Stigma Within the Clubhouse Community by Tom Sweet

Schizophrenic, manic-depressive, specialist, generalist, staff, member, line-staff, residence counselor, director, bureaucrat, administrator, personality disorder, unit-based, non-unit based – the list of how we can label each other, or self-stigmatize, is seemingly endless.  Even as we vociferously advocate against stigma in the media, discrimination in the workplace, and unequal application of laws and funding for people with mental illness, we continue to apply some of the same techniques that we despise so much outside our clubhouses, to ourselves within.  The first direction we must undertake, as a worldwide community, as distinct clubhouses and as individuals, is to eradicate stigma from our daily lives, at least within the context of the clubhouse and our work.

Stigmatization occurs when we say “I’m just a member” or, “he’s a specialist.”  The fundamental and exhilarating truth is that there are no such people – there is only us.  We are all part of the same community, and as such, equal in and as much as we all contribute our unique talents and abilities.  In a clubhouse, there can be no room for distinguishing between, or comparing the levels of contribution.  The single act of contributing itself promotes the healing environment of the clubhouse which, in turn, facilitates recovery of the membership and strengthening of the staff, even as the community itself becomes stronger and more vibrant.  When we differentiate between the value of certain roles, contributions, or abilities, we violate our most deeply held beliefs: that all of us have some part that is well; that all of us have some unique talent or skill; and that all of us are worth of the same level of respect, decency and kindness that we accord anyone else with whom we come into contact.

When we label each other (or ourselves) we pigeonhole people as being limited to certain roles, abilities, or functions, thereby capping their potential.  This, of course, directly contradicts the vision of Fountain House, which states that our vision is “…that people with mental illness everywhere achieve their potential and are respected as co-workers, neighbors and friends.”  While this image explicitly pertains to men and women with mental illness, it is impossible to treat members one way, and staff in a diametrically opposed fashion, and still have one community.  Further, if staff are stigmatized through appellations such as “administrator,” “specialist,” “caseworker,” or any other limiting terminology, how can we expect them not to do likewise to members, consciously or unconsciously?  We treat those around us as we are treated ourselves, by our superiors as well as our peers and our friends.

In the clubhouse, it is incumbent upon us to see each other as individuals, as people, not as “cases” or “caseworkers” in order to assist each other in achieving our respective potentials.  In so doing, we will strengthen our community thorough the resultant relationships that will be built upon, mutuality, respect and dignity.

Community Through Contribution and Mutuality

Once we have established the fact that in a clubhouse we cannot label ourselves or others, we must tackle the job of articulating how to talk intelligently and meaningfully about the individuals who make up the community (staff and members).  How can we identify roles, responsibilities and accountability, without stigmatizing, pigeonholing, or limiting the potential of the people who are identified with them?

Perhaps the clearest way to start is to talk about how all of the individuals who comprise the clubhouse community contribute, irrespective of their perceived role or position.  There are as many different ways to contribute to the clubhouse community as there are people, but for our purposes, we will concentrate on the general ways that all members, staff, board and other stakeholders can contribute, irrespective of role, title or function.

Engaging And Attracting Attitudes: A Contribution We All Can Make

The way we carry ourselves and interact with others, even (or perhaps especially) non-verbally, can convey powerful meaning and invoke strong reactions, negative or positive.  For example, staff and members who arrive at the clubhouse full of cheer and excitement about beginning a new day, full of opportunities, are much more likely to attract, inspire and engage others in the work of the house, than those that arrive looking hangdog and depressed, or simply rush to their area and begin working.

If we accept the premise that people (staff, members and board) keep coming because of how they are welcomed, celebrated, and supported for who they are, then how we present ourselves and interact each day clearly becomes of paramount importance.  Our presentation of ourselves, if it is positive and upbeat, is most likely to attract and engage those around us, contributing to a healthy, healing environment and promoting meaningful relationships.  The converse is true as well.  If we are negative, act angry, depressed, distressed or otherwise out-of-sorts, our presentation is most likely to repel, discouraging relationships (even previously established ones) and we can be a destructive influence on the atmosphere of the clubhouse.

The beauty of this premise is that anyone can be a positive, contributing force for clubhouse strength, as described above, irrespective of role, status, job, or function.  In this way, there are no specialist (or we are all specialists) when it comes to the fundamentals of establishing and nurturing an environment of recovery.  All of us can and must treat ourselves and others with honesty, respect, decency and warmth.  This, not the specific roles we perform, is what creates the essence of the healing clubhouse community.

