Important, but off-center

This legislation, I feel is important, but off-center. This is putting a band-aid over a cut artery. The real issue is better treatment for the mentally ill. This is the legislature that needs reform. This is like the abortion issue. The issue is why are so many women getting pregnant in the first place. There are free clinics in every city that give birth control devices. Stop having children you can't afford to raise on your own. But that is a different issue. The similarities are in the way the cart is placed in front of the horse. We need to address what causes people to be mentally ill or why are these women getting pregnant. Legislating gun control, or campus safety, or passing laws about abortion are all after the fact. Let's back up a few steps to the roots of these issues. These are, of course, just my opinions.

Topics in University Security: Lockdown 101

Related

Op-Ed Contributor: Fear and Learning on Campus (April 16, 2008)

IN February, a man carrying a fake assault weapon burst into an American foreign policy class at Elizabeth City State University in North Carolina. The seven unsuspecting students, along with a stunned professor who later remarked that he was “prepared to die at that moment,” were held hostage for 10 minutes. During that time, the gunman said he would kill at least one of them.

The class survived because the gunman was a volunteer, part of an exercise intended to test the university’s system for responding to a possible campus attack. The university had alerted its students and faculty with e-mail and text messages, but not everyone read them. Fortunately, no one was hurt in the simulation — at least physically.

In the year since the shooting at Virginia Tech last April 16, American colleges have been under pressure, from worried parents as well as from the news media, to beef up campus security. Like Elizabeth City State, many schools have overreacted by instituting safety measures of questionable effectiveness. Safety officials are quick to shut down classes, as happened recently at California State University, Dominguez Hills, when an R.O.T.C. student with a drill rifle was mistaken for an assailant toting an automatic weapon. Instead of making campuses safer, we are fostering an unwarranted and unhealthy level of fear.

An article in Newsweek’s “College Guide” last fall advised families on how to tell whether a university is safe, and earlier this year Readers’ Digest graded 135 colleges nationwide on their safety precautions — notification systems, campus lockdown plans, armed security and the like. A bill in Congress, too, pushes the security agenda by proposing that universities be required to issue campus alerts within 30 minutes of a reported emergency.

The vast majority of institutions in the Readers’ Digest survey have in place security measures that not long ago would have been considered unnecessary, if not absurd. All but six of the schools surveyed have installed mass notification systems; more than half have lockdown plans; and more than 40 percent have authorized their campus police officers to carry firearms.

Although a popular response, campus-wide notification systems, ranging from low-tech sirens to text-message alerts on cellphones, are not necessarily a reliable way to protect students. An emergency siren could signal anything from a fire to gunfire. Text alerts would fail to reach a packed lecture hall if the instructor requires students to turn off their cellphones.

Anxious parents have been particularly keen on lockdowns, plans to seal off buildings manually or electronically to prevent a gunman from moving from place to place. The lockdown may do little to prevent casualties, however: Almost all college shootings have taken place in one location — in just one building, if not just one classroom. And a lockdown introduces dangers of its own. The same locks that bar a gunman from entering classrooms and dorms can also prevent potential victims from escaping into a locked building if they are being chased by a gunman.

Perhaps the most important change inspired by Virginia Tech is a renewed emphasis on mental health services. And given that there are many times more suicides on campus than homicides, this could benefit countless students, the vast majority of whom pose no danger to others. Over the past year, one-third of campus counseling centers have added staff members, including psychiatrists, and 15 percent of campus counseling centers have received larger budgets.

But this approach, too, may fail to identify and stop a violent student. Thousands of college students are depressed or even suicidal, but there is no consistent profile of a person who turns from disappointment and frustration to violent rage.

Colleges are not helpless in preventing and responding to campus shootings. Certain measures clearly make sense. Every university should have a well-trained and sufficiently large security force. Faculty and staff members should be trained to handle volatile students and situations. And it pays to conduct emergency preparedness drills, but not ones that involve students nor ones that are staged when classes are in session.

