While Fatuma Ali knows things could be worse, she still hopes that someday soon she’ll be able to go back to her old life. For the last three years, Ali’s been a member at Vail Place Hopkins, a clubhouse for people with serious and persistent mental illness (SPMI). There she’s found a welcoming community of support, something she desperately needed when her family distanced themselves after her schizophrenia diagnosis.
In its Hopkins and Uptown Minneapolis locations, Vail offered welcoming physical space for Ali and her fellow club members to spend time together, building friendships, sharing meals, creating art, running clubhouse operations, and, with the support of staff, figuring out how to live independent lives. In mid-March, as coronavirus was taking hold across the country, Vail temporarily closed its physical locations and shifted to virtual programming. While members supported the decision, many, like Ali, say they long for the way things were before.
“I miss the smiles,” Ali said. She lives alone in a subsidized Vail Place apartment and works part time at a nearby nursing home. Work keeps her busy, she said, but it’s not the same: “Every time I go to Vail Place, as soon as I enter the door they all shout, ‘Fatuma’s here!’ I miss that. I cannot wait to see everyone again. I want to see my friends and the staff so much.”
Ali isn’t alone in wanting to be back in the physical clubhouses, said Chad Bostrom, Vail Uptown program director.
“We’re a community that’s really high touch. We make our relationships on a handshake, on having the ‘Cheers’ effect, where you walk in and everyone knows your name. We knew that shutting our doors was going to be a challenge for us, no matter what, but we also knew it needed to happen in order to keep everyone safe.”
Before COVID-19, Vail had been working on an emergency-response plan, said Executive Director Vicky Couillard, so as news about the virus began to spread, agency directors were ready to spring into action. They knew they needed to contact members quickly and get them all on board with the idea of taking the clubhouses online.
“Our approach from the beginning was looking at this as an opportunity rather than getting caught in the scarcity and fear of it,” Couillard said. “Instead we were focused on thinking about how do we continue to do what we do in a virtual format.”
Staff felt it was particularly important to make this move quickly. People with SPMI have higher rates of co-occurring health risk factors like smoking, obesity and lung disease. Keeping members safe means isolating them from the general public as much as possible.
“Between half and three-quarters of our members are in the categories of high risk,” Bostrom said.
As the clubhouses’ physical closings approached, Vail staff began contacting hundreds of members, explaining why the buildings needed to close their doors and soliciting input on which programs and activities could be best shifted online.
The message to members was upbeat and hopeful, Bostrom explained. “We said, ‘We’re not closed. Our approach to physical distance is going to be different than others. We’re going to encourage as much contact as you can tolerate on a Zoom call.’”
Jamie Fann, program director of Vail’s Hopkins clubhouse and the Vail House program, said that members were happy to hear from staff.
“They told us they understood what was happening and why it needed to happen,” she said, adding that staff explained that Vail was following the governor’s guidelines in making their decision. “The response from members was, ‘OK. Go for it.’ And, ‘How long?’ While they understand why we had to close, members still tell us they miss the clubhouse and wish we were open.”
Despite their longing to be back together again, Fann said that most members have made the adjustment to their new, temporary reality: “They have embraced the virtual clubhouse and are 100 percent bought into participating in it.”
Even Ali, who still misses the welcome feeling she gets at Vail, is adapting.
“I stay in contact with people,” she said. “I talk to my Vail friends on the phone all the time. I call the staff all the time. They made sure that I had everyone’s number before they closed the doors. So now I can reach out and ask questions and they give me honest answers.”
Making sure that all Vail members had a way to get online and learn how to participate in the virtual clubhouse was a heavy lift, Bostrom said. “In three days I think we reached out to between 300 and 400 clients.”
While the majority of members had cellphones, many didn’t realize that their phones had cameras. And others didn’t have a computer or a laptop at home. This meant that many needed a crash course in online communication. “Imagine teaching a bunch of people how do a Zoom call — and mute themselves,” Bostrom said, with a laugh. “It was a pretty big shock.”
A big part of shifting online involved helping members access technology. Vail staff launched a fund-raising campaign for members who did not have smartphones or computers. The money raised will go to purchase phones and pay for service.
“It is one thing to give someone a phone,” Couillard said. “The other half is paying for the data and the service so they can connect.” She explained that staff has been working with different vendors to get a deal on technology. To date, the agency has raised $35,000, and plans to use the funds to cover connectivity bills for members.
“This is something we’ve talked about for ages,” she said. “COVID pushed it to the forefront for us.”
This sort of support is key for Vail members, Bostrom said, because people with SPMI are far more likely than the general public to live in poverty. “With poverty comes a divide of access and privilege. For a lot of people with SPMI, they have to decide between buying food and buying medicine. Where do you fit in a cellphone bill?”
Hurdles like this mean that many people living with serious mental illness are technologically behind. Bostrom said that before this shift, 50-70 percent of his organization’s members had some access to technology. Those numbers represent a sizable digital divide. “That left us with almost half of our folks really needing some support,” he said.
Once staff helped Vail members get connected, they worked to spread the message that life in the Twin Cities Clubhouses could go on fairly normally in this new virtual environment. Fann said that she and her staff “hit the ground running,” talking to as many members as possible and reassuring them that even though meetings were shifting online their conversations would still exist in a safe zone.
“We’re really trying to build a platform of trust within our membership to feel comfortable with using Zoom or knowing that Facebook is safe. We’re creating that as a value for them to stay connected with their community and also do the work of the club.”
