Quality of life in alternative residential settings.

Central to policy revisions over the past forty years toward persons with psychiatric disabilities has been a change in where they live. Whereas forty years ago those patients needing assistance were generally housed in large public mental hospitals, today a myriad of alternative community housing settings are offered. A major impetus for this shift in housing, at least as currently articulated in most public forums, has been to improve their quality of life. Here we examine the quality of life experiences of psychiatrically disabled persons living in alternative settings: a state hospital, large residential care facilities, small group homes, and supervised apartments. Our central hypothesis, only partly supported, is that a quality of life gradient exists across these living settings. The results lend support to the value of quality of life assessments and point to the importance of more focused notions about how our various interventions may affect the persons whom we serve.