By overreacting to Virginia Tech, not only are college administrators instituting security measures that may well prove ineffective, but they are also undermining the carefree atmosphere of campus life. They chance making students feel like walking targets.

I especially worry that the anniversary of the Virginia Tech shootings will mean endless replaying of video images of that campus under siege. With last year’s shooting there, and the Valentine’s Day massacre at Northern Illinois University, the violence on campuses feels like a conflagration. There is no need to stoke the flames.

James Alan Fox, a professor of criminal justice and law, policy and society at Northeastern University, is a co-author of “The Will to Kill” and “Extreme Killing.”

Mentally Ill Children

This article is correct with the concept that a lot of mental illness is present in younger school-age children. This illness goes un-diagnosed sometimes with these young children. I have worked, as an educator, with 5th grade students who were already taking Lithium. It is frightening to think of what will happen to their brain cells and body chemistry if they continue to take anti-psychotic drugs for life. That could be seventy years of serious drugs. I do recognize that some drugs are the only thing to help maintain a severe mental illness, but I am encouraged by the research coming out about chemicals and dyes found in the food that a lot of children are eating. These chemicals and dyes have been found to increase and sometimes create ADD and ADHD in children. This is research that should be taken seriously and watched closely for excellent results.

Parents, advocates push for better mental health care for kids

By Steve Landwehr
Staff writer

SALEM — Sally Padden, chief justice for the Essex County Juvenile Court, had a somber message for parents and advocates gathered in Salem yesterday morning to push for better mental health care for children.

Sooner or later, she said, we pay the price for not treating children.

"I guarantee that if you walk into Middleton Jail or Cedar Junction, 90 percent of the inmates had problems when they were 5 years old that weren't treated," Padden said.

Padden was one of about 60 child advocates packed into a room at Children's Friend and Family Services to promote greater awareness and better treatment of kids with mental health issues. They were also lobbying legislators for passage of a bill, currently in the Senate Ways and Means Committee, that would ensure early screening, prevent overly long stays in psychiatric hospitals, improve coordination of services and increase coverage for children with mental illness.

Lisa Lambert, executive director of the Parent/Professional Advocacy League, offered a compelling statistic.

"We have the No. 9 expulsion rate (from kindergarten) in the country," Lambert said. "Only eight states expel more than we do."

Many of those expulsions are the result of undiagnosed or untreated mental illness, Lambert said.

Marblehead's Betsey Cassidy has three sons, all enrolled in Marblehead public schools and all diagnosed with mental health issues. Her oldest, Brian, is 16. He was diagnosed with bipolar disorder when he was 7.

She and her son's psychiatrist eventually found a combination of medications that kept Brian fairly stable, but Cassidy had problems convincing his teachers he had the disorder. They also tried to get her to take Brian off his medications and give him Ritalin instead.

Ritalin helped Brian learn better, Cassidy said, but had nasty side effects, including severe tics.

Brian's care became a battle when he was in seventh grade. Cassidy said he was going through a particularly difficult time, and the psychiatrist, who was out of town and unable to consult with school officials, told her to get Brian into a hospital immediately.

She called the hospital and the school nurse, but when she arrived at school, the nurse told her she had called the hospital and told them Brian didn't need to be hospitalized.

"She treated me really badly," Cassidy said. "That woman thought she knew more about my son than I did."

Lack of understanding

Several parents spoke to the frustrations of dealing with a health care system they said is failing them. Lack of resources has created what is called the "stuck kid" syndrome.

Parents take their child to the emergency room, where treatment in a psychiatric hospital is recommended — but there are no beds available, anywhere. And if more home-based mental health services were available, advocates said, kids might not get "stuck" in a restrictive hospital environment to begin with.

Rodel Treggiari of Salem said she and her husband ended up spending $1,600 a month for 18 months — money they could ill afford — to get their daughter the treatment she needed.

Cassidy said she doesn't think school officials act inappropriately intentionally. She said she thinks they just don't understand mental health problems in children and don't recognize that the diseases don't come with age limitations.

