Club Itaca in Parma: A Project to Increase the Inclusion of Young People with Mental Health Problems into Society and in the World of Work

Project location: Italy, Parma
Project start date: January 2015 - Project end date: December 2017
Project number: 2014-064
Beneficiary: Fondazione Progetto Itaca ONLUS

The Club's activities have the aim to increase the inclusion of young people with mental health problems into society and in the  world of work; are finalized to the recovery of the individual, to empower its resources, its network, develop its wishes, accompany him or her in the recovery of well being. Activity within the Club Itaca (as the Clubhouse International model) are going to be open from Monday to Friday from 9.30 am to 5.30 pm and will be organized in "working units" in which staff and Club members work side by side in a defined daily schedule; also collaborating with the volunteers of the Association in organizing events and external relations.
The most extraordinary feature of Club Itaca, and different from the current psychiatric approach, is that there are no users, consumers or patients, but just members of a club.
Club Itaca becomes an exercise for independent life based on the strength of the "healthy part" of each person. (The "ill part" is taken care outside the Clubhouse through professional medical care.) The activities inside Club Itaca are vital for its own functioning (administration, fundraising, communication, kitchen, secretary, gardening etc..) and are aimed to reinforce a daily work structure and reaffirm self-confidence.
The final objective for the members is a temporary job and eventual employment in the competitive business world. The Clubhouse cannot function without the involvement and activity of the members. This makes it also a very innovative (new approach) and economic (less staff) model. Members work side by side with a purposely generic and limited staff in the daily running of Club Itaca.
Club Itaca is free for its members and they are not paid for any work done inside the Club.

In Parma 20-25 volunteers are already involved in social activities. One of them is members of the Board of the Association Progetto Itaca Onlus, actively working with issues of Mental Health in Milano since 1999. The mission of Progetto Itaca Parma is to develop projects for information, prevention and rehabilitation for people with mental illness as well as much needed support for their families.
The Director, after following a 3 week training at the Clubhouse in Usa, will be able to open Club Itaca and start the activities with the members.
For Progetto Itaca Parma has already organized:
- three courses "Family to Family" for the support of the relatives of people with mental disorders;
- the first Training Course for the volunteers in collaboration with psychiatrists, psychologists and social workers from the public health services, Mental Health Department USSL Parma, started in December 2014

Good mental health is central to overall health and well-being as reflected in the WHO definition of health; it is an essential component of community and national development. Recent research, highlighted in the 2013 World Happiness Report, shows that mental health is the leading determinant of happiness and life satisfaction, contributing more than physical health, age, gender, income or employment.
People with mental illness and associated psychological disability are among the most vulnerable members of the society and continue to experience systematic exclusion from social and economic life. Mental disorders account for 13% of the total global burden of disease and 37% of Years Lived with Disability.
Mental disorders affect very young people; in 75% of the people affected the symptoms started when they were between 15 and 25 years old and many years were lost before they could receive good treatments and care, with the results in missed life opportunities, social exclusion, underemployment, and high healthcare costs.
Much is now known about what works in mental health information, prevention, care and treatment. The challenge is now to implement this knowledge. Services and practice do not always reflect what works in mental health care and treatment. Many countries have limited community-based mental health services and little specialized help for young or elderly people.
European countries in the last 35 years have been transforming their mental health programs and activities, shifting from institutional practices to person-centered community-based care. A large majority of countries have made significant progress over the past few years, and several are world leaders in mental health promotion, mental disorder prevention activities, service reform and human rights. Many countries are reducing the numbers of beds and are moving towards closing mental hospitals to replace such institutional forms of care with community-based mental health services.
Community-based services place great emphasis on people's autonomy and providing care that is based on the needs of the individuals and sensitive to their life experiences and culture. Introducing community based services considerably changes the rights, duties and protection of individuals, families and staff.
Thirty six years ago the Italian psychiatric reform law (Law 180/1978) made radical changes to the whole concept of Italian mental health care, which, until then, had combined some components of community care with a prevalent mental hospital care. The above mentioned law 180 stated that community care must stand alone, and this led to the closing of mental hospitals. Italy became the first developed country to base its mental health care solely on a community network of mental health facilities. This process was neither linear nor uniform, and the effective closing down of the mental hospitals only took place twenty years later, at the end of the 1990s. This closing down process will be successful if two main scopes can be realized: the first one is to provide effective care to people with severe mental illness and the second one is to reduce the stigma and therefore realize social inclusion for people with mental illness.
The Clubhouse model is based on the belief that work and normal social and recreational opportunities are restorative and play an important part in a person's path to recovery and has in its mission to realize the second scope. It is a certified international model to help with integration in society and in the work world for people with major mental illness.

