Evolution of JHC Itabashi
|1984||JHC Oyama||Acquisition of job-related skills and habits|
|1986||JHC Shimura||Peer making and accustoming to the rhythm of everyday living|
|1998||JHC Akatsuka||Realization of self-help employment through operation of a bakery and a café|
|1999||JHC Akizakura||Welfare activities for welfare service recipients shut-in at home through operation of food service and a light meal restaurant and a café|
|1991||JHC Izumi||Workshop with culture center functions|
|1992||JHC San Marina||Club house aiming at self-help activities|
|1994||Residence Niji (Rainbow)||Group home with community living support system|
|1995(6)||Harmony||Peer support network center|
|1997||Produce Michi (Road)||Community job placement support center|
|1998||Super-Peer||Local living support center|
|2001||Working Try||Referral-type job placement support center|
I Development of skill in community life
- Care management
- Self-help group
- Employment with support
- Club house
- Peer counseling
II Evolution of peer support
III Evolution of community life support network
At the time of establishment of JHC Itabashi, a simple survey was conducted on the persons with mental disabilities both in hospitals or outpatients through which we ascertained five principal hopes and aspirations from them, namely:
- Want to work
- Want to be able to live alone (independently)
- Want to have friends
- Want to continue hobby and study
- Want to be useful to other people
JHC Itabashi’s activities were started by ensuring that these five hopes and aspirations are reflected in them.
The first task that we tackled was the establishment of Oyama Workshop whose program centered on the preparation for employment, for which the users of the public health center’s day-care service desired strongly. It preceded the ratification of the ILO Convention. The mainstay of the program we adopted was to instill “work personality” in them whereby they become accustomed to reporting to work on time as required and performing work as prescribed. In the process leading to the establishment, the public health center’s day care OB (former personnel) were our biggest collaborators and most dependable partners. This fact gave us the maximum strength in rendering our service centered on the need of the persons with mental disabilities themselves.
Secondly, we established JHC Shimura in response to the desire expressed to be able to live independently. The program was geared to help those who have experienced a long-term hospital stay to overcome problems with inter-personal relations that they are likely to encounter and also to help them acquire skill to cope with problems related to daily living routine. Toward this end, we placed nurses nearby and other personnel available to serve meals provide companionship and help resting to reflect the users’ expressed desires, thus we provided our program to help them acquire the rhythm of routine of daily life as well as finding friends in the community.
The third JHC Akatsuka started by standing up against the challenge of becoming a proprietor who made and sold own products rather than serving as a subcontractor to some enterprise. Later on, international volunteers indicated that this form of self-employment was prevalent in Europe and US. Purchase orders came mostly from those institutions that provide mental health and welfare service that the enrollees themselves required but gradually the customers begun spreading among schools, citizens’ groups and cafes.
The accumulation of experience with these workshops led to the establishment of the fourth workshop JHC Akizakura for meal service to aged persons living at home. It gave us the opportunity to function as a participant in local welfare work with the support from the Social Welfare Council. The challenge associated with this workshop helped to give us power to promote the better understanding from citizenry since it is not only a undertaking for those who needed sheltering and training but also it constituted a project that is essential to achieving the QOL (quality of life) for the community residents.
The fifth and latest JHC Izumi was designed to partially introduce the club house model of Fountain House in New York and brought in the program to conduct culture classes and to publish news magazines for subscription. The true value of this program is in rendering citizen service from the point of view of providers of newsworthy information collected from the point of view of consumers or in serving as lecturers at culture classes. Joint activities evolved where the persons with mental disabilities themselves and ordinary citizens get together work with information about any social barriers that might exist and as well as any emotional barriers. Its activities aim at promoting the strength of peer support among residents of the same community.
Thus the course of evolution of JHC Itabashi’s workshops posed as a challenge of materializing the metamorphose from recipients of mental health welfare service to providers of service for local citizen through the program to render support in acquiring necessary personal skills. Also, JHC Itabashi’s daily activities have led us to awareness that we come to share the sense of trust in the latent possibilities. It serves as the source of power to join forces in creating services required to build a heart-warming community (See Table 2).
