The author reviews the literature on the impact of residential environment on the course of serious mental illness. In most studies, environmental variables were better predictors of outcome than were patient variables. There is a growing body of evidence to suggest that the course of serious mental illness can be favorably modified by providing a low-stress environment that neither overwhelms nor understimulates the patient. Findings suggest that supportive and satisfying social relationships, in conjunction with moderate expectations for functioning, correlate with the best outcome and that excessive structure, protection, and supervision have the opposite effect. This overall finding suggests the value of further research on environment and the importance of applying the results to program development (author).
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