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Finland’s Clubhouse Study Report 2009

Finland’s Clubhouse Study Report 2009. Data collected in years 2004 - 2006. Esko Hänninen, Helsinki, Finland. 14/09/09. 1. The Clubhouse is not one-idea model _______________________________________________________________________________________________.

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Finland’s Clubhouse Study Report 2009

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  1. Finland’s Clubhouse Study Report 2009 Data collected in years 2004 - 2006 Esko Hänninen, Helsinki, Finland 14/09/09 1

  2. The Clubhouse is notone-idea model _______________________________________________________________________________________________ Clubhouses are consisting of several components bringing in the positive outcomes for persons recovering from mental illness. Clubhouses are linking the integrative rehabilitation pathway from dependency to independent living. Since 1980s the scientific community has produced a growing evidence on the positive impacts of the CH model(e.g. UMASS, Worcester USA, data on R&D findings). Finnish study report 2009 confirms the previous research findings.

  3. The Finnish Research Team • Hietala-Paalasmaa Outi • Hujanen Timo • Härkäpää Kristiina • Reuter Anni Study covers: 18 Clubhouses in Finland in 2004 2630 CH Members Living in 92 Finnish Municipalities Research Data were collected in years 2004 - 2006

  4. Finland’s 18 CHs in 2004 Are owned by • 5 municipalities/cities  3 CHs • 1 Espoo Diaconia Foundation  1 CH • 12 NGOs in mental health or related fields  14 CHs And financed by • Gambling profit, collected by RAY (Finnish Slot Machine Association) • Allocated annually by the Ministry of Social Affairs and Health to NGOs & Foundations • 46 Finnish Municipalities/Cities

  5. Population (N) Less than 25.000 25.000 – 100.000 More than 100.000 Clubhouses 3 16.5 % 8 44.5 % 7 39.0 % Population Served by CHs in Finland

  6. Attendance Daily 2 - 4 times in week Once in week 1 – 3 times in month Non-active members (attending less than one visit per month) Percentage 8 % 17 14 17 44 (56 % of all were active members in 2004) Participation rate in CH Activities

  7. Age groups 18 – 24 25 – 34 35 – 44 45 – 54 55 – 64 65 + Percentage 4 % 24 % 29 % 26 % 15 % 2 % (53 % of all members belong in age group 25 – 44) Members’ Age in Finnish CHs

  8. Years 1997 1999 2001 2004 In 2008 CH Members in TE 4 26 87 101 (TE jobs 69) circa 200 ??? Ville ? Growth of TE placements in Finland

  9. The Components of a Clubhouse • Work Day in the CH • Peer Support • Supported Education and Training • Employment Programs •  TE, SE, IE • Housing Support • Case Management • Evening, Weekend and Holiday Programs • Quality Assurance & Certification process • Outreach • Advocacy for People with Mental Illness (including research)‏ • Health Promotion Activities • Administration and Management of the Clubhouse • Supporting the Development of Other Clubhouses (All these components are identified in Finland’s CHs) 14/09/09 Esko Hänninen, Helsinki, Finland 9

  10. Main Findings of the Follow Up Studyin FINLAND, published in March 2009

  11. Development Needs Reported by CHs • Organizing the Transitional Employment is a continuous challenge for many CHs • Content of the work-ordered day • Need for increase of staff • Financing problems – more money…. • Certification • Free-time programs

  12. Integrative Pathway from Dependency to Independent Living Clubhouse as Learning Community Clubhouse Psychiatric Medical care and treatment Functional Rehabilitation Day Centres Other activities • Employment • Transitional • Supported • Independent Supported education & training • Psychosocial rehabilitation • Work-ordered day • Pre-training / learning to • learn / Computer skills etc. • Peer support • Social skills • Education & Employment • Programmes Mental Health services Supported education & training. Transition to and employment in the open labour market Individual Empowerment Process

