TandC Associates, LLC

                                          Clubhouses and Psychiatry

                                                Thomas J. Malamud

                                                    May 29, 2012

Recently two activities of interest have transpired, concerning the relationship of clubhouse programs and the field of psychiatry.  Just a few months ago a Utah-based clubhouse conducted a brief survey of ICCD programs, asking if psychiatrists are on Boards of Directors.  Currently, Fountain House is planning on hosting a two-day seminar exploring the ways that psychiatry and clubhouses can work together in the rehabilitation process.

These developments brought to mind a 1985 telephone survey of clubhouses that was conducted to collect information regarding their relationship with the psychiatric community.  In that survey all 72 clubhouses contacted responded, producing significant findings.  In brief, 42 (58%) of the 72 programs indicated that a connection with psychiatrists existed.  These programs were more likely to be older, have larger number of members and more staff, than those having no formal relationship with psychiatrists.  It was also of interest that over half of these programs indicated a desire to seek such consultation.  For those with a relationship, staff consultation was by far the most often service (93%), followed by medication monitoring (64%) and crisis intervention (52%).  These findings were presented in workshops held at the 1985 annual meeting of IAPRSR (now known as USPRA) and the 3rd International Clubhouse Seminar.  As a result, specific issues were raised:  For example, noticeably absent in the findings was the fact that no program indicated any involvement by psychiatrists in the rehabilitation process as a whole.  A second issue related to the location of psychiatric involvement — whether within the clubhouse or strictly off-site.  A third issue revolved around how a clubhouse could get acquainted with specific psychiatrists.

Over 25 have elapsed since the survey and the workshops, with little obvious change within the clubhouse community as a whole.  While a number of significant developments have occurred such as the evolvement of that which is called the “Rehabilitation Alliance” (and an increased concern for “Wellness”), there is little observable indication of a generalized acceptance of these or other similar efforts to increase the clubhouse-psychiatrist collaboration. 

Perhaps now is the time to document the current state of the clubhouse-psychiatrist collaboration by conducting a similar telephone survey of ICCD clubhouses.  By doing so, more clubhouses might decide to establish collaboration with their own psychiatric consultant.  If nothing else, up-to-date data would be available for the upcoming two-day seminar being organized by Fountain House in June of this year.

(This article is an abstract of a recent publication Online, “We See a Better Life…Clubhouses and Psychiatry” at www.Reintegration.com.)