Schools are geared toward learning and are good when dealing with learning disabilities, less so with mental health problems, she said.

The bill that advocates are backing is estimated to cost about $4.7 million. It's not a large sum as state budget items go, but state Rep. Steve Walsh, D-Lynn, cautioned that in this budget crisis, every program is fighting over a limited supply of money.

Betsey Cassidy continues to have good days and bad ones, but her determination to support her sons is paying at least one dividend

"When he was in the seventh grade in school he was told he'd never be anything more than he was right then. He's going to graduate (high school), and I think he's going to go to college," she said proudly.

Children's mental health statistics

r More than 140,000 young people in Massachusetts need mental health services. More than 100,000 do not receive them.

r The number of children with mental health needs is greater than the number with leukemia, diabetes and HIV/AIDS combined.

r Of youths involved in state and local juvenile justice systems, 70 percent suffer from mental disorders.

r Nearly 50 percent of the students with a mental disorder drop out of school.

r Ninety percent of children who die by suicide have a diagnosable and treatable disorder. Suicide is the third leading cause of death among young people 10 to 24.

Source: Children's Mental Health Campaign

Money paid to Mentally Ill Victim's Families

Another twist in the shooting on Virginia Tech's campus. Whose money is being spent to pay these families of the victims? This would not be happening either if that young man had proper mental health care.

Not all pleased with state's proposed deal to families of Tech shooting victims

Posted to: News Virginia Tech Shootings Virginia

Close Slideshow

Click for full view

Dale Harris, background left, and John Meston, members of Nansemond River Baptist Church, hang ribbons April 19, 2007, in memory of Virginia Tech shooting victim Nicole White. (Genevieve Ross | The Virginian-Pilot)

---

By Matthew Bowers
The Virginian-Pilot
© March 25, 2008

A proposed multimillion-dollar settlement by Virginia to head off lawsuits over the Virginia Tech mass shooting offers $100,000 to each of the families of those killed; payment and insurance for medical and counseling expenses for families and surviving victims; and repeated opportunities to question the governor and university officials, in person, about the tragedy and its aftermath.

The mediated agreement isn't pleasing everyone, though.

"My people are pretty unhappy with it, and I don't blame them," said Edward Jazlowiecki, one of the lawyers representing the family of Henry Lee, a sophomore from Roanoke who was among the 32 students and professors killed by gunman Seung-Hui Cho in the April 16, 2007, attacks.

Like other families, Jazlowiecki's clients fault Virginia Tech for not better warning or protecting students after the first two students were killed.

"One hundred thousand dollars for a human life is an insult, an absolute insult," Jazlowiecki said.

It's also Virginia's legal maximum when suing the state in cases of simple negligence, as opposed to gross negligence or willful misconduct. Juries could be asked to determine which, if any, of these standards applies to the Virginia Tech tragedy if any families decide to sue.

Families and victims already have received payments ranging from $11,500 to $208,000 from the Hokie Spirit Memorial Fund, created from more than $8 million in donations that poured in for victims and the Blacksburg school after the shootings. Some recipients used part or all of the money to endow memorial scholarships.

The proposed state settlement is still being negotiated and revised, participants said. According to a copy obtained by The Virginian-Pilot and dated March 14, families have until Monday to decide whether to participate. If they do, they agree not to sue the state - including Virginia Tech - the town of Blacksburg, Montgomery County or the local New River Valley Community Services Board, which provides mental-health services.

Roger O'Dell of Roanoke, whose son, Derek, was wounded, said families were asked not to discuss the settlement negotiations. He added that his son has made no decision - he doesn't want to become adversarial toward the school that he loves, but he has been told his lifetime counseling costs could range from $125,000 to $500,000, plus higher health-insurance costs because of his pre-existing conditions.

Post-traumatic stress disorder "could flare up at any time and could be disabling without regular treatment," Roger O'Dell said. "He'll have constant reminders because he'll have the bullet holes."

