In America, one in 17 people live with a serious mental illness such as schizophrenia, major depression, or bipolar disorder. In 1988, Ohio passed the Mental Health Act, which would change how mentally ill patients were treated throughout the state. The legislation would move the treatment of the mentally ill from state institutions to a smaller more community-based system. During the past two decades, Ohio's public mental health system has tried to improve the quality of and access to care. This community-based system often leaves employees overworked which leads to a lack of individualized attention that many of the residence may need. In a secluded part of Carroll County, there is a cluster of group homes where caregivers live and work with residents, who have serious mental illnesses. Many of these people depend upon each other for emotional support because they don’t receive it from their families.  Brenda writes in a birthday card for her 11-year-old son Evan at a group home in Robertsville, Ohio. Brenda tries to see Evan whenever she can but her mother makes it very difficult because she insists that Brenda pay for her travel.

In America, one in 17 people live with a serious mental illness such as schizophrenia, major depression, or bipolar disorder. In 1988, Ohio passed the Mental Health Act, which would change how mentally ill patients were treated throughout the state. The legislation would move the treatment of the mentally ill from state institutions to a smaller more community-based system. During the past two decades, Ohio's public mental health system has tried to improve the quality of and access to care. This community-based system often leaves employees overworked which leads to a lack of individualized attention that many of the residence may need. In a secluded part of Carroll County, there is a cluster of group homes where caregivers live and work with residents, who have serious mental illnesses. Many of these people depend upon each other for emotional support because they don’t receive it from their families.

Brenda writes in a birthday card for her 11-year-old son Evan at a group home in Robertsville, Ohio. Brenda tries to see Evan whenever she can but her mother makes it very difficult because she insists that Brenda pay for her travel.

 A heavy fog obscures the view of the property where a few of the group homes are located in Robertsville, Ohio.

A heavy fog obscures the view of the property where a few of the group homes are located in Robertsville, Ohio.

 Brenda laughs as she attempts to joke with an irritated resident. Mood swings are a common occurrence among residents. They are extremely sensitive. One wrong word or a misinterpreted sigh can ruin a relationship between housemates.

Brenda laughs as she attempts to joke with an irritated resident. Mood swings are a common occurrence among residents. They are extremely sensitive. One wrong word or a misinterpreted sigh can ruin a relationship between housemates.

 Tom, a resident who is diagnosed with schizophrenia, paces outside of the group home as he smokes a cigarette.

Tom, a resident who is diagnosed with schizophrenia, paces outside of the group home as he smokes a cigarette.

 Tom often writes on the walls or desk in his room and struggles to put coherent sentences together.

Tom often writes on the walls or desk in his room and struggles to put coherent sentences together.

 A resident approaches nightly medication with apprehension.

A resident approaches nightly medication with apprehension.

 Brenda smokes outside on a cold morning. She wakes up most mornings in a muddled state, struggling to get out of bed while arguing with the caregivers who try to keep the residents on a schedule.

Brenda smokes outside on a cold morning. She wakes up most mornings in a muddled state, struggling to get out of bed while arguing with the caregivers who try to keep the residents on a schedule.

 Tom sleeps in his chair. Tom is noncompliant with his medication, refusing to take it or even hiding it. As a result, he is often tired during the day.

Tom sleeps in his chair. Tom is noncompliant with his medication, refusing to take it or even hiding it. As a result, he is often tired during the day.

 A resident sits a bag of cigarettes next to his feet before he smokes. Once a week the residents do their shopping. Many spend what little money they have on cartons of cigarettes.

A resident sits a bag of cigarettes next to his feet before he smokes. Once a week the residents do their shopping. Many spend what little money they have on cartons of cigarettes.

 A resident smokes a cigarette outside of the group homes activity center in Malvern, Ohio.

A resident smokes a cigarette outside of the group homes activity center in Malvern, Ohio.

 Dennis has poor circulation that causes extreme water retention in his legs. He has a concurrent condition that causes him to spend most of his day sleeping, even while eating and smoking.

Dennis has poor circulation that causes extreme water retention in his legs. He has a concurrent condition that causes him to spend most of his day sleeping, even while eating and smoking.

 “I cried everyday. I would tell myself stop crying. I don’t want to cry anymore because of him. It’s all in the past now but I want my father to burn in hell,” Brenda said, regarding the abuse she suffered at the hands of her father.

“I cried everyday. I would tell myself stop crying. I don’t want to cry anymore because of him. It’s all in the past now but I want my father to burn in hell,” Brenda said, regarding the abuse she suffered at the hands of her father.

 Brenda struggles to swallow some of the large pills she is prescribed.

Brenda struggles to swallow some of the large pills she is prescribed.

 As the sun comes up in Robertsville, residents begin another repetitive day living from cigarette to cigarette and pill to pill.

As the sun comes up in Robertsville, residents begin another repetitive day living from cigarette to cigarette and pill to pill.