‘It will never be a true home, but you have to see it as home’: residents’ experiences of aging with severe mental illness in a Dutch gerontopsychiatric facility

OBJECTIVES: Research on older individuals with severe mental illness (SMI) residing in long-stay mental health wards remains scarce. Understanding their lived experiences helps to inform care practices. This qualitative study explored, for the first time, how long-term residents with SMI experience living and aging in a gerontopsychiatric facility. METHOD: Twelve adults with SMI (aged 60-77) residing in a Dutch gerontopsychiatric facility participated. Participants had been hospitalized for over 21 consecutive years on average. Semi-structured interviews were conducted and analysed using thematic analysis. RESULTS: Three overarching themes were identified: (1) sources of well-being, including meaningful relationships with staff and fellow residents and engagement in daily activities; (2) living with constraints and dependency, reflecting institutional care practices, limited autonomy, and mental and physical health challenges; (3) finding room to move, describing opportunities to influence one's situation. Relationships with staff were experienced as both supportive and restrictive. While health problems contributed to diminished well-being, some participants described ways of coping with losses and achieving fulfilment in everyday life. CONCLUSION: Findings reveal an ambivalent picture of aging in a long-term institutional setting, characterized by both support and constraint. Recovery-oriented approaches may inspire efforts to enhance residents' autonomy and opportunities for agency.