Finland’s Clubhouses are recovery-oriented communities for mental health rehabilitation, offering members peer support, individual guidance, and daily activities that help in maintaining everyday routines. The core idea of Clubhouses is to emphasize the strengths of individuals recovering from mental health challenges rather than their issues, and the goal of many of the Clubhouse members is to return to working life or studying. The Clubhouse model is also fundamentally based on the shared participation and decision-making of its members and staff. This means that every Clubhouse member has an equal right to be involved in decisions concerning the community.
However, research on Clubhouses has revealed that this principle is not always achieved in practice. Studies have shown, for example, that in Clubhouse meetings, staff members’ opinions and aims often take precedence over others. Additionally, the concept of joint decision-making and what it ideally entails is not always self-evident from the staff’s perspective.
In our discourse-analytic study, we examined the ideals of joint decision-making as expressed in discussions among Clubhouse staff and members. Our research was based on interview data collected from ten Clubhouses in Finland. We found contradictions between ideals, which we described using the concepts of interpretative repertoires and ideological dilemmas. An ideological dilemma refers to the tension that arises between opposing but equally justifiable ideals. Interpretative repertoires refer to the opposing views that lead to such dilemmas, rooted in coherent linguistic expressions about a specific issue. Making these ideological dilemmas and the related dynamics of power visible can help explain why the principle of joint decision-making is not always successful in Clubhouses.
In our study, we identified three ideological dilemmas and six related interpretative repertoires. The first dilemma was between interpretative repertoires of equal and efficient decision-making. In this case, the interviewed staff and community members considered whether joint decision-making should prioritize the inclusion of all voices or the efficiency of decision-making. Community members tended to favor equal decision-making, and staff members also recognized its empowering value. However, staff also noted that, in some situations, equality could be a slow and cumbersome approach and generally placed greater importance on the ideal of efficiency.
The second dilemma emerged between interpretative repertoires emphasizing individual approaches and encouraging active participation. Here, staff recognized that participating actively might demand significant effort from individuals recovering from mental health challenges, who might lack the resources or confidence to express their opinions. On the other hand, staff also emphasized that Clubhouse members should voice their opinions in meetings and thereby exemplify the ideal Clubhouse member.
The third dilemma arose between interpretative repertoires of avoiding power use and the necessity of power structures. Staff expressed that they should avoid the temptation of using their influence and remain neutral in decision-making situations to allow members’ own voices to be heard. However, they also emphasized that it is impossible to please everyone equally and that sometimes decision-making requires intervention from staff. In these cases, they highlighted the importance of certain power asymmetries to ensure efficient functioning.
Our study revealed that the perspectives of Clubhouse members and staff on joint decision-making are conflicting and that staff risk undermining joint decision-making if they emphasize the ideal of an active member and equate efficient decision-making with the power structures within Clubhouses. Based on these findings, we suggest that interventions aimed at improving joint decision-making in Clubhouses should critically examine staff perspectives on ideal practices.
Read more in the open-access research publication:
Mäntysaari, K., Stevanovic, M., Weiste, E., Paananen, J. & Lindholm, C. (2024).