Psychosocial Support for Clubhouse Members and Staff in Hawai'i: A Maslowian Perspective on Wellness.

Fifteen participants from 5 Clubhouses on 2 islands in one state; the authors themselves note this limits generalisability. The focus groups ran for only about one month, so the data capture a narrow time window and cannot speak to long-term patterns. The researchers had worked with these Clubhouses since 2015 and had conducted multiple prior participatory projects there, which they acknowledge could have skewed interpretations positively. The researchers differ from many participants in key ways (no lived experience of SMI, different financial circumstances, different digital literacy), which they note may have led to oversights in interpretation. Only 9 of the 15 participants completed the optional demographic survey, so the sample description is incomplete. The Photovoice method is participatory and co-constructed; the themes reflect what these particular participants chose to share in a collaborative format, not an objective measurement of Clubhouse effectiveness.

The authors declare no competing interests. No funding source is named in the text.

Do not read this as evidence that the Clubhouse model is effective or superior to other treatments. It is a qualitative description of 15 people's experiences in one Hawaiian context, conducted by researchers who had worked with these specific Clubhouses since 2015, with no comparison group, no outcome measures, and no intervention. The positive themes reflect what these particular participants chose to share in a participatory, co-constructed format, not a measured treatment effect, and the authors themselves call for comparative studies to test whether Clubhouse produces different outcomes than conventional care.