Finding Time for Wellbeing Among Older Adult with SMIs: Feasibility and Acceptability of a Wellbeing Course in a Psychosocial Clubhouse

Background and Purpose

Older adults with serious mental illnesses (SMIs) face heightened morbidity and mortality rates, increased isolation, and reduced quality of life compared to their peers. Despite these challenges, the current body of research does not address their wellbeing needs, overlooking the potential benefits of evidence-informed positive psychology interventions (PPIs) for this population. Additionally, little research explores how psychosocial clubhouses, a recognized psychiatric rehabilitation approach, can support their aging members. Therefore, this research aimed to assess the feasibility and acceptability of a wellbeing course for older adults with SMIs within a psychosocial clubhouse setting.

Methods

Participants were English-speaking adults with SMI diagnoses; aged 50+, members of the psychosocial clubhouse where the course was offered; and competent to provide verbal and written informed consent. Being under legal guardianship was exclusion criteria. Clubhouse staff recruited participants to the course through regular clubhouse meetings. The 10-week wellbeing course had been co-designed by the author of this presentation, in collaboration with certified older adult peer specialists (COAPS) in a multi-focus group process. COAPS contributed insights that informed course content, processes, and setting.

The course was facilitated by this author and a COAPS, and two staff from the clubhouse also joined. Due to the Covid-19 pandemic, the course was delivered in a hybrid online-on-ground model. Feasibility and acceptability of the course was evaluated using qualitative data generated from the course and attendance records. Attendance records were examined for trends. Qualitative data included descriptive notes and memos of what happened in each class session, including in a final debriefing class meeting. In total this data was represented in about 30 pages of text, single-spaced. Deductive thematic content analysis was used to analyze the qualitative data; the COAPS co-facilitator and clubhouse staff member-checked the initial analysis, enhancing rigor and adding insights.

Results

A total of 11 clubhouse members participated. Findings suggest the course was feasible in a clubhouse setting and acceptable to participants, clubhouse staff, and administration. The hybrid model had the unexpected benefit of promoting regular participation of members who otherwise had low on-ground attendance.

Thematic analysis of qualitative data developed insights into participants’ perceptions of the course: Participants valued how the course brought people together, building relationships and a sense of togetherness, which was especially valuable due to recent social distancing. In response to course content, participants emphasized the multifaceted nature of their lives, attending to both positive and negative experiences. Participants shifted to and/or underlined their self-perceptions of “illness does not define who we are.” Things went awry when participants felt the class briefly turned into group therapy, but they stayed with the course.

Conclusions and Implications

Qualitative acceptability and feasibility findings mark a crucial step in the development of this co-produced, innovative course designed to enhance wellbeing for older adults with SMIs while broadening the array of services available to older psychosocial clubhouse members. Further research is needed to assess the effectiveness of the course in bolstering wellbeing for participants.