The ICCD Benchmarks for Clubhouses: A Practical Approach to Quality Improvement in Psychiatric Rehabilitation

Macias, Cathaleene; Barreira, Paul; Alden, Meredith; Boyd, Jeremy

doi:10.1176/appi.ps.52.2.207

Cited by 50 publications

(46 citation statements)

References 9 publications

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“…The question of how individuals with severe mental illness structure and spend time is one that has been addressed not with regard to its relationship to criminal justice involvement, but instead in the area of employment training and rehabilitation. Here, interventions attempt to structure what has been termed the "work-ordered day," which, from a routine activities perspective, uses the temporal structure of the standard American work day as a "normalizing" template for determining what individuals do, when, and with whom (Fountain House, 1999;Jackson, 2001;Macias, Barriera, Alden, & Boyd, 2001;Waters, 1992).…”

Section: The Routine Activities/lifestyles Perspectivementioning

confidence: 99%

Beyond Criminalization: Toward a Criminologically Informed Framework for Mental Health Policy and Services Research

Fisher

Silver

Wolff

2006

Adm Policy Ment Health

192

121

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The problems posed by persons with mental illness involved with the criminal justice system are vexing ones that have received attention at the local, state and national levels. The conceptual model currently guiding research and social action around these problems is shaped by the "criminalization" perspective and the associated belief that reconnecting individuals with mental health services will by itself reduce risk for arrest. This paper argues that such efforts are necessary but possibly not sufficient to achieve that reduction. Arguing for the need to develop a services research framework that identifies a broader range of risk factors for arrest, we describe three potentially useful criminological frameworks-the "life course," "local life circumstances" and "routine activities" perspectives. Their utility as platforms for research in a population of persons with mental illness is discussed and suggestions are provided with regard to how services research guided by these perspectives might inform the development of community-based services aimed at reducing risk of arrest.

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Section: The Routine Activities/lifestyles Perspectivementioning

confidence: 99%

Beyond Criminalization: Toward a Criminologically Informed Framework for Mental Health Policy and Services Research

Fisher

Silver

Wolff

2006

Adm Policy Ment Health

192

121

View full text Add to dashboard Cite

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“…In estimating program costs, it is important to not only estimate the costs, but to draw a comprehensive picture of the services provided, to enable proper comparisons with other program models where appropriate. While a number of studies have examined costs of human service programs (Baker & Woods, 2001;Chandler, Meisel & Hu, 1999;Chandler & Spicer, 2002;Clark, Xie, Becker, & Drake, 1998), few have examined costs of clubhouse programs (Cowell et al, 2003;Macias, Barreira, Alden, & Boyd, 2001;Macias, Jackson, Schroeder, & Wang, 1999). This paper describes costs associated with the clubhouse model of psychosocial rehabilitation at three levels: the overall annual program cost, the annual cost per participant (member), and the cost per visit.…”

mentioning

confidence: 99%

Costs of Clubhouses: An International Perspective

McKay

Yates

Johnsen

2005

Adm Policy Ment Health

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Costs of providing psychosocial rehabilitation services are analyzed using data from clubhouse programs in 12 countries. We explored effects of several program operating characteristics on total program cost per year, cost per member per year, and cost per visit. We also examined the relationship between program costs and the range of services offered. Clubhouse costs were found to be a function of the country in which the program was located, program age, and certification status. The number of specific services offered was not related to cost. Findings provide a more complete understanding of the operations and expenses of clubhouses.

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“…We do not present cost data in this article, but the comparatively high operating cost for specialized employment programs (71,72) suggests that providing supported employment through multiservice certified clubhouses would be especially costeffective (73), and vocationally integrated ACT could be reserved for consumers who need intensive clinical care. This assumption needs to be tested within the context of total service system costs.…”

Section: Discussionmentioning

confidence: 99%

Supported Employment Outcomes of a Randomized Controlled Trial of ACT and Clubhouse Models

Macias¹,

Rodican²,

Hargreaves³

et al. 2006

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Objective-In a randomized controlled trial, a vocationally integrated program of assertive community treatment (ACT) was compared with a certified clubhouse in the delivery of supported employment services.Methods-Employment rates, total work hours, and earnings for 121 adults with serious mental illness interested in work were compared with published benchmark figures for exemplary supported employment programs. The two programs were then compared on service engagement, retention, and employment outcomes in regression analyses that controlled for background characteristics, program preference, and vocational service receipt.Results-Outcomes for 63 ACT and 58 clubhouse participants met or exceeded most published outcomes for specialized supported employment teams. Compared with the clubhouse program, the ACT program had significantly (p<.05) better service engagement (ACT, 98 percent; clubhouse, 74 percent) and retention (ACT, 79 percent; clubhouse, 58 percent) over 24 months, but there was no significant difference in employment rates (ACT, 64 percent; clubhouse, 47 percent). Compared with ACT participants, clubhouse participants worked significantly longer (median of 199 days versus 98 days) for more total hours (median of 494 hours versus 234 hours) and earned more (median of $3,456 versus $1,252 total earnings). Better work performance by clubhouse participants was partially attributable to higher pay.Conclusions-Vocationally integrated ACT and certified clubhouses can achieve employment outcomes similar to those of exemplary supported employment teams. Certified clubhouses can effectively provide supported employment along with other rehabilitative services, and the ACT program can ensure continuous integration of supported employment with clinical care.Supported employment is designed to help adults with serious mental illness obtain jobs in socially integrated settings that pay at least minimum wage (1-3). Randomized controlled trials have established supported employment as an evidence-based practice on the basis of higher employment rates for specialized supported employment teams compared with interventions NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript that do not provide supported employment (4-9). The effectiveness of supported employment has been partially attributed to rapid job placement, which bypasses prevocational training, trial jobs, and sheltered work (9-12).However, being hired does not guarantee success on the job. Enrollees express interest in employment when entering a supported employment program, yet typically average only a few months of employment after finding a job (1,8,11,(13)(14)(15)(16). One explanation for brief work tenure is the failure of many supported employment specialists to work closely with treating clinicians (17). Encouraging integration of supported employment with case management and other rehabilitation services, such as supported housing or supported education, also seems beneficial (18,19). Research suggests...

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The ICCD Benchmarks for Clubhouses: A Practical Approach to Quality Improvement in Psychiatric Rehabilitation

Cited by 50 publications

References 9 publications

Beyond Criminalization: Toward a Criminologically Informed Framework for Mental Health Policy and Services Research

Beyond Criminalization: Toward a Criminologically Informed Framework for Mental Health Policy and Services Research

Costs of Clubhouses: An International Perspective

Supported Employment Outcomes of a Randomized Controlled Trial of ACT and Clubhouse Models

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