Table 2: Development of Skill in Community Life
|1984||JHC Oyama||Janitorial work|
Nighttime Groups 3 locations (Itabashi Ward Project)
|Sewing work and club activities
Informational exchange, dinner meeting, joint use of specialists
|1987||JHC Akatsuka||Baking and sale of cakes and cookies|
|1989||JHC Akizakura||Meals service for elderly persons and persons with disabilities stay at home|
|1990||JHC Izumi||Compilation and publication of news magazine “Peer Mental Health”|
- Workshops to provide activities to support life in the community
- Contribution to the society by persons with mental disabilities themselves as providers of service to local residents
This service is subsidized uniquely by Itabashi Ward at its own volition as is the clubhouse to be described later in this paper. In the mid-1980’s, only limited mental health and welfare service was available (in term of the number of sheltered workshops, about 12% of the current number) and what was available was limited to daytime. Having one’s wish for job granted would have meant having to give up the opportunity to avail himself to the community life support service. JHC Itabashi’s new attempt to provide nighttime care was prompted by the suicide committed by a member of a workshop who had chosen to go independent on the occasion of his brother’s marriage and was about to be gainfully employed. A group of volunteers including public health nurses, social workers from hospitals, members of workshop staff had gotten together for nighttime group activities to cope with this kind of problems. It so happened that these volunteers related the story of their activities to Director of Public Sanitation of Itabashi Ward Office whom they met at a subway station on their way home. With the support from the director, this service came to be subsidized uniquely by Itabashi Ward.
These activities are now taking place at three different locations. The feature of this group is to prove a venue where they can share and jointly make use of the expertise of their peers and of support from specialists and ordinary citizens in order to cope with problems they are confronted with in the course of their daily life. The activities may be termed as mutual self-help among persons with mental disabilities who live in the same community through informational exchanges and occasional dinner meetings. It also functions as the venue for job placement and post-employment counseling.
(3) International exchange-mutual support system
The strongest impact on JHC Itabashi came with the talk given on the topic of “Consumers’ Activities” by a professional rehabilitation consultant from the City of Sacramento who himself was an afflicted person. The lecture meeting was held in commemoration of the opening of the fourth workshop, “Akizakura”
According the talk titled “Journey to Recovery”, the speaker was born in a mental hospital where his mother was hospitalized and brought up by his stepfather until he reached the age of 16 when he ran away from home to hop from one job to another about 20 times. While studying about social welfare at university, he had an experience of being hospitalized in a mental hospital but managed to graduate from university while continuing to receive management service from social workers as well as medication. Following the graduation, he worked as a job coach assistant and received a master’s degree from a graduate school at the age of 42, while busily engaged in the effort to establish a consumers’ self-help center. He had been commissioned by the government as a consultant, which had led to his present position. All the while, he has continued receiving a disability pension from the government.
The journey to recovery taken by one certain consumer serves as a proof of the importance of belief in the latent possibility that lies in each individual person and that of reciprocal actions in supportive circumstances which makes possible to fully explore such a possibility. The lecture gave us an opportunity to reassure of the common target we share with those who join hand in hand with us at JHC Itabashi so as to create the right environment where the individual quality and endeavor can be explored to the fullest extent. (See Figure 7 and Table 3)
Fig.7: Reciprocal Actions between Individual Conditions and Environmental Conditions
Table 3: Fundamental Approach to Support for Independent Living in the Community
- To aim at the development of both skills and environment for rendering support from a positive point of view that given an proper opportunity, people are able to take upon themselves to solve their own problem.
