The purpose of this study is to understand how different types of community-based mental health care affect thinking abilities, daily functioning, and brain activity in adults with schizophrenia and related conditions. The investigators are especially interested in learning whether the Clubhouse Model-a structured, supportive community for individuals with mental illness-has unique benefits compared to standard outpatient mental health services. If participants decide to join, they will be asked to complete a total of six study visits with the research team over the course of your participation. Three of these study visits are at the beginning (baseline) and the remaining three are six months later. Two of the three visits will includes interviews, questionnaires, and thinking and memory tasks (cognitive testing) and one session will be an MRI brain scan, which is a safe and non-invasive imaging procedure. The total time required for each visit will be approximately 90 minutes to two hours. Participants may take breaks as needed.
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Change in overall cognitive performance as measured by MATRICS Consensus Cognitive Battery (MCCB)
Timeframe: Baseline and 6 months
Change in functional outcome as measured by Specific Levels of Functioning Scale (SLOF)
Timeframe: Baseline and 6 months
Change in quality of life as measured by World Health Organization Quality of Life Brief Assessment (WHOQOL-BREF)
Timeframe: Baseline and 6 months
Change in disability as measured by the 12-item WHO Disability Assessment Schedule 2.0 (WHODAS 2.0
Timeframe: Baseline and 6 months
Change in task-based brain activation during functional MRI (fMRI) as measured by the AX-Continuous Performance Task (AX-CPT)
Timeframe: Baseline and 6 months
Change in task-based brain activation during functional MRI (fMRI) as measured by the Emotional Faces N-Based Task (EFNBACK)
Timeframe: Baseline and 6 months