title: Keeping Clubhouses Open: Toward a Roadmap for Sustainability.
abstract: Clubhouses are recovery centers that help persons with serious mental illness obtain and maintain community-based employment, education, housing, social integration, and other services. Key informants from U.S. clubhouses were interviewed to create a conceptual framework for clubhouse sustainability. Survival analyses tested this model for 261 clubhouses. Clubhouses stayed open significantly longer if they had received full accreditation, had more administrative autonomy, and received funding from multiple rather than sole sources. Cox regression analyses showed that freestanding clubhouses which were accredited endured the longest. Budget size, clubhouse size, and access to managed care did not contribute significantly to sustainability.
authors.affiliation: Edith Nourse Rogers Memorial VA Medical Center, Bedford, MA, USA.
authors.forename: Jay A
authors.initials: JA
authors.lastname: Gorman
authors.affiliation: Department of Psychiatry, The Program for Clubhouse Research, Systems and Psychosocial Advances Research Center, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Colleen E
authors.initials: CE
authors.lastname: McKay
authors.affiliation: Department of Psychology, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016-8062, USA. brian.yates@mac.com.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Yates
authors.affiliation: School of Criminology and Justice Studies, University of Massachusetts Lowell, Lowell, USA.
authors.forename: William H
authors.initials: WH
authors.lastname: Fisher
mesh_terms: D000068:Accreditation; D002017:Budgets; D004493:Education; D004651:Employment; D005260:Female; D006297:Health Services Accessibility; D006798:Housing; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D000073038:Mental Health Recovery; D015397:Program Evaluation; D016016:Proportional Hazards Models; D000067250:Psychiatric Rehabilitation; D036301:Qualitative Research; D012189:Retrospective Studies; D013808:Therapeutic Community
keywords: Clubhouse; Psychiatric rehabilitation; Survival; Sustainability