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Since deinstitutionalization began during the 1950's in North America, thousands of individuals with a Severe and Persistent Mental Illness were forced out of large, state run, institutions. While society may have seen deinstitutionalization as a positive direction for society, the outcome of this grand plan is obscure because the plan made no provision for new living environments for this population and funding issues prevented adequate community support services. Therefore, many individuals with a mental illness became homeless, makeshift living environments were developed without prior understanding of the specific housing needs, and funding issues prevented adequate community-based support services for this vulnerable population. In addition, current public policy prohibits a full range of activities of daily living which ensure the continued institutionalization of this population. In this qualitative case study I interviewed residents living in Residential Care Facilities (RCFs) and participants in their lives in an effort to understand the interaction between the residents and their environment. The findings from this study illuminated the daily struggles of individuals with a mental illness and the substantial effects of the interaction between the residents and their social and physical environments. The results show that the individuals living in Residential Care Facilities exhibit institutionalized behaviors and the program of deinstitutionalization was never realized for these individuals. The program of deinstitutionalization was supposed to ensure more freedom and choices for individuals with a mental illness. Instead, these individuals were transinstitutionalized as opposed to deinstitutionalized.

Transinstitutionalization : a case study of two residential care facilities in rural midwest North America