Services for elders with severe mental illness (SMI) have major deficiencies, among them a lack of adequate psychosocial services. Some analysts have attributed this situation to “double stigmatization” targeting both ageing and mental illness in our societies. Using qualitative methods (23 semi-directed interviews, theme-based content analysis), our exploratory research aims to understand better the perceptions of psychosocial practitioners working in community and institutional settings about the elderly with SMI and their living situations. Our informants evoke living situations marked by a lack of support (isolation), of resources (financial precariousness/poverty) and of power (learned passivity), traits that are related not only to mental illness per se, but also to long term psychiatric institutionalization. For them, the current situation of elders with SMI is the end product of biographies in which life-course, illness-course and life in services and/or institutions join and, sometimes, become indistinguishable. Implications for psychosocial practices are discussed.