- To turn our attention to reciprocal actions between individual conditions and environmental conditions
JHC Itabashi’s first international exchange came immediately after the public release of the result of WHO Specialized Working Group on the role the consumers played and were expected to play in mental health, welfare and rehabilitation JHC Itabashi has taken this WHO Report as the principle of its activities since 1990 and has been endeavoring to reflect it on every phase of its activities. (See Table 4)
JHC Itabashi’s international exchange and training program including on-the-site training in the US and lecture meetings in Japan with foreign speakers, which became an integral part of its regular activities, have given great strength to its mutual support network as much of common experiences can be made good use of in such areas as the club house activities as related to transitional employment, employment with support, fostering of self-help groups, training in skills in life in the community, peer counseling, peer advocate, local job placement support system, etc.
With everyone’s common wish for a venue where anyone can become involved as a member of the community, we all have participating actively in joint activities toward the creation of a heartwarming community in every phase of JHC Itabashi’s undertakings based on the concept of mutual support toward development of power of self-help.
Table 4: Consumers’ Point of View
WHO: Consumer Involvement in Mental Health and Rehabilitation 1989
- Preparation for self-help and mutual support
- Movement for renovations in mental health care
- Movement for expansion of resources for mental health care
- Movement for policy changes
- Movement for enlightenment and for assistance based on the desires of consumers
- Surveillance and appraisal of care
- Educational activities for specialists and general citizenry
(5) Japan’s first club house “Sun Marina” 1992
The clubhouse provides an opportunity to stand up to a new challenge as a model of mutual support system under the management of JHC Itabashi staff.
In the course of evolution of JHC Itabashi, we continued to built up our confidence in the peer support as a function of mutual support based on our common experience. The fifth workshop was named Fountain “Izumi” and part of the club house model was introduced into it. In the area of international exchange, a two-day seminar was conducted on club house for understanding of this new type of support system together with some members of administrative staff.
Under Itabashi Ward’s own support policy, a club house came into being in 1992 as the first in Japan. This club house model has as its mainstay program unique job placement support system through transitional employment. It aims to offer total rehabilitation service in the area with management service provided by the staff. America has over 50 years history. In many countries of the world, Europe and American on down activities and supports are being offered based on the common conventions through the world federation.
Club House “San Marina” has brought transitional employment into fruition in partnership with enterprises and have been positive in implementing friendship visits and counseling activities for the service users who have participated in the self-help group development courses. The continuation of educational program for development of self-help group leaders in turn gave a strong impetus to study of peer counseling, which has lead to study abroad and invitation of American peer counselors to Japan for one-on-one guidance in Japan.
The accumulation of experience in self-help activities and peer counseling study has led the service users themselves to taking up the challenge of independent support service in the form of peer support, network centers.
(See Tables 5, 6 and 7)
Table 5: Worldwide Universal Support Activities under the Convention of World Federation of Club Houses
- It must be an entity managed privately with approval from the administration.
- Members’ participation is mandatory to its management.
- To promote mutual support activities around self-help activities
- Accessibility by public transportation takes precedence in its site location
- No remuneration is paid for work performed within the club house
- It offers program for transitional employment.
- It offers evening and weekend programs.
- It has a trusteeship organization of its own.
- It offers own housing service.
- 25 countries at 100 locations with 70,000 members
- Asia: Japan, Rep.of Korea, Pakistan, China (Hong Kong)
- Budget: \400,000 per member annually
- Staff: 1 Members: 12
- Staff Size: 9 persons per location
To provide those members who lack in self-confidence to work full‐time with an opportunity to actually perform some productive work by way of helping them regain self-confidence.
- Part-time work: 20 hours per week for a short term of 3 to 9 months.
- Simple enough task yet to give the participating member some work experience.
- The participating members receive from the employing enterprise remuneration for the work performed at the same rate as other employees.
- It takes in a pinch hitter system whereby the participating member can be relieved by another member or a member of the staff if need be.
- Since the club house decides as to who gets to work, there is no need to pass the review of curriculum vitae or a personal interview.