The Nando Peretti Foundation has awarded a grant for this project. The aim of the project is to achieve social inclusion and wellbeing of people with major mental illness through the creation of a Clubhouse. This model has a fundamental concept: being a member of an organization means that an individual has both shared ownership and shared responsibility for the success of the organization. To be a member of an organization means to belong, to fit in somewhere, and to have a place where one is always welcome. For a person living with mental illness, these simple things cannot be taken for granted. In fact, the reality for most people who live with mental illness is that they have a constant sense of not fitting in, of isolation and rejection. Mental illness often has the devastating effect of separating people from others in society. "Mental patient," "client," "disabled," "consumer" and "user" are all terms used by society as a reference to people living with mental illness. People living with mental illness are often segregated according to these labels and defined by them as people who need something, or as social burdens that need to be managed. The Clubhouse offers a complete change in this perspective. It is designed to be a place where a person living with mental illness is not treated as a patient and is not defined by a disability label. In a Clubhouse, a person with mental illness is seen as a valued participant, a colleague and as someone who has something to contribute to the rest of the group. Each person is a critical part of a community engaged in important work. In a Clubhouse, each member is given the message that he or she is welcome, wanted, needed and expected each day. The message that each member's involvement is an important contribution to the community is a message that is repeatedly communicated throughout the Clubhouse. The daily work of the Clubhouse community is organized and carried out in a way that continually reinforces this message of belonging. This is not difficult, because in fact the work of the Clubhouse does require the participation of the members. The design of a Clubhouse engages members in every aspect of its operation, and there is always much more work to be done than can be accomplished by the few employed staff. The skills, talents, and creative ideas and efforts of each member are needed and encouraged each day. Participation is voluntary, but each member is always invited to participate in clerical duties, communication activities, reception, food service, outreach, maintenance, research, managing the employment and education programs. Clubhouses are developed in a way to ensure that there is ample opportunity for human interaction and that there is more than enough work to do. Clubhouse staffing levels are purposefully kept low to create a perpetual need for the involvement of the members in order to accomplish their jobs. Relationships between members and staff develop naturally as they work together side by side carrying out the daily duties of the Clubhouse. All of the staff has generalist roles in the Clubhouse; they are involved in all of the Clubhouse activities including the daily work duties, the evening social and recreational programs, the employment programs, reach out, as well as subsidized education and community programs. Members and staff share the responsibility for the successful operation of the Clubhouse. Working closely together each day, members and staff learn mutual strengths, talents and abilities. Because the design of a Clubhouse is much like a typical work or business environment, relationships develop in much the same way. The role of the staff in a Clubhouse is not to educate or treat the members. The staff is there to engage with members as colleagues in important work and to be encouraging and engaging with people who might not yet believe in themselves.
Another positive aspect of the Clubhouse is preparation of daily meals by the members. Meal planning, cooking and eating encourage conviviality, knowledge and exercising patience. Everyone participates in all stages of the meal from purchasing to preparation and clean up with great pleasure.
The Clubhouse focuses on nutrition and helping them make choices for healthy living.
The Clubhouse promotes social inclusion also in organizing sport, cultural and social activities on some evenings, weekends and holidays.
Communication Unit: More than 70% of the activities in general deal with communication.
Club Itaca has a unit responsible for all communications, both internal and external.
One of the communication aims is to work together with clarity and effectiveness with other Clubhouses in the world as well as the ones in Italy. Club Itaca aims, in the best way possible and with all available tools, to spread information about our activities and organize fundraising.

The following communication tools shall be used:

• An internal newsletter
• A web site
• Support for any communication material needed to promote the various events to raise awareness and fundraising organized by the Association.
• Synergetic initiatives with Companies and Foundations supporters
• Material that may be required in connection with ad hoc training courses offered by partner companies.

This unit will be composed by members who show interest, organized by staff and with the active collaboration of volunteers who have expertise in this field.
The Clubhouse staff, members, volunteers and Members (Consiglieri) of the Board look for contacts with company partners who can offer temporary or permanent jobs for the members. The Clubhouse gives support to its members and staff throughout the recruitment process.

Design and implementation (done in 2013 - 2014):
• Organize the community of people that share the vision and mission of the project (founders & Board)
• Find the location (contract and set up)
• Presentation of our activities to the local mental health public services
• Official event for the presentation of the project to the public October 25th 2014;

First year, January to December 2015
• Selection and recruitment of the Director;
• Training of the Director and a member of the Board in a Clubhouse in USA.
• Develop contacts with the territory: with local public institutions, other advocacy and mental health public services;
• Organize the main work units of Club Itaca. The director will recruit one staff part-time and 10/15 active members
Second and third year - January 2016/December 2017
• Develop all activity of Club Itaca. At the end of the third year, Club Itaca expects to have in the Clubhouse
- 25/30 active members;
- 2 full time staff.

The criteria to verify the achievements of the project are:
• number of hours that the members attend the Clubhouse;
• number of active members;
• Number of members at work in an external company.

In the first year Club Itaca expects:
• 4.500 hours attended in the Clubhouse;
• 10/15 active members;

In the second and the third year :
• 9.000 per year hours attended in the Clubhouse;
• 25/30 active members;
• 7/8 working members (temporary work)

All above figures have been forecast with the help of results already achieved by Club Itaca in Milan.

think global, act local
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