Predictors of Loneliness of Clubhouse Members

Background/Purpose: Psychosocial clubhouses are at the forefront of mental health efforts to address the isolation of adults with serious mental illness through fostering the development of meaningful relationships. Social network studies have served as proxy to examining loneliness and isolation among this population. However, there has been limited research on the predictors of loneliness among persons with a serious mental illness and no studies of the degree to which clubhouse participation affects the loneliness of its members. This study examined the impact of clubhouse participation on members' loneliness after controlling for demographic and qualitative social support variables suggested by previous research. Methods: Eighty randomly selected respondents from a Midwestern urban clubhouse agreed to in-person interviews in this cross-sectional study. The refusal rate was low (23%). The dependent variable, loneliness, was assessed by the UCLA Loneliness Scale (Version 3) (Cronbach's alpha= .92 in our sample). The focal predictor variable, clubhouse participation, was measured by the number of clubhouse visits. Control variables were gender, race (African American vs. others), receipt of overall concrete, emotional, and informational supports, and overall satisfaction of relationships with social network members. Results: Participants averaged 44.2 years of age; over half were African American (53.8 %) and predominately male (70%). Almost three-fifths (58.8%) had a diagnosis of schizophrenia. The results of a hierarchical multiple regression analysis indicated that the first model with gender and race as predictors was not statistically significant (F (2, 77) = .115, R² =.00, p = .89). After concrete, emotional, and informational supports and satisfaction with relationships were entered, the second model was statistically significant (F (6, 73) = 5.50, p < .001), accounting for 31 % of the variance in loneliness(R² = .31). In this model, satisfaction with relationships was a significant predictor (p < .05). For the final model, adding the number of clubhouse visits accounted for an additional 6% of the variance in loneliness (F (7, 72) = 6.02, R² = .37, p < .001). There were two significant predictors in the final model (p < .05). The number of clubhouse visits (β = -.27) was the strongest predictor followed by satisfaction with relationships (β = -.23). Conclusion/ Implications: Previous clubhouse studies have shown that clubhouses can positively impact members' employment status and recovery; this study indicates that clubhouse participation can also impact loneliness. Findings show that even after controlling for qualitative social support, greater clubhouse participation was associated with lower levels of loneliness. Given the isolation and loneliness experienced by many adults with serious mental illness, the study suggests that participation in the socially oriented clubhouse model can be helpful in addressing this loneliness. An important limitation of this study is its cross-sectional design. Future longitudinal studies are warranted to assess the causal relationship of types of activities and amounts of clubhouse participation with members' loneliness.