Based on ethnographic studies and individual narratives of the experience of institutionalisation, this book explores the lived experience of institutionalisation and the profound effects it has on the subsequent lives of those who return to life in the outside world. It also looks at the behaviour and attitudes of the people who work in institutions, and the perceptions and beliefs of those who live outside in the wider social environment. Using in-depth case studies, this book compares and contrasts the lives of a group of institutionalised people, those who have severe intellectual disabilities and serious mental health problems with the lives of others with similar impairments who live at home with their families. It then examines the essential similarities between the experience of institutionalisation for diverse groups of people, incarcerated for different reasons, drawing on an extensive field of witness accounts from people who have lived in other kinds of total institutions, such as prisons, psychiatric hospitals, ‘care’ homes, detention centres and concentration camps. Exposing and emphasising the physical and emotional deprivation suffered by those who live in a closed institution, the book discusses the idea that the short and long-term effects of institutionalisation on individuals depend to a significant extent on the nature of this experience, rather than on the characteristics of the individuals and groups concerned. Exploring concepts of social exclusion, stigma, powerlessness and identity in the context of the lived experience of life in total institutions, and the long-term effects of this experience, this book is an important contribution to the cross-disciplinary literature on institutionalisation, social exclusion and stigma.