The Power of “Thank You”

When we talk in clubhouse about engaging members, we often hear stories about members who come to the clubhouse day in and day out, but when asked to help, adamantly refuse.  The work of the staff and members of the clubhouse is to engage this person, which sometimes means just recognizing that getting up and out to the clubhouse can be a day’s work in and of itself.  However, there is a reason that these members are coming – in some way they feel connected perhaps even comfortable.  Understanding this, it then becomes incumbent upon us, members and staff, to place opportunities in their path, open doorways that can become portals to recovery.

Perhaps the most effective way to start this engagement process is by creating mechanisms for thanking the person for something, no matter how trivial.  The specifics are not the issue; the importance is in the ability to say “thank you” and to mean it sincerely.  This simple act recognizes the person as an individual, not as a random choice of someone to perform a task.  Saying thank you has the effect of recognizing the person as someone of value and worth (whom you consider to be capable).  When the task is accomplished, no matter how small it was, the person knows that he or she has been appreciated for a job well done.  Saying thank you assures the person that he or she is a full member of the community, having performed something that contributes to the common weal.

This process is so powerful that we all must, as we go about our clubhouse work, consciously seek out opportunities to use it.  Whether we are the one that has engaged someone else in a task, or whether we simply recognize that someone has performed a function that contributes, no matter how small (picking up litter and throwing it away, delivering a piece of mail), the possibilities are endless, and should be seized whenever possible.

The widespread use of “thank you” in the clubhouse is one of the most powerful ways of building and strengthening individual bonds that, in turn, make our community stronger.  Whenever we can take the opportunity to thank each other, we must do so; if opportunities fail to appear, we must create them.

There is nothing to prevent any member of our clubhouse community from performing this very simple, but powerful function that recognizes, dignifies and celebrates another member of the clubhouse community.  There is nothing to limit it to unit staff, members only, or any other category that one might care to create.  Again, when it comes to the absolute fundamentals of what we do, there is no such thing as a generalist or a specialist.  There is nothing to stop any of us from respecting and acknowledging one another’s contributions, thereby contributing to the continued strength of the community.

Functions, Accountability and Role Modeling

All clubhouse community members have specific functions, responsibilities and accountability.  Clearly, depending on one’s role in the clubhouse, these differ, sometimes significantly.  What does not change is our responsibility to each other, and our individual accountability for our work.  Though members cannot and should not be held accountable for bottom-line responsibility for actual clubhouse work, they can and must, be held accountable to the same standard that applies to the entire clubhouse community – that of treating other members of the commuting with dignity and respect.  We are all responsible and accountable for our behavior and that is where the commonality lies between all community participants.

For staff, no matter what their specific role within the clubhouse, the same clearly holds true.  Staff are expected to be in control of their behavior, to role model positive interactions, and to substantially and meaningfully engage members in their work.  They are also expected to serve as role models, whenever possible, demonstrating best work practices, in terms of social and vocational behavior.  For small clubhouses this is fairly straightforward as many specialized tasks are performed by a parent auspice agency, while the clubhouse staff focuses on basic clubhouse work.  However, as clubhouses grow in size and complexity they tend to take on more and provide more, necessitating adding on roles and functions that often require special training, education or skills.  Examples include fundraising, accounting, supervisory positions, housing staff, etc.  All of these functions require some level of expertise or specific education, credentialing or training.

None of these so-called “specialist” functions preclude contributing to the community in the ways previously described.  However, accountability for these jobs may limit the amount of support, Transitional Employment, involvement in after hours recreational programs and the like.  This does not mean that they cannot or should not be involved in these and other aspects of the clubhouse.

Ideally, everyone, especially staff, should be an integral part of the community through participation in all that the community has to offer.  However, some staff have other contributions that they are required to make to the community, as part of their accountability to the clubhouse.  In smaller, auspiced clubhouses, this premise most likely pertains to the director only, who must attend meetings, raise money, prepare levels of service reports, meet with the advisory board and representatives from the auspice agency, etc.  In addition, of course, the director would be contributing in the ways that all community members contribute, and probably have many of the “regular” staff functions, just fewer in quantity, not quality.  In larger, more complex clubhouses, the role of director is often divided amongst one or more staff.  As with the director of the small agency, these staff have certain functions for which they have the primary responsibility.  However, they must also see themselves as full members of the community, and as substantial contributors, who contribute on multiple levels: by fulfilling their job, by performing “regular” staff roles, and by how they present themselves and interact with all other members of the clubhouse community.

For example, if accounting staff do not pay the bills because they have forsaken their primary roles for other functions, (talking with members, taking on community support functions, or simply spending the majority of their time performing work that is done more typically by the units) and the lights, heat and phone are disconnected, who benefits and who suffers?  Clearly, the electricity, heat and phones must be in good working order for the clubhouse to function.  Without proper administration, the clubhouse might well close its doors, at which point everyone is the poorer.