  13. Type of Evidence on the participa-tion in the CH activities Class I Class II Class III Benefit>>>Risk Benefit>Risk Risk>Benefit Multiple randomized clinical trials (RCT) or Single site RCT’s with matched participants CH Services & Support SHOULD be performed and offered, because advantages of active participation in Clubhouse activities are e.g. IT IS REASONABLE to provide Clubhouse services because they have positive impacts on e.g. No additional studies needed. Service should NOT be offered, IT IS NOT HELPFUL & MAY BE HARMFUL • Less hospital care ++ • Outreach ++ • Quality of Life ++ • Satisfaction ++ • No this category findingson CH model Observational Studies • Employment + • Social Relations + • Social Inclusion + • No this category findings on CH model Expert consensus or testimony by experienced individuals • Education +(Source 2009: • Work-ordered day +Colleen McKay, • Wellness +UMASS Medical School • Housing +Worcester MA USA)‏ Classification of Clubhouse Research Outcomes 14/09/09 Esko Hänninen, Helsinki, Finland 13

  14. Clubhouse Development in Europe

  15. Existing European Clubhouses – 90 Clubhouses in 18 countries Albania 1 Austria 3 Denmark 6 England (?) 17 Estonia 1 Finland 22 Germany 3 Iceland 1 Ireland 4 Italy 1 Kosovo 1 Macedonia 2 Netherlands 1 Norway 3 Poland 2 Romania 1 Russia 4 Scotland 7 Sweden 9 TOTAL 90 About 90 Clubhouses serving over 11000 members annually Esko Hänninen 14/09/09 15

  16. Europe is divided in the use of CH model: • Best CH practice countrieshave included CHs in their Government Mental Health Policy, e.g. Finland, Sweden Denmark, Iceland, Norway and Scotland/UK; • In 13 other countries in Europe CHs are approved but not actively promoted; • In the 35 other WHO – Europe countries CH model is not used and decision-makers are not aware about the CH integration & inclusion possibilities; • The strategic goal  the experienced Clubhouse countries start to transfer their positive outcomes for use in other European countries! 14/09/09 Esko Hänninen, Helsinki, Finland 16

  17. CLUBHOUSES ARE PART OF SOCIAL SERVICE SYSTEM • CHs belong to the Community Mental Health services & cooperate with relevant stakeholders • CHs work together with Companies & Employers, and Education, Housing, Employment, and Social Security Benefit Agencies • CHs follow the Community-Based Rehabilitation (CBR) approach, recommended jointly by the WHO, UNESCO and ILO (1990s & 2004 & 2008) www.who.int/en/disability/cbr • Continuous Improvement of Clubhouse Activities is supported by ICCD - The International Center for Clubhouse Development (e.g. Training, Standards, Quality Assurance & Certification)www.iccd.org 14/09/09 Esko Hänninen, Helsinki, Finland 17

  18. European Partnership for Clubhouse Development - EPCD(was created in March 2007 in Stockholm City Hall in the ELECT partners’ meeting)‏ • The overall goals of the EPCDwill be to • Improve the social inclusion, education and labour market integration of people with mental health problems by enlargement of the net of European CHs. • Promote and coordinate the European research on the Clubhouse model. • Next phase is  permanent formal organisation for the EPCD. • Strategic Choice: 1 – 2 EPCD Office in Europe or should we create Alliance with some existing one? • Do we open EPCD as a collaborative network of all interested parties and actors? 14/09/09 Esko Hänninen, Helsinki, Finland 18

  19. ELECT is a consortium of 11 partners from 7 EU countries & ICCD, USA www.elect-project.eu 14/09/09 Esko Hänninen, Helsinki, Finland 19

  20. Additional Information in websites: • ICCD: www.iccd.org • CBR (WHO, ILO & UNESCO): www.who.int/en/disability/cbr • ELECT-project: www.elect-project.eu • Helsinki Clubhouse: www.helsinginklubitalo.org • Esko Hänninen, Coordinator of the EPCD • e-mail: hanninen.esko@gmail.com • Tel (gsm): +358 40 503 7095 (Finland)‏ 14/09/09 Esko Hänninen, Helsinki, Finland 20

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