JHC Itabashi’s first group home, a residential-type facility came out of the 1990 discussion between JHC Itabashi and Itabashi Ward administration over plans for the future. The reason why the club house was given the priority was because the degree of readiness to provide service of support in daily living in the society would affect the QOL of a residential-type facility. Since this undertaking was targeted at those who are either employed or slated for employment, the preparation was geared to the provision of service of support in daily living through job placement support service and peer support. As part of this effort,
Employment Support Work Department was established, training program was carried out for develop the readiness for job placement by introducing SST. To help alleviate the anxiety and tension over independent living in the society to experience for the first time, JHC Itabashi’s support network with citizens participation is giving a sustaining support through such tender care as the cooperation from public health nurses, friendship visits to the club house on down.
(7) “Harmony” a support center for and by persons with mental disabilities themselves, 1996
The educational program for the development of self-help group leaders implemented at the club house gave an impetus to the birth of a peer counseling educational program, which in turn led to friendship visits to the club house implemented through mutual cooperation and the job coach system for transitional employment. On the other hand, it led to the evolution into persons with mental disabilities themselves own independent support system in the form of peer support network center.
Peer counselors who function as the principal bearers of responsibility for peer support have received training in peer counseling through study abroad and international exchanges and are continuing reciprocal study among the partners, while they provide counseling through hearing and provision of information and service relative to specific items of daily living. The staff members perform the role of coordinators to support the peer support activities.
(8) Social Job Placement Center: Produce “Michi”, 1997
Through the process of building the foundation for the system for rendering support in daily living in the area over the past 13 years as so far introduced in this paper, a target was set to integrate JHC Itabashi’s own and unique support service and promote job placement in the society through the formation of a juridical body for social welfare and the establishment of a sheltered work shop. While respecting the individuality of each of the separate support service, it could be expected to achieve further contribution to the benefit of the area if seen from the viewpoint of admitting inherent limit to what each can accomplish on its own and if a step is taken toward offering integrated service through coordination and cooperation.
The center was characterized as a facility for welfare-minded employment which provides a place to work, fosters working skills, and makes it possible to obtain employment in the future even under the circumstances where obtaining employment is difficult in general. JHC Itabashi set up several work programs to choose from including sewing, janitorial work, restaurant operation, etc. and established the work shop in the shopping district only 2 minutes’ walk from a railway station (See Table 8).
Table 8: Produce “Michi”(Road) (Social Job Placement Center)
◆ Comprehensive support system SELP
- S = self help
- E = employment
- L = living
- P = participation
- Operation of Restaurant “Kazamidori” (Weather Cock)
- Janitorial service
- Laundry service
- Sewing work
- Arrangement with private enterprises
- Joint use of area facilities (Nonresidential sheltered workshop for persons with mental disabilities)
Area Center for Support in Daily Living, JHC Itabashi’s newest service, is a state-of-the-art facility under the Mental Health and Welfare Act. This support program has as its outstanding feature that self-help and peer counseling constitute essential part of the service rendered. Much is expected of the coordination functions it performs with other types of service, including counseling and supportive activities rendered by peer counselors. The other function, namely the program for area personal interchange and fostering of volunteers provides venue for social dances, hobby and cultural classes in which any members of the community can participate and enjoy personal interchange whether they are persons with or without disabilities.
The true value of this program is that it is intended to perform the function of “respite service” for the family members. The family members are afforded opportunity to build up friendly ties as peers through contact with people of the same generation. The scenes that reciprocal support comes to form naturally gives one a true feel for a heart-warming community where everyone stands ready to support each other. It can be said to be offering precious opportunities and venues. (See Table 9)
Table 9: Space Peer (Area Center for Support in Daily Living)
“Soft” service through coordination
◆ Counseling program
- Peer telephone counseling(by users or family)
- Counseling regarding living support service
◆ Living support program
- Bathing service
- Housework help service
◆ Area personal interchange program
- Open Space
- Peer entertainment (events for personal interchange in the area)
- Hobby and culture lecture and study sessions planned by the local residents) (Program for local support in daily living for persons with mental disabilities)