The Scotia Clubhouse is part of the worldwide movement of ‘Clubhouses’ offering an important different way for people who suffer with severe and enduring mental health problems to contribute and engage with the world. Scotia is more than a “service” for this group of people. It provides an accepting environment which is to all intents and purposes a physical work place. People who access Scotia become its members and they are responsible for the operation of the Clubhouse. Staff are also members and there is a deliberate blurring of the boundaries between staff and other members. Areas of work include a cafe, learning activities, administration, finance and care for other members. There are deliberately not enough staff for the project to run, thus members have to be the main workforce, with staff being mainly facilitators. There is an active membership of around 160 people at any one time.