Institutional placements in foster care are out-of-home, non-family placements where some foster youth are sent to live. Each year, of the hundreds of thousands of youth in foster care, over 43,000 live in institutional placements. These placements disproportionately impact Black youth, other youth of color, older youth, and pregnant and parenting teens. Due to calls to reckon with longstanding institutionalized racism, the spread of COVID-19 through institutions, concern over the use of forceful restraints, emerging research on trauma, and the recent death of 16 year-old Cornelius Fredericks in a Michigan group home, there is a growing body of research and a movement calling for the reduction or elimination of institutional placements in foster care. Missing from this conversation was a deep, nuanced understanding of the experiences and mental models of young people who have recently lived in these places. This study exists to fill that gap. Proceeds from the sale of this book will be used to fund youth participation in other similar research at Think Of Us.