TandC Associates, LLC

Prior to coming to Hawai’i, we had been appraised of the streamlined organization of the Adult Mental Health Division, as well as the relationship between community mental health centers and the clubhouses in the community. We also knew that currently 10 clubhouses – 5 of which are on the island of Oahu – are up and running on all 8 of the neighbor Hawaiian islands. Furthermore, 4 of the clubhouses have been certified by the Clubhouse International (formerly known as the International Clubhouse Community Development or ICCD). The other 6 are in the process of renewing (or undergoing initial) certification as clubhouses. In addition, Kathleen Rhoads Merriam, our consultation coordinator in Hawai’i, had updated us regarding: 1) The current stage of development of some clubhouses’ transitional employment programs; 2) The need for ongoing research; 3) The issues of reaching out to engage homeless mental health consumers; as well as 4) The impact of public transportation accessibility to clubhouses impacts attendance rates by members who do not drive or have cars.

As we mentioned awhile ago, we wanted to write separately about our meeting with Mark Fridovich, Ph.D., MPA, who is the Administrator of the Adult Mental Health Division for the State of Hawai’i.  On our consultation agenda, this meeting was scheduled for 2:00 pm on Monday, September 9th, lasting approximately one half-hour. We were introduced to his staff and Kathleen’s colleagues on our way into the meeting.  Mark wasted no time in opening up the discussion with the question:  “Why are you here and how may I be of help?”

With such a straightforward approach, we had no difficulty in laying out our goal:  To establish an ongoing consultation to promote continued development and expansion of the clubhouse model of psychosocial rehabilitation in Hawai’i.  We noted that we had just come from Waipahu Aloha Clubhouse, having been driven past 2 other of the 5 Oahu clubhouses , and were looking forward to seeing those located at Makaha and Diamond Head later in the week.  So in response to Mark’s offer of help, we stated we had heard that because of the lack of public transportation – i.e., buses – some of the outer clubhouses had issues of attendance.  We then related how clubhouses in New Jersey, for example, had initiated and expanded their own means of transporting members to the clubhouse before and after transitional employment placements.  This issue was dispatched as a non-item rather quickly.

Our discussions then turned to the relationship between the clubhouse and the psychiatric community, with the examples given about the “Rehabilitation Alliance” that was started at Fountain House in the ‘90’s.  This supportive engagement of the member, a helping partner of the member’s choice (whether a staff worker or other stable member) and the psychiatrist — at a storefront nearby the clubhouse — has proved to reduce psychiatric hospitalizations further.  It has also allowed for the collection of health related data by a general practitioner attached to the storefront, documenting the rates of co-morbidity among some 700 Fountain House members over time.  This part of the discussion caught Mark’s attention immediately.  He indicated interest in and support of both the “Rehabilitation Alliance” and such research were it to be established in the clubhouses in Hawai’i.

Before we knew it, our allotted half-hour with Dr. Fridovich had lasted over an hour, and we quickly concluded this cordial meeting with him.  We came away with the impression that the opportunity for innovative expansion of clubhouses services could be facilitated with the organizational set up of the Adult Mental Health Services in Hawai’i.   Further news of our first consultation in Hawai’i will describe our participation in a Clubhouse Coalition meeting, and not one but two presentations at the University of Hawai’i.

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