Abstract: Examining Demographic and Functional Predictors of Engagement within the Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness (Society for Social Work and Research 29th Annual Conference)

Schedule:

Friday, January 17, 2025

Issaquah B, Level 3 (Sheraton Grand Seattle)

* noted as presenting author

Anju Kotwani, MSW, MSW, Case Western Reserve Universtiy, Cleveland, OH

Wilson J. Brown, PhD, Assistant Professor of Clinical Psychology, The Pennsylvania State University, PA

Rochanne L. Honarvar, MSW, Clinical Social Worker, Case Western Reserve University, Pittsburgh, PA

Lori D’Angelo, PhD, Executive Director, Magnolia Clubhouse, Cleveland, OH

Shaun M. Eack, James and Noel Browne Endowed Chair and Professor of Social Work and Professor of Psychiatry, University of Pittsburgh, PA

Jessica A. Wojtalik, PhD, Assistant Professor, Case Western Reserve University, Cleveland, OH

Background: The Clubhouse Model (CM) of psychosocial rehabilitation for serious mental illness (SMI) is an effective, recovery-oriented, and member-driven approach to improving functional outcomes among individuals living with SMI. This model creates an intentional community of support to reduce social isolation and promote functional improvement through various programs including supported employment/education and social events. Certainly, engagement within the CM is important for members with SMI to have the greatest opportunity for functional recovery. However, nothing is known about the facilitators or barriers of CM engagement. Understanding personal factors that predict level of CM engagement is necessary for improving service delivery and encouraging member engagement.

Methods: Using attendance data (January 2019- November 2023) from a retrospective administrative dataset from an accredited Clubhouse in Cleveland, OH, the aim of this research was to identify demographic and functional predictors of engagement among active Clubhouse members (N = 137). Demographic predictors included age, gender, race, education, and living status; the functional predictor was the members’ initial total score from the World Health Organization Disability Assessment Scale (WHODAS)-2.0. Average monthly attendance (outcome) was calculated by dividing total attendance (number of visits) of each member by their length of membership in months. A multivariate negative binomial regression (MASS package), most appropriate for overdispersed count data, was conducted in RStudio to examine functional and demographic predictors of average monthly attendance.

Results: The average age of the sample was 42.63 years (SD = 15.53), with 53% of participants identifying as male, 67% as non-white, 59% with below a high school education, 61% residency in supported housing, and moderate functional disability on the WHODAS-2.0 (M = 25.46, SD = 6.72). Average length of membership was 24.08 (SD = 13.10) months, and members attended the Clubhouse an average of 5.31 times a month (SD 4.53). Age (b = 0.01, p = <.05) and level of education (b = 0.36, p = <.05) emerged as significant predictors of Clubhouse engagement, holding all other predictors constant. Older members and those with a high school or less education were significantly more likely to have higher rates of average monthly attendance. No other demographic or functional predictors were significantly associated with average monthly attendance.

Conclusions and Implications: This preliminary research provides important insights into member characteristics that may predict engagement in the CM for SMI, with age and level of education emerging as significant predictors. While the findings indicate that as age increases, the likelihood of monthly attendance at the Clubhouse increases, this positive association also suggests that younger members have a lower likelihood of engagement. Future research is needed to further examine the association between age and engagement and identify the needs of younger members to inform adaptations to the CM to increase engagement. Furthermore, members with higher education levels (above high school) may have different needs and require novel strategies to encourage CM engagement, relative to members with a high school education or less.