CARRBORO, N.C. — Club Nova is a form of pyscho-social rehabilitation, in which members and staff create a work-like environment and a work-ordered day. Members are called upon to assist in running the clubhouse, as it is called, performing essential tasks ranging from Medicare billing to preparing lunch.

Heather Nash has been a member at Club Nova for several years. She says she comes mainly for the sense of community. As mental health reform flounders, she has become increasingly involved as an advocate for those trapped in a complex and unsatisfying bureaucracy.