With an Affinity to Care

Members and staff of Affinity House gather in front of their garden, in which they grow a variety of vegetables and herbs. (Deborah Haak-Frost|Watershed Voice)

Everyone is working side-by-side. Whether making lunches or cleaning bathrooms or calculating finances, members of Affinity House (Clubhouse) at 667 East Main St. in Centreville have a job to do—and they do it alongside the three staff members overseeing operations. 

“We are all on an equal playing field,” says Jessica Niblock, clubhouse director. 

With about 40 members registered, most days see an average of 15 members coming in. Members are part of a community of persons with mental illness, and the clubhouse provides a place for them to gather, develop friendships, learn job skills, develop resumes and connect with employers, and generally access community resources for a more independent life. 

“Good morning!” Troy calls out upon entry. He takes out a printed page and makes announcements his job for the day. “Today’s lunch. Taco salad. Fruit. Today’s weather—sunny, 83 degrees. Have a nice day.” His job done, he sits back with a satisfied smile.

Several members are working in the kitchen preparing lunch, each at their own station, gloved and hair tucked up in hair nets. “Chopping!” Travis calls out, a cutting board in front of him with neatly diced and sliced onions. “Making pizza,” Berta adds, pressing dough out on a pan. Their joy in their jobs is evident.  

“If it wasn’t for our kitchen staff, we would go hungry,” Niblock smiles. 

Social events take place at Affinity House and in the community on a regular basis; staff and members celebrated a “Christmas in July – now August” party with food and decorations. (Deborah Haak-Frost|Watershed Voice)

About 2% of American adults – an estimated 14.2 million people – have severe mental illness, defined as a behavioral disorder severe enough to hinder major life activities. It’s a group at high risk of homelessness, incarceration, unemployment, poverty,  substance abuse, suicide attempts and social isolation.

For instance, 37% of people incarcerated have a diagnosed mental illness, and nearly 21% of the homeless have a serious mental health condition, according to the National Alliance on Mental Health. Mental illness and substance use disorders are involved in one out of every eight emergency department visits by a U.S. adult, while mood disorders are the most common cause of hospitalization for all people in the U.S. under age 45.

Depression is the leading cause of disability worldwide, along with anxiety disorder. And people with serious mental illness earn, on average, one-third less than the median income of people without serious mental illness throughout the world, according to a 2021 story in Psychiatric News.

The Centreville operation is part of a national network of clubhouses offering community support. Research shows the programs are a cost-effective way to reduce incarceration, homelessness and psychiatric hospitalization among people with severe mental illness, and also improves employment rates, social connections, and well-being among participants.

“The first such clubhouse, Fountain House, was established in 1948 in New York City,” Niblock says. “Affinity House has been around since 1995. There are now about 320 clubhouses in 30 countries, but Michigan has the most of any state. Mostly, we have members here with issues of anxiety, depression, or schizophrenia.”

Clubhouse International, established in 1994, oversees all clubhouses and sets standards for all to meet. Clubhouse membership is free and open to everyone on a voluntary basis and without time limits. Membership is open to anyone with a history of mental illness unless that person poses a current and significant threat to the safety of other clubhouse community members. 

“Once a member, always a member, that’s how we see it,” Niblock says. “Our goal is to get people out of the house as people with mental illness tend to isolate. If someone stops coming in, we give them a call or send a text to give encouragement and check on them. And our program is designed to not only get our members out of the house but also to provide opportunities to find work in the community. We do that through transitional employment.”

Transitional employment, Niblock explains, means that members are eased into employment one step at a time. They may begin with jobs within the clubhouse. They receive help preparing resumes and conducting interviews. Next, they progress to employment in the community while supervised by clubhouse staff members. 

Studies show that 42% of members participating in transitional employment programs at accredited clubhouses gain employment annually, double the average rate for people in the public mental health system. Clubhouse members also have longer on-the-job tenure, said a 1995 study published in Psychosocial Rehabilitation Journal.

“Our members receive training and supervision in jobs in the community,” Niblock continues. “We make sure all is going well, and after six to nine months in a position, depending on the member, we transition them into a new position. If needed, we provide transportation to and from the clubhouse for local members—and we pay for public transportation if they are not local–as well as to and from work. By transitioning that way through different positions, they can expand their resumes. We call it supportive employment.”

For those who remain at the clubhouse during the day—Affinity House is open from 8 a.m. to 4 p.m. every day—each completes a job to keep the clubhouse running. While some prepare meals in the kitchen, others work on finances for the clubhouse and maintain accounts under staff supervision. Still others take on cleaning duties. 

“We are funded by Medicaid, so no one has to pay,” Niblock says. “Members work on our banking, too.”

Members and staff of Affinity House, left to right, top row: Donna, Holly, Bea, Sandra, Joe; Bottom row: Karen, Jessica. (Deborah Haak-Frost|Watershed Voice)

The clubhouse community does not just center on jobs, however. Social connections are equally valued. While those working outside of the clubhouse may not always be able to attend clubhouse social outings, depending on their schedules, other members regularly participate in community events. After-hours and weekend events are scheduled so that working members may also participate. 

“We mimic the real world,” Niblock says. “We have two outings on weekdays and two over the weekends. Members get together to go to movies or to restaurants or wherever anyone would want to go.”

While Niblock says that Affinity House does not currently have a measurement system for outcomes, clubhouses across the country and internationally have shown a positive effect in reduced incarcerations and significantly reduced admissions to hospitals and psychiatric institutions. 

Clubhouse International studies show that one year of holistic recovery services as delivered to clubhouse members equate to the cost of a two-week stay at a psychiatric hospital. Clubhouse members are significantly more likely to report that they have close friendships and someone they can rely on when they need help, said a 1999 paper published in the International Journal of Social Psychiatry. A 2004 study suggests service systems like clubhouses that offer ongoing social supports enhance mental and physical health by reducing disconnectedness in their members.

“Another service we offer is help on housing applications,” Niblock says. “Although we don’t actually provide housing. We recently had a member who had been on a waiting list for housing for four years, and she finally received a housing voucher. Housing can be scarce, especially for someone with mental health issues.”

When families have been interviewed about the changes they have observed in loved ones with mental illness who are clubhouse members, most reported four main pillars of positive changes in improved attitudes, improvement in challenging behaviors, positive affective behaviors, and greater social interactions, said a 2016 study published in the Journal of Mental Health.

“Although we don’t have a specific measurement of outcomes at Affinity House at this time, we do regularly talk to our members to be sure they are achieving their personal goals,” Niblock says. “And we celebrate all the little victories together.”

The clubhouse program is not a cure-all. It requires participants to take personal initiative, which can be challenging for someone with chronic mental illness. It also doesn’t address some of the challenges that people can face, such as treatment compliance and the need for stable housing and a sustainable income. Also, not all of the people who could benefit from the program are aware that it exists, and not all communities have an accredited clubhouse program.

On Niblock’s wish list is getting out the word to the community of all that Affinity Clubhouse offers members. Being in a rural county, she says, has challenges in connecting with people living far apart and far out of town. 

“We invite anyone to call for information or come in for a tour,” she says. “As long as the clubhouse has been in the community and considering the numbers of those who suffer from mental health issues, I hope to get the word out about what we offer—and that it is free of cost. The community needs to know we are here—and we can help.”

Affinity House can be reached at 269-467-1923.

This story is part of the Mental Wellness Project, a solutions-oriented journalism initiative covering regional mental health issues, by the Southwest Michigan Journalism Collaborative. SWMJC is a group of 13 regional organizations, including Southwest Michigan’s Second Wave, dedicated to strengthening local journalism. For more info visit swmichjournalism.com.