
{"id":23724,"date":"2012-02-16T10:04:08","date_gmt":"2012-02-16T15:04:08","guid":{"rendered":"http:\/\/www.carrborocitizen.com\/main\/?p=23724"},"modified":"2012-02-15T16:15:27","modified_gmt":"2012-02-15T21:15:27","slug":"a-mental-health-model-that-works","status":"publish","type":"post","link":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/2012\/02\/16\/a-mental-health-model-that-works\/","title":{"rendered":"A mental health model that works"},"content":{"rendered":"<p><strong>By Taylor Sisk<\/strong><\/p>\n<p>To be diagnosed with a severe and persistent mental illness is, quite often, to be labeled an \u00e2\u20ac\u0153other.\u00e2\u20ac\u009d It\u00e2\u20ac\u2122s an isolating experience. For many, simply having a place to go, where a sense of belonging is nurtured, can make all the difference in the world.<\/p>\n<p>This premise is the foundation of a model of mental health care called clubhouse, introduced 64 years ago with the opening of Fountain House in New York City. <\/p>\n<p>There are now more than 300 clubhouses around the world, eight in North Carolina, which follow standards set by the International Center for Clubhouse Development.<br \/>\nThese clubhouses are founded on the belief that \u00e2\u20ac\u0153recovery from serious mental illness must involve the whole person in a vital and culturally sensitive community,\u00e2\u20ac\u009d with the individual as a partner in that recovery.<\/p>\n<p>Essentially, clubhouses are community centers, offering hope and opportunity. <\/p>\n<p>My first-hand experience with clubhouses is as a board member of Club Nova in Carrboro. Club Nova operates under a Community Bill of Rights comprising four guarantees: a place to come, meaningful work, meaningful relationships and a place to return.<\/p>\n<p>Club members participate in the management and upkeep of Club Nova, and the club offers an employment program in collaboration with the local business community. <\/p>\n<p>Transitional employment helps bridge the gap between work within the clubhouse and independent employment. Members are often then placed in permanent jobs, with ongoing support.<\/p>\n<p>\u00e2\u20ac\u0153Before Club Nova,\u00e2\u20ac\u009d said Jim Huegerich, director of Crisis and Human Services for the Chapel Hill Police Department, \u00e2\u20ac\u0153like clockwork, those with chronic and persistent mental illness would cycle in and out of state mental hospitals every six months, initially surfacing with law enforcement in a crisis. For those who are members of Club Nova, this cycle has essentially been broken.\u00e2\u20ac\u009d <\/p>\n<p>\u00e2\u20ac\u0153Throughout my career as a police officer, I\u00e2\u20ac\u2122ve met many people associated with Club Nova, and I\u00e2\u20ac\u2122ve grown both professionally and personally through those contacts,\u00e2\u20ac\u009d<\/p>\n<p>Carrboro Police Chief Carolyn Hutchison said. \u00e2\u20ac\u0153I value the collaborative relationship that exists between the Carrboro Police Department and Club Nova.\u00e2\u20ac\u009d<\/p>\n<p><strong>Why not more?<\/strong><\/p>\n<p>Clubhouses are \u00e2\u20ac\u0153the most cost-effective treatment for the persistently mentally ill,\u00e2\u20ac\u009d said state Sen. Ellie Kinnaird, a longtime supporter. <\/p>\n<p>Threshold Clubhouse in Durham compiled some statistics in 2010 that help define the cost-effectiveness of the model. Based on its Medicaid reimbursement rate, six months of care at Threshold costs $10,412, less than the price of eight days of psychiatric care at Central Regional Hospital. (That reimbursement rate has since been reduced.) <\/p>\n<p>Studies have shown the rehospitalization rate for people with severe and persistent mental illness to be as high as 40 percent after six months and 75 percent after five years. For 2011, Threshold had a rehospitalization rate of 7 percent after one year, a number consistent with past years and with other clubhouses in the state. <\/p>\n<p>Places of employment for Club Nova members have included Staples, the YMCA, Carolina Fitness, the UNC School of Social Work, Open Eye Cafe and the Mental Health Association.<\/p>\n<p>\u00e2\u20ac\u0153Club Nova members gain real work experience and renewed self-confidence,\u00e2\u20ac\u009d state Rep. Verla Insko said, \u00e2\u20ac\u0153and the business people gain insights into the strengths and abilities of people with mental illness, as well as some very good workers.\u00e2\u20ac\u009d<\/p>\n<p>Clubhouse members aren\u00e2\u20ac\u2122t just good workers, they\u00e2\u20ac\u2122re good teachers.<\/p>\n<p>\u00e2\u20ac\u0153Club Nova has been a place of learning for me and for my students that is penetrating and constantly renewing,\u00e2\u20ac\u009d said Sue Estroff, a professor in UNC\u00e2\u20ac\u2122s School of Social Medicine. Club members have been guest lecturers in her classroom for years, and she sometimes moves that classroom to the clubhouse. <\/p>\n<p>\u00e2\u20ac\u0153The visit is indelible for the students,\u00e2\u20ac\u009d she said.<\/p>\n<p><strong>Welcome<\/strong><\/p>\n<p>These are all compelling arguments for the funding of clubhouses. But the importance of that simple guarantee of a place to go shouldn\u00e2\u20ac\u2122t be downplayed. In a fundamental regard, the clubhouse structure itself is salvation.