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Personal Accounts: Jack and the Clubhouse Road to Recovery

Back in 2001 I was a member of Quabbin House in Orange, Massachusetts, which I'd joined in 1992. We had just received the mail, which included newsletters from other clubhouses worldwide. Ever since I'd been a colleague in the Genesis Club's three-week training in 1993 in Worcester, Massachusetts, I would peruse these newsletters. I found the current issue of Genesis Alive and looked for familiar names and places. I scanned the back page, which listed employment opportunities. I discovered two transitional employment positions with UMass Medical School in collaboration with the International Center for Clubhouse Development (ICCD) at the Program for Clubhouse Research. I told the then-director of Quabbin House, "If I had a car, I would want that job!" What attracted me to such work? My steps to recovery from bipolar disorder can be retraced in terms of work.

I started becoming career oriented in junior high school, when I chose to attend a vocational high school instead of traditional classes. I was not encouraged to think that college was in my future, and I wanted a marketable skill. While exploring six different shops in vocational high school, I finally chose computer processing as my career path. I obtained two computer operator positions through the school and worked throughout my junior and senior years.

Aspiring to become a computer programmer, I made a couple attempts at a college education but withdrew. Excelling in math and computers has helped me get far, but poor reading skills have always been the bane of my existence. I know I'll be butting heads with this issue forever. Instead, I continued to work. Most of my computer operator positions were in hospitals or banks. I consistently saw the data collection and billing phases of the businesses. However, I longed for computer work that was closer to the sciences or that was for the betterment of humankind, not for the greed of business.

My slow professional advancement and troubling personal issues culminated in a crashing and debilitating mental illness in 1989. The next 20 years were spent in recovery. I discovered clubhouses during this transition.

Living in Athol, Massachusetts, without a job or transportation leads to a very dismal existence. No jobs were available there in 1992. Quabbin House was first pitched to me as a means to finding work. I feel extremely fortunate that in a small community such as Athol there exists a place that would open up my world to opportunities for personal growth, discovery, leadership, housing, education, employment, and family.

Like most people, I did not take to the clubhouse in my first visit. I was uncomfortable in my own skin and being with other people with mental illness. Being there scared me, and I could not see how the clubhouse was going to help me in my recovery. Stigma was also quite the barrier within my own head, not just in the community. Back then there was not an elaborate orientation process—you just attended and participated where interested.

Eventually I found my niche, functioning in the work-ordered day structure. I naturally gravitated to the computers, mostly used for attendance, accounting, statistics, and newsletters. Tracking clubhouse attendance introduced me to the membership. I started connecting the names to faces along with the tasks they performed at the clubhouse; members' talents were revealed and discovered. Before I knew it, relationships sprouted everywhere. Although I identified more with staff, it was the members' openness, acceptance, and care that kept me returning.

My leadership qualities were springing up in many facets. Clubhouses hold many types of meetings on various topics through various committees. I launched myself into advocacy, political meetings and rallies, and Massachusetts Clubhouse Coalition meetings. Such involvement was a major learning curve for me. The only type of meeting I'd previously attended at a workplace was when the boss scolded the entire department without giving anyone a chance to speak, which left me apprehensive about other meetings.

In the summer of 1993 the membership chose me to go with two staff members to represent Quabbin House in a three-week Clubhouse Colleague training course at Genesis Club in Worcester. This experience gave me not only a unique standing within the clubhouse membership but also a deeper understanding of the ICCD clubhouse model.

I was happily overwhelmed the first time I walked into Genesis Club. I was from a small clubhouse that operated out of an auspice agency (as opposed to a free-standing clubhouse), with an average attendance of about 20 people per day split into two work units. Genesis Club has been a free-standing clubhouse from the start, with a much bigger community, about 100 daily attendants working in six units. I enjoyed the activity and energy of this busy place! The most impressive aspect of our training was visiting three transitional employment sites—the UMass mailroom, the Worcester Art Museum mailroom, and the Marriott laundry room. We even had an opportunity to perform tasks alongside the working members. It was hard not to get swept up in the momentum.

It was hard to carry the momentum of Genesis Club back to Quabbin House. It still could not help with locating appropriate transitional employment. The job market was not much better in the general community of north-central Massachusetts, where I lived.

