The Stepping Stone Clubhouse Evaluation: Exploring Members' Experiences, Service Engagement, and Perceived Impact of the Clubhouse International Model

The Clubhouse Model of Psychosocial Rehabilitation provides non-clinical social support for adults living with a diagnosed mental illness or self-reported mental ill-health (referred to as 'members'). The Stepping Stone Clubhouse in Brisbane, Australia was evaluated between August 2022 and August 2023 using a participatory action research approach. Data was sourced from member surveys, member interviews, and an existing Clubhouse Member Database. Outcomes included members' self-reported psychosocial recovery, social connectedness, quality of life, frequency of hospitalizations, and their attainment of employment and/or education aspirations. In this cross-sectional evaluation, it was hypothesized that existing members (membership: 11 months - 28 years) would report better outcomes than new members (membership: 0-14 days). In total, 161 existing members and 76 new members completed a survey. Twenty-three members also participated in a semi-structured interview. Participants were aged on average 47.1 years (± 13.5), 62% were male and 31% had a primary diagnosis of schizophrenia/schizoaffective disorder. Existing members reported better scores than new members for: three of the four psychosocial recovery domains (Functional Recovery: 78.0% vs. 74.0%, p = 0.01; Symptom Management Recovery 69.5% vs. 65.2%, p = 0.03; Social Recovery 74.3% vs. 70.0%, p = 0.01); social connection with other members (38.1 vs. 32.2, p = 0.03) and staff (44.5 vs. 38.1, p = 0.02); quality-of-life summary scores (4.6 vs. 4.1, p = 0.01), and rates of mental health-related hospitalization (16% vs. 41%, p < 0.01). Existing members were also more likely to be in some form of employment, compared to new members (p = 0.01). There were no significant differences between existing and new members for their educational goals, with 58% of each group wanting further formal education. Stepping Stone members have better outcomes than members who have recently joined the Clubhouse. This evaluation was successful because it intentionally built evaluative capacity and empowered member-centric processes.