Exploring the lives of individuals with a mental illness living in a residential care facility : a qualitative study

Since deinstitutionalization began in the 1950’s hundreds of thousands of individuals with a Severe and Persistent Mental Illness were forced out onto the streets. Once a refuge from the unrelenting demands of a rapidly changing and complex world, the shelter sought by millions of people for more than a century would no longer be available. While society may have seen deinstitutionalization as a positive direction for society, the outcome of this grand plan is obscure because the plan had no provision for new living environments for this population. In this qualitative study I interviewed residents living in a RCF, their guardians, the Administrator, and staff members of the facility in an effort to understand the daily lives of the residents living within the confines of a RCF. The findings from this study illuminated the daily struggles of individuals with a mental illness and the substantial effect of the interaction between their social and physical environments. Additionally, findings revealed several architectural dimensions (crowding, noise, lack of stimulus shelter, disruptive circulation path, lack of control over space, and vague behavior settings) caused stress which exacerbated their condition and perpetuated their institutionalization. This study suggests that the detrimental effects of institutional living of individuals with a mental illness have been ignored. Furthermore, it recommends further thinking and research on the possibility creating specialized environments for individuals with a mental illness based on a social ecological model in which patterns of health and well-being are affected by a dynamic interplay among biologic, behavioral and environmental factors.