The era of the Victorian asylum, regarded in its heyday as providing a safe institutional environment, finally came to an end after a series of scandals revealed neglect and abuse. In 1981, the Jay Report promoted a ‘care in the community’ programme for people with learning disabilities and mental health needs. Tens of thousands of people left the long-term hospitals and returned to mainstream communities. However, many mental hospitals remain. Some are located in rural areas and quite isolated. And because of the shortage of mental hospital beds, many patients are admitted to a hospital far from their home.
In February 2024, The King’s Fund reported that inappropriate out-of-area placements can delay the patient’s recovery and are associated with increased risk of suicide.
Sir Norman Lamb has extensive experience in the field of mental health. He is Chair of NHS Maudsley, which provides in-patient and community mental healthcare, and founded The Sir Norman Lamb Mental Health and Wellbeing Fund.
“Very occasionally, for a very small number of people, removal from their local area may offer some benefit. But not for the vast majority. Sending people a long distance away from home is an appalling practice. Dislocation from family and friends, to a remote place, and being locked up, is for most people, the worst possible treatment.
“We lock up too many people. If you are young and black, you are three to four times more likely to be detained under the Mental Health Act. We put a lot of young men together in a confined space, with little access to the outside world, and expect them to recover.”
An outdated Mental Health Act
The government is reforming what they call the ‘outdated Mental Health Act’. They acknowledge that patients currently have little say over their care, or over who should be involved in making decisions related to their care, such as family members and carers.
Modernising the law was a Labour manifesto commitment. Their proposed reforms aim to improve patients’ experiences. This includes intervening earlier, trialling new 24/7 crisis mental health hubs to prevent people needing hospital care, and if an admission to hospital is needed, ensuring this is delivered in a safe and therapeutic environment close to people’s homes.
A better model for recovery?
The Clubhouse Model offers a different style of engagement with individuals recovering from mental health challenges. It is not new, having its origins in 1948. Back then, a group of ten mentally ill people living in Rockland State Hospital in New York City, developed “a dynamic recovery model”, and Fountain House was born. The group focused on what remains a central problem for people living with severe mental illness today – social isolation.
There are over 320 Clubhouses around the world adhering to the Clubhouse model. The Norfolk Clubhouse in Norwich, one of three in the UK, was founded in 2019 by June Webb. Like Mosaic Clubhouse in Lambeth (founded in 1994) and Flourish House in Glasgow (1997), it is a charity and follows the Clubhouse model. Their aim is to help people build meaningful relationships through meaningful activity.
Lamb is a strong advocate for the Clubhouse approach. He has visited Fountain House in the US and also Mosaic Clubhouse. “It’s an enlightened model giving purpose to life. It emphasises humanity, kindness and generosity of spirit,” he says. “Each clubhouse has to adhere to a set of standards which guarantees how they operate.”
One aspect which makes the model different, is its membership policy. All participants in a Clubhouse are its members. And it is this idea of membership that is fundamental to the Clubhouse concept. The implication being that the person, treated as a member and not a patient, will have both shared ownership and shared responsibility for the success of the Clubhouse.
It’s difficult to compare the everyday cost of someone joining a Clubhouse with that of being admitted to a mental health hospital. However a study identified that Clubhouse members receiving outreach for two years had significantly lower re-hospitalisation rates.
Regardless of when members begin their Clubhouse journey, we know that attendance makes a huge and positive difference,” says Tabby Farrar, a trustee of Norfolk Clubhouse. “We also know that this has a knock-on benefit for friends or relatives of those accessing Clubhouse services, who often act as unpaid carers and can wind up seeking mental health support themselves if holistic help is not at hand for their loved ones.”
The Norfolk Clubhouse
Participation at the Norfolk Clubhouse is voluntary. Members are invited to participate in work. This may include clerical duties, reception, food service, transportation management, outreach, maintenance, research, managing employment and education programmes, engaging in wellbeing activities, financial services and other areas.
The National Lottery Community Fund has recently awarded the Norfolk Clubhouse a £20,000 grant. The money will finance further services including peer support, skill-building workshops, and greater community and wellbeing-building activities. The Clubhouse has moved its Norwich hub to a new location at Carrow House, part of the recently established Norwich Unity Hub. This new space will provide an expanded and welcoming environment where members can gather in a more central location and the charity can collaborate more easily with other community groups.
June Webb expressed her gratitude, saying, “We are deeply thankful to The National Lottery Community Fund for this grant, which will go a long way in helping us grow our community and support more individuals in their recovery journey.”
Membership in a Clubhouse is open to anyone who has a history of mental illness and has been referred by a GP or other health or social care professional, or support worker. A prospective member may self-refer by filling in the Contact Form and choosing the option ‘Member Query’. Carrow House will provide services from 10am-4pm on Mondays, Wednesdays and Fridays. The Watton hub is open 1pm-4pm on Mondays and 10am-1pm on Thursdays.