We all have our designated areas of responsibility – not ‘specialist’ or ‘generalist’ – just designated jobs that we are paid to do.  One of these responsibilities is to role model good working habits.  In all cases, for all employers, good working habits are characterized by getting one’s job done, doing it well, and in a timely fashion.  We all contribute to our clubhouse by following these tenets, irrespective of our job title, role or function.  When we take time away from fulfilling our primary roles we send the wrong message.

We are all accountable for the same general set of expectations, and then, above and beyond that, we may have additional accountability or responsibilities, the fulfillment of which provides substantial contributions to the welfare of the clubhouse community, and the abdication or abrogation of which could be extremely harmful.

The synthesis that happens in a healthy clubhouse ensures that the sum is greater than the component parts.  The key to this synthesis, I believe, likes in the mutuality amongst us all.  Not equality, as no person is truly equal to another in a literal sense, but the fact that we all have something of value and merit to give and something to receive, otherwise none of us would be here.  What we give and receive range from concrete services to life-long friendships, and everything in between.  The distinguishing feature is that such mutuality, such giving, is possible and necessary for all of us, and is the dynamo that drives the clubhouse, keeping it strong, exciting, vibrant and healthy.  When mutuality fails to develop, however, we not only become strangers to each other; we begin the process of unraveling the tapestry that comprises our clubhouse.

Behavior Vs. Symptomatology

Behavior, particularly that of the staff, can have a profound impact for good or ill upon the community environment.  While it is incumbent on all of us, staff and members, Board or Advisory Board, to contribute positively, and all of us can and should be held accountable, there are differences in the nature, type and application of this accountability.  In the clubhouse, in recognition of the various stages of recovery that members often go through, we tend to accept (or try to work with) an enormous range of behavior.  Some of this behavior would be considered unacceptable at worst and off-putting at best, in other places of business or in public or family settings.  As a community, our responsibility and great joy, often, is in challenging such behavior and, over time and with consistent reinforcement, observing positive changes.

Does mental illness excuse bad behavior?  Clearly, the answer is a resounding no.  If we did not believe in people’s ability to change, to grow, to improve, none of us would have embarked on this journey.  However, the question is not an easy one to ask, let alone answer.  Is it never reasonable to make the assumption that someone’s mental illness has a direct causal relationship with a negative behavior?  However, we can all also agree that some people are capable of being rude, unpleasant, or just downright nasty, mental illness or no mental illness – staff or member – just as others are consistently sunny and pleasant, with most of us vacillating somewhere in the middle.

Seldom, if ever, do staff (or members, for that matter) confront rude behavior and address it.  Yet, this is precisely what must happen.  Such behavior, whether inspired by mental illness or not¸ is rude and unacceptable.  When tolerated, it is harmful to the individual, to others around who receive the message that such behavior is ok, and, therefore, harmful to the community at large.  Such behaviors are infectious and can spread perniciously throughout a community, corrupting the culture, if not corralled and dealt with at the point of origin.  We are all members of the same community, which is only as strong and healthy as we keep it.

Mental illness does not discriminate, and people can be rude or otherwise unpleasant for reasons totally disassociated with any mental illness they may have.  When rudeness is caused or created by symptomatology directly associated with someone’s illness, it is just as important, if not more so, to address these actions as we would any others.  Anything less is discriminatory and stigmatizing.  This does not mean we should be insensitive or rude ourselves.  Once again, every action and every word sends powerful messages to our community, and we are all accountable for those actions and words.  Thus, we must each – members and staff – consciously and conscientiously be aware of our behavior.  We are each charged with opening portals that lead to members recovering their lives.  Just as we can, individually and as a community, open these portals and usher people through them, we also have the power to slam them shut, through our behavior and actions.


Clubhouses, when distilled down to the absolute basics, are founded on certain crosscutting truths that relate to the humanity in each one of us: mutuality, respect, dignity and decency.  As such, all of us can and must contribute to the healing clubhouse environment that promotes recovery, through the various mechanisms delineated in this paper.  We can, and must, each start by seeing ourselves as equal contributors, without differentiation or categorization and without comparison of relative contributions.

We must conscientiously and consistently seek out ways of contributing, through our actions and behaviors.  Our actions, behaviors, and interactions must promote mutuality.

We must seek commonality through mutual esteem and respect in our relationships, and constantly reinforce that which binds our communities tighter, turning strangers into friends, neighbors and co-workers.  Then, and only then, can we assure a unified community that is strong, vibrant and healthy.

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