Member response to the changes has been impressive, Bostrom said. They worked hard to learn new computer skills and kept an open mind about changes that needed to happen quickly.
“Members didn’t really miss a beat,” he said. “They were like, ‘You’ve been saying this is what we need, that you’d be doing this for safety.’ Even today I just got off a Zoom call. People were still like, ‘Yep. This is what we’ve got to do. It sucks. None of us want it to be like this, but we know this is what we have to do.’”
That strong community support has made this massive shift possible. “Not that long ago we had a lot of members who didn’t even know their phone had a camera,” Bostrom said. “Now we’re having department Zoom calls with 20 to 25 members. It’s been a pretty wild shift. We’ve jumpstarted access to the modern technical world. It’s something that I don’t think we would’ve done had COVID not happened.”
A full schedule
Because they were committed to keeping virtual Vail as close to in-person Vail as possible, staff and members worked hard to develop a range of activities and events that are now available online Monday through Friday 8 am-4:30 pm. There are departmental meetings, member-led creative hours, meditation sessions, book clubs, variety hours, trivia quizzes and laugh hours, among other options.
A monthly schedule is posted online, and members are encouraged to take part in as many events as possible. They’re also encouraged to create their own events, like cooking classes and discussion groups. Vail Place has begun producing a member-written newsletter — and launched a weekly Radio Hour.
“It’s created by members and staff,” Fann said of the show. “It includes voice messages, songs, anything we can think of. We compiled everything and formulated it into a radio show. We broadcast that weekly along with an email blast that goes out to our membership. It is a way for members to keep in touch.”
Members are also using Facebook Live to host a regular art show featuring members’ creations, and a weekly comedy routine that is morphing into a variety show.
Robin Hoy and Caylnn Hendrikson are roommates and members at Vail Place Hopkins. Both are visually impaired, and they say that though they miss socializing in person with their friends, they actually find Vail’s virtual option to be more convenient.
“Because I’m blind, for me in some ways virtual clubhouse is a little easier,” Hendrikson said. “I don’t have to worry about finding transportation to come and go.”
Because she and Hoy both use adaptive equipment with their computers, it took time and patience to figure out Zoom and other online meeting platforms, but once they mastered the technology, opportunities began to open up.
“The communication is nice with other people,” Hendrikson said. “In some ways we are more involved with Vail now than we were before. It feels good to be busy.” She said that she and Hoy have been contributing to the radio hour and writing articles for the newsletter.
In both formats, the pair found ways to inject humor. On the radio show, Hoy explained, “We put together an approximate script. We laid out a game plan and ad-libbed a show, which was a really a fun experience. I don’t think either of us have ever laughed so hard.”
Their newsletter article was written from the perspective of their guide dogs. “We wrote about what it is like to have humans around more than usual,” Hoy said. “They talk about how we’re always hanging around, getting in their way when they want to take a nap.”
Both Hendrikson and Hoy said that they appreciate Vail staff’s efforts to keep the community strong during this time of crisis.
“They’ve done so much, helping people get connected,” Hendrikson said. “They are working with everyone. It is really impressive to watch the way they have doubled down, created new activities and helped people feel connected in any way they could. I think they’ve made this community even stronger.”
Vail going forward
Staff at Vail know that the quarantine can’t last forever, and so they are making plans to build toward an eventual re-opening of the clubhouses. Different open dates have been floated, but when the doors do open, things will feel different.
“Jamie and Chad and I have had a conversation about how the clubhouses are going to reopen,” Couillard said. “It is not going to happen the minute the shelter-in-place order ends. We are going to open slowly because we care about people’s health.”
In order for re-opening to happen safely, Vail will need to make significant operational changes. The clubhouses operate in relatively tight spaces. Meetings can be large, and several times a week as many as 40 people gather for meals in both clubhouses’ dining rooms.
“What does social distancing look like in a community where we are usually working side-by-side?” Bostrom asked. “That’s one of the elements of the clubhouse model.” To make plans for the future, Vail Place leaders are reaching out to the international clubhouse network and working on plans about how to reconfigure spaces and practices to keep members safe.
“We’re finding out what other clubhouses are doing, what works for them,” Bostrom said. “There is no good analogy to our experience. We’re not a school. We’re not a church. We’re kind of like both but neither at the same time. We have to be really thoughtful as we go through this process.”
Couillard believes that this spring’s full-scale shift to virtual will make Vail’s gradual re-opening easier, and because so many members now say they appreciate having the ability to attend meetings and events from home, those options will likely continue to be available.
“The entire staff, team and members made an incredible shift to a virtual world, which is something I know that we will leverage into the future,” she said.
While other mental health service providers struggled to serve clients during lockdown, Couillard said that the Vail Place clubhouses remain on solid ground. “Vail Place made the commitment early that we are not closing. We kept all our services running and we said no to laying off any staff. We have even filled four positions during this time.”
Bostrom said that staff is thrilled to see how virtual meeting options — when combined with enhanced technology access — make the clubhouses more accessible for all. “There are so many members who can’t make it to the club on a regular time because of weather and transportation issues. Now we have a platform for them to more easily be part of our community.”
The hundreds of calls that staff made to members this spring had the unexpected benefit of re-engaging some individuals who were formerly on the inactive list, Fann added. In Hopkins, as many as 22 inactive members re-joined the club because of the new virtual meeting options.
“That’s huge for us in terms of bringing people back into the clubhouse,” she said. “We’re all about building community, so it feels great to see people coming back.”