‘The Hidden Gem of Mental Health’: Massachusetts Clubhouse employment and recovery programs provide tools for success, independent living

Kenny would pace back and forth in front of the YMCA every day for hours at a time. It was part of his daily routine as someone living with a mental health condition. Kenny and 21 other men moved out of  Danvers State Hospital in the 1980s into the Clubhouse within the YMCA, searching for community. One day, Kenny wasn’t out front anymore. He had gone down to a closeby greasy spoon for breakfast with another member, David. Kenny never walked aimlessly in front of the YMCA again. Why? Because he had made friends that shared life experience and the desire to create meaningful connections. He no longer had to spend his days alone. He had found the community he was looking for, through the Clubhouse. 

Everyone wants to feel like they have a purpose, and Clubhouses and the programs they offer to people with mental health conditions can make all the difference in offering opportunities for community, employment, and recovery. 

There are over 350 local Clubhouses in 32 countries around the world. Their approach is based on the Clubhouse Model of Psychosocial Rehabilitation, which “offers a collaborative, restorative environment where Clubhouse members can recover by gaining access to opportunities for employment, socialization, education, skill development, housing and improved wellness.” Clubhouse International is a non-profit organization dedicated to fostering spaces where people with mental health conditions can ‘go to get their lives back.’ 

The Massachusetts Clubhouse Coalition comprises 36 Clubhouses across the Commonwealth dedicated to the Clubhouse mission and providing services to members in line with the goal of fostering community and providing tools to community members with mental health challenges. 

According to a 2012 survey of Clubhouses, 46% of Clubhouse members are diagnosed with schizophrenia or schizophreniform disorders, 22% are diagnosed with bipolar disorder, and 16% are diagnosed with depression amongst other mental health conditions. 

Clubhouse members and staff work side-by-side on various tasks such as personal goal planning, data entry for the program’s reports, and important preparation before they start a new job placement. Elliot House, one of the Clubhouses in the Boston area, is one thriving example of how these programs work. 

“People who come to a Clubhouse are looking for community. They’re looking to be around people, meet new people, to spend time with their friends. They’re looking for purpose,” said Stephen Chaffee, Program Director at Elliot House in Needham. 

Elliot House currently works with between 25 to 35 members a day, with 135 members actively enrolled in the program as of February. The program currently relies on word-of-mouth referrals and conducts an evaluation of applicants to determine if they’d be a good fit for the program. 

“I’ve been saying we’re the hidden gem of mental health. And we don’t want to be, that’s the last thing we want because we can’t help anybody if we’re a secret,” said Chaffee. 

Their Work-Ordered Day approach serves as the backbone of their program and allows members to regain confidence in their ability to work, develop positive work habits and skills, and establish job references. Elliot House gets its members on the path to paid employment, which can be classified as transitional, supported, or independent. 

Transitional employment is a six to nine month paid employment available on a rotating basis to members of the Clubhouse. Clubhouse staff are trained on the job and onboard the Clubhouse members in-house. Clubhouse staff also help members throughout any part of the hiring process including an application, background check, or physical. There is no interview process for Clubhouse members, but they have a chance to visit the workplace and meet their supervisor prior to beginning their employment. 

“This whole job is essentially predicated on the fact that we have an outstanding relationship with this employer. They trust that we're going to select a member that, you know, not necessarily is going to do the best, but is somebody who is going to be able to do the job and with the right support, succeed,” said Chaffee. 

Programs like the one at Elliot House not only provide a space for adults with mental health challenges to be together, but empower them through employment and hands-on learning to become independent and put their skills to use. 

Employers partnered with Clubhouses include large hotel chains, big-box grocery stores, libraries, restaurants, clothing stores, and cleaning services. This year, 23 employers were presented with Employer of the Year by various state legislators on behalf of their respective Clubhouses. Elliot House’s Employer of the Year was Homewood Suites by Hilton Needham Boston, who has employed Elliot House members in a transitional employment position. 

This year’s annual Employment Celebration hosted by the Massachusetts Clubhouse Coalition at the Massachusetts State House was sponsored by State Representative Tram Nyguen. Nyguen has served the 18th Essex District since 2018 and was the first first Vietnamese-American woman in elected office in Massachusetts. Out of the five committees she’s a member of, her position as a member of the Joint Committee on Mental Health, Substance Use, and Recovery seems particularly relevant to the work of Massachusetts Clubhouses like the Elliot House. 

“Clubhouses are a lifeline for people who have had their lives disrupted by mental illness, giving them back their sense of community and a place to realize that many other people are going through the same thing,” said Nyguen in her opening remarks at the event. “That helps them to reach their full potential, live a life of success, and live a life of purpose.”

Brooke Doyle, Commissioner of the Massachusetts Department of Mental Health, also was in attendance. Her partnership, connecting Clubhouses with government entities, has been vital in legislative pursuits as well as the goal to connect Massachusetts residents with recovery resources most suitable for their situation. 

“Our communities are all stronger because of the local Clubhouse-employer relationships,” said Doyle, addressing the crowded Great Hall of Flags during the event. “While people living with mental illnesses experience challenges, Clubhouses are uniquely able to break through these challenges with the power of natural support and connection.”

Tom Coppinger, who has dedicated 44 years of his career to Clubhouses, was appointed the Executive Director of the Massachusetts Clubhouse Coalition in August 2023. His mother started the Point After Clubhouse in Lawrence, which he joined in 1980 and began directing in 1995. His passion for the work is made clear by his lifelong commitment and his eagerness to make real change as he serves the MCC community. 

“Even back in the early 80s, when we started the club, people wanted to work. They wanted to contribute to society. They wanted the opportunity to do that. It's something that is a normal part of our society, it's such a normal part of life,” said Coppinger in an interview. “ Jobs and housing are the two most incredible, life-changing things for people.”

Coppinger pointed to SSI and SSDI benefits as a contributing factor to lessened ambition for employment amongst people with mental health conditions. In order to qualify for these benefits, an extensive work history and income below a certain threshold is required. If one returns to work in any capacity under these benefits, they may only have around four years of additional support until they receive no further disability benefits. The threshold for ‘extended period of eligibility’ earnings is $1,550 a month, or $9.69 per hour for those working 40 hours per week. This is over five dollars below Massachusetts’ minimum wage. 

“So, you're told you can't work. New members will come in and tell us to our face 'I can't work, I'll lose my check.' How bad is that? You know? Let's stick you in a corner. That's going to make people isolate,” Coppinger said. “Why would I go to school if I can't work? Why would I do anything if I can't work? And when they start working, I mean, it is so powerful.”

One of Coppinger’s many responsibilities includes lobbying for legislative support that will support Massachusetts Clubhouses and the members they serve. One of his first projects is to improve the reimbursement rates that determine how much Clubhouses get paid to provide their services to individuals who need it. 

Many versions of a bill to accomplish this goal have been introduced over the years, but most recently Bill S.84 is working its way through the Massachusetts legislature. As of March 28, both the State Senate and State House of Representatives had concurred on the bill, which would reduce the disparity between salaries of human services workers and other direct care workers, nurses, clinicians or other comparable employees in the state. The bill proposes that the rate of reimbursement be increased to eliminate the pay gap by July 1, 2027. 

For such a large organization like Clubhouse International, which originated in 1948, to not have the resources, funding, and exposure they need is a disservice to members of communities around the world whose lives could be changed by the programs provided. While the programs may not be the best solution for every case of mental health conditions, the people who have benefited from the programs prove an overarching desire for those struggling: a desire for purpose.