Psychiatric Hospitalization in Canada: A Cohort Study

We investigated the relationship between membership in an accredited Clubhouse for mental health support and psychiatric hospitalization in Canada using linked administrative data. Results show that Clubhouse members were less likely to be hospitalized after enrollment and after longer-term enrollment, and younger members diagnosed with schizophrenia and/or bipolar disorders were at increased risk of hospitalization compared to older members without such diagnoses. These findings provide evidence of the possible benefits of Clubhouses in Canada and the characteristics of members who may benefit from support.

Authors: Matthew Joseph Russell, Natasha Lifeso, Jordan Fazio, Carley Piatt, Frank Kelton, Xinjie Cui, and Izu Nwachukwu

Publication: Canadian Journal of Community Mental Health   ·   October 25, 2021   ·   https://doi.org/10.7870/cjcmh-2021-019

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Developing a Realist Theory of Psychosocial Rehabilitation: The Clubhouse Model

Background: Psychosocial rehabilitation is a service that supports recovery from mental illness by providing opportunities for skill development, self-determination, and social interaction. One type of psychosocial rehabilitation is the Clubhouse model. The purpose of the current project was to create, test, and refine a realist theory of psychosocial rehabilitation at Progress Place, an accredited Clubhouse.

Method: Realist evaluation is a theory driven evaluation that uncovers contexts, mechanisms, and outcomes, in order to develop a theory as to how a program works. The current study involved two phases, encompassing four steps: Phase 1 included (1) initial theory development and (2) initial theory refinement; and Phase 2 included (3) theory testing and (4) refinement.

Results: The data from this two-phase approach identified three demi-regularities of recovery comprised of specific mechanisms and outcomes: the Restorative demi-regularity, the Reaffirming demi-regularity, and the Re-engaging demi-regularity. The theory derived from these demi-regularities suggests that there are various mechanisms that produce outcomes of recovery from the psychosocial rehabilitation perspective, and as such, it is necessary that programs promote a multifaceted, holistic perspective on recovery.

Conclusions: The realist evaluation identified that Progress Place promotes recovery for members. Additional research on the Clubhouse model should be conducted to further validate that the model initiates change and promotes recovery outcomes.

Authors: Christina Mutschler, Jen Rouse, Kelly McShane, and Criss Habal-Brosek

Publication: BC Health Services Research   ·   June 13, 2018   ·   https://doi.org/10.1186/s12913-018-3265-9

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