<\/p>\n<p>Susan Coppola is a clinical associate professor in UNC\u00e2\u20ac\u2122s division of occupational science. We build ramps for wheelchairs and make other adaptations for conditions like vision or hearing loss, she points out. <\/p>\n<p>But \u00e2\u20ac\u0153invisible conditions, like mental illness, require more subtle environmental adaptations that are difficult to understand,\u00e2\u20ac\u009d she said. \u00e2\u20ac\u0153Because of the complexity, and, let\u00e2\u20ac\u2122s face it, the stigma of mental illness, we are reluctant to invest in environmental situations that reasonably accommodate and support these conditions. <\/p>\n<p>\u00e2\u20ac\u0153Individuals with mental illness and their families have had to work outside the system to create these environments, and do so at a very low cost.\u00e2\u20ac\u009d <\/p>\n<p>Clubhouses, Coppola said, are such efforts in action.<br \/>\nRecent research into the phenomenon of resiliency finds that people recover from illness \u00e2\u20ac\u201c both physical and psychological \u00e2\u20ac\u201c better when they have social support.<\/p>\n<p>\u00e2\u20ac\u0153Clubhouse member\u00e2\u20ac\u009d may just sound like pretty words, said Jacquie Gist, a member of the Carrboro Board of Aldermen. \u00e2\u20ac\u0153But that\u00e2\u20ac\u2122s what it\u00e2\u20ac\u2122s about, and it really makes a difference. Not \u00e2\u20ac\u02dcpatient\u00e2\u20ac\u2122; not \u00e2\u20ac\u02dcclient.\u00e2\u20ac\u2122 \u00e2\u20ac\u02dcClubhouse member.\u00e2\u20ac\u2122 It\u00e2\u20ac\u2122s a sense of belonging, and an indication of how members are valued.\u00e2\u20ac\u009d<\/p>\n<p>Some years ago, Jonah Pierce, a nurse now working with HIV\/AIDS patients, was receiving treatment after two suicide attempts, and was progressing well. But, he said, \u00e2\u20ac\u0153I desperately needed to be needed in some way.\u00e2\u20ac\u009d<br \/>\nThe desire to belong is universal, Pierce said, but it\u00e2\u20ac\u2122s especially true for those with a stigmatizing illness. \u00e2\u20ac\u0153Immediately upon coming to Club Nova, I felt this incredible sense of welcome.\u00e2\u20ac\u009d<\/p>\n<p>\u00e2\u20ac\u0153I\u00e2\u20ac\u2122ve known some members for 30 years now,\u00e2\u20ac\u009d Gist said, \u00e2\u20ac\u0153and I\u00e2\u20ac\u2122ve seen how they\u00e2\u20ac\u2122ve been given the resources to get by, the support tools they need to live and thrive.\u00e2\u20ac\u009d<br \/>\nAnd, she adds, \u00e2\u20ac\u0153Most importantly, it\u00e2\u20ac\u2122s done with dignity.\u00e2\u20ac\u009d<\/p>\n<p>The clubhouse experience can help people with mental health disabilities overcome not only their symptoms but the feelings of despair that can develop when their lives are turned upside down by mental illness.<\/p>\n<p>\u00e2\u20ac\u0153These are the things that can disable you,\u00e2\u20ac\u009d said Larry Fricks, a national advocate for peer support in mental health treatment, \u00e2\u20ac\u0153your symptoms, the stigma and the way your self-image changes when you experience mental illness.\u00e2\u20ac\u009d <\/p>\n<p>\u00e2\u20ac\u0153I have no desire to go back to my former days before Club Nova,\u00e2\u20ac\u009d said member Charlene Lee. \u00e2\u20ac\u0153I have a strong desire to move forward,\u00e2\u20ac\u009d and she has.<\/p>\n<p>Insko said that among her priorities as a member of the House Appropriations Subcommittee on Health and Human Services is protecting funding for clubhouses across the state.<\/p>\n<p>As we continue to defund and dismantle mental health care services in North Carolina, please ask your representatives to advocate for this critical, cost-effective and proven model of care. You\u00e2\u20ac\u2122ll be serving your community well.<\/p>\n<p>\u00e2\u20ac\u0153Club Nova is something our community can be straight-up proud about,\u00e2\u20ac\u009d Gist said. \u00e2\u20ac\u0153It\u00e2\u20ac\u2122s something we\u00e2\u20ac\u2122ve done right as a community. \u00e2\u20ac\u00a6 It saves lives.\u00e2\u20ac\u009d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>To be diagnosed with a severe and persistent mental illness is, quite often, to be labeled an \u00e2\u20ac\u0153other.\u00e2\u20ac\u009d<\/p>\n","protected":false},"author":9,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-23724","post","type-post","status-publish","format-standard","hentry","category-opinion"],"_links":{"self":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/23724","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/comments?post=23724"}],"version-history":[{"count":3,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/23724\/revisions"}],"predecessor-version":[{"id":23729,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/23724\/revisions\/23729"}],"wp:attachment":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/media?parent=23724"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/categories?post=23724"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/tags?post=23724"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}