A recent notice by the Center for Reintegration (“Medicaid Managed Care Consolidates,” www.reintegration.com) raised concern about health care for those diagnosed with serious mental illnesses. As many of these men and women are homeless, it is most often the case that when they need health services they end up receiving in-patient treatment which is most costly. This report goes on to say that such treatment fails to provide integrated services such as social and vocational rehabilitation, housing and educational activities. The article concludes that a more comprehensive approach is needed.
One example of a comprehensive approach is the emerging partnership between ICCD clubhouses and the psychiatric – including primary care — community. In a previous online publication at this site, Clubhouse and Psychiatry, it was noted that a two-day meeting regarding this subject was scheduled for June 5th and 6th, 2012. This symposium, entitled “Partners for Wellness,” was hosted by Fountain House, Magnolia House (Cleveland), the Sydney Baer Center and the Sydney R .Baer Jr. Foundation. Our present posting will summarize some of the presentations and discussion at that symposium.
Two ICCD programs, Fountain House and Magnolia House, provide easy access to both psychiatric and primary care for members (who so choose) were described. Both of these clubhouses have developed relationships with psychiatric and primary care personnel. The Sydney Baer Center is located some 10 city blocks from Fountain House, while the Carriage House Clinic is much closer in proximity to Magnolia House.
The following are some of the major characteristics of the care provided by these facilities:
- Services which are close to home, including general hospital care for acute admissions, and long-term residential facilities in the community;
- Interventions related to disabilities as well as symptoms;
- Treatment and care specific to the diagnosis and needs of each individual;
- A wide range of services which address the needs of people with mental and behavioral disorders;
- Services which are coordinated between mental health professionals and community agencies;
- Ambulatory rather than static services, including those which can offer home treatment;
- Partnership with caregivers that remains consistent over time, helping to meet individual needs.
Key to the success of this process, we believe, is the innovative device identified as the Rehabilitation Alliance. This approach to community-based programming for members who have experienced serious and persistent mental illness consists, at a minimum, of a member, physician, and at least one other individual – either a clubhouse staff person or another member. The goal is the provision of vocational, social, educational, residential, mental, and physical health services along with the time and support needed to fulfill these opportunities.
This unique approach to improving the psychiatric and medical well-being of men and women with serious mental illness is revolutionary. It represents both a challenge and a potential solution to the problems articulated in this paper. Unfortunately this challenge has yet to be accepted in either the medical or psychiatric field by most practitioners, despite the some 20-year successful track record at Fountain House and the more recent results at Magnolia House.
This two-day symposium o “Partners for Wellness” presented a pilot demonstration of how these goals and objectives might be achieved. Positive results have been recorded consistenty through diagnosis, intervention and follow-up as well as remission data. Dissemination and replication of such an approach, however, to other settings depends on the good will and vision of clubhouse management – and membership – in partnership with healthcare providers.
As in past postings, it is our practice to invite your comments and opinions which we will publish upon review.
Thanks for sharing this important information from the symposium. I think it is essential that members of Clubhouses get first rate and accessible psychiatric and medical care. It is hard for anyone to navigate our current medical system and our members need more help to get the crucial clinical services they need for a full recovery. So I think increasingly getting more recognition from Psychiatry as a profession of the importance of Clubhouse as the “gold standard” in psychiatric recovery and building more accessible opportunities, geared to member needs for good clinical care is an idea whose time has come!
I believe it is important to underscore the value of the clubhouse model in the bigger arena of recovery. Too often I read about recovery models that are doing good work, but never cite clubhouses in the article or in the bibliographies. Clubhouse may not work for everyone with a serious mental illness, but in the shortage of quality programs available for persons trying to turn their lives around, Fountain House and similar clubhouse models are a valuable option.