Part of my work in advocacy involved addressing the lack of local public transportation. I delayed going to college so that I could start a transportation service for commuting to college. In 1994 I won a $10,000 grant from Massachusetts Department of Mental Health, a part of their consumer initiative program. The business name was "Consumers on the Move." This is where I learned more about myself and new talents. I gained a wealth of experience, from computer work, to provider presentations, to incorporating the business and getting more consumers involved. Although the business eventually folded, the advocacy work was not wasted. Part of my presentation was repeated for the U.S. Congress and led to the current public transportation system for Athol and nearby Orange. Between 1996 and 2002 I completed what has been the majority of my college experience.

In February 2003 a housing voucher enabled me to move to Worcester. I immediately joined Genesis Club, with the goal of pursuing my associate's degree in computer information systems. I could see how much Genesis Club had grown since my training there, and I was excited to be a member of this vibrant clubhouse. While waiting for the next semester to begin, I started working in its business and research unit. Once again, I gravitated to the computers and used the task of attendance as a way to become acclimated. In three months' time I learned almost every task of the unit. The placement manager for transitional employment positions at the program for clubhouse research talked to me about the exact job I had wanted from long ago. I jumped for it.

Transitional employment positions are designed so that individuals can overcome barriers such as the formal interview process. Some people may feel they do not interview well, which may prevent them from working altogether. I had the best "interview without an interview." After visiting the job site and learning about the details of the job, I returned to the club to update my resume and fill out an application. While there, I was invited into a research advisory meeting with UMass Medical School faculty. Back then Genesis was keeping attendance with the Memphis software program and was having problems generating reports and producing useful data. During the meeting, I was asked about Memphis. I gave a half-hour explanation of my activities with the software. It still amazes me that I had three important researchers listening to me as I held forth.

In April 2004 I represented Genesis Club in ICCD faculty training. This was a week of the most intense training of my life. We worked late every night and performed a mock visit simulating the level of work expected during a real certification visit.

Now I get to travel outside of Massachusetts to evaluate other clubhouses' fidelity to the ICCD clubhouse standards as part of the accreditation process. The certification team typically consists of a staff person and clubhouse member, usually from different clubhouses, who spend four days immersing themselves in the clubhouse and its culture. We spend two days active in the club, the next day working on a verbal findings report, and the last day presenting the verbal report to the entire membership, staff, board of directors, advisory board, auspice agency, and even some family members. To date I have performed nine certification visits, mostly in New York City; one in Dublin, Ireland; and my last at Diamond Head Clubhouse in Honolulu. I have made site visits to 25 clubhouses since 1992.

In June 2005 I was offered a permanent, part-time supported employment position at the Program for Clubhouse Research. Although I was still working on my education (I look forward to completing my college degree by the end of 2009), I jumped at the opportunity.

After I held that position for almost three years, the Program for Clubhouse Research needed some restructuring. This led me to my current position at the Center for Mental Health Services Research (CMHSR) at UMass Medical School working on the Institutional Review Board Study. With data entry my primary task, I hope to continue to gain experience in research. My hope is that this job will allow me to participate more in the Consumer Workgroup, the Consumer Advisory Council, and the Area Research Monitoring Committee.

The Consumer Workgroup consists of staff members of CMHSR who have been mental health consumers. Originally I was offered the chance to chair this committee, but between working limited hours and my lack of experience doing committee work, I was concerned about becoming overwhelmed. The work of this group is to review all grant proposals to evaluate the protective measures for the study participants. We are also free to express any ideas on any aspect of the proposal to the principal researcher.

The Consumer Advisory Council is a group of consumers and staff from CMHSR and Harvard Medical School who are charged with disseminating to the general public the information learned from their respective studies, via brochures, leaflets, and other media.

And I recently joined the Central Massachusetts Area Research Monitoring Committee as the consumer representative. This group also includes professionals from Massachusetts Department of Mental Health, doctors from the region, and researchers. We meet quarterly to monitor and coordinate studies up for review or in progress.

Clubhouses have been my "yellow brick road" to recovery. Too many know too little about the clubhouse model, hence this communication to you all.

Mr. Grillo resides in Worcester, Massachusetts, and is working at the Center for Mental Health Services Research (e-mail: [email protected]). Jeffrey L. Geller, M.D., M.P.H., is editor of this column.