The proposal seeks to have all agreements signed by April 15 - one day before the first anniversary of the shooting rampage in which disturbed senior Cho killed two students in a dorm and 30 more in Norris Hall classrooms, wounded or injured another 27, and then killed himself.

The proposal also states that "(p)articipation by nearly all claimants is necessary. The Commonwealth may withdraw the proposal if there is insufficient agreement for settling claims on these terms."

Among the terms:

- A Direct Payment Fund that, in addition to paying $100,000 each to representatives of the 32 deceased victims, would provide a total of $800,000 for the injured, with a maximum of $100,000 to any individual.

- A Special Damages Fund to reimburse or advance expenses for medical, psychological and psychiatric care for victims and immediate families that is not covered by insurance.

- An attempt to provide to "seriously injured victims" state employee health insurance at employee rates, which would require changes to the state budget and possibly state law. If that is impossible, negotiations would continue over ways to provide coverage.

- Attempts to provide free or reduced-fee treatment through the University of Virginia or Virginia Commonwealth University health systems, with fees covered by the Special Damages Fund.

- A two-pronged, state-administered $3.5 million Public Purpose Fund. Half of the money would be for charitable purposes, such as campus safety and related grants or remembrance activities, decided on by a board of victims, family members and state officials. The other half would be for payments to victims and family members suffering "severe hardship, injury or loss" from the shootings. A neutral party would evaluate requests, and payments to any individual would be capped at 7.5 percent of the hardship fund. Money left over from the Direct Payment Fund also would go into the Public Purpose Fund.

- The Hokie Spirit Memorial Fund, scheduled to close this past December, would remain open for at least five years for new contributions to its scholarship fund.

- Gov. Timothy M. Kaine would meet personally with victims and family members three more times in the next two years before he leaves office to review legislative and administrative actions taken in response to the shootings and other family concerns.

- Within six months of the settlement, victims and families would meet with senior Virginia Tech officials, including President Charles Steger and police Chief Wendell Flinchum, for an overview of campus changes, to ask questions, and to weigh in on April 16 remembrance activities. Also within that time, Flinchum and Virginia State Police would update victims and families on the shooting investigation and answer questions.

- Families would be able to contribute to and review contents of an electronic document archive relating to April 16.

- Lawyers from the Washington firm of Bode & Grenier, representing 20 families, would receive $750,000 in fees plus $50,000 for expenses. Others who had filed notices on behalf of families would receive $25,000.

Several of them, as well as a lawyer in the governor's office overseeing the mediation, either declined to comment or didn't return phone calls Monday.

Exciting News

Maybe with this we can find the root cause of mental illness and really help with a prevention and/or cure.

Epigenetic Changes Discovered In Major Psychosis

ScienceDaily (Mar. 12, 2008) — Scientists have discovered epigenetic changes (i.e. chemical changes to a gene that do not alter the DNA sequence) in individuals with schizophrenia and bipolar disorder. This is the first epigenome-wide investigation in psychiatric research, and this groundbreaking data may be a significant step on the journey to fully understanding major psychosis.

---

Dr. Arturas Petronis, senior scientist in the Krembil Family Epigenetic Laboratory at the Centre for Addiction and Mental Health (CAMH), and his team studied 12,000 locations on the genome using an epigenomic profiling technology developed at CAMH. Approximately one in every two hundred of these genes showed an epigenetic difference in the brains of psychiatric patients. Significantly, these changes were noted on genes involved in neurotransmission (the exchange of chemical messages within the brain), brain development, and other processes linked to disease origins.

Dr. Petronis explains that these epigenetic changes may be the missing link in understanding what causes an illness. "The DNA sequence of genes for someone with an illness like schizophrenia and a for someone without a mental illness often look the same; there are no visible changes that explain the cause of a disease. But we now have tools that show us changes in the second code, the epigenetic code, which may give us some very important clues for uncovering the mysteries of major psychosis and other complex non-Mendelian illnesses."

This proof-of-principle study is the first demonstration of what CAMH epigeneticists have hypothesized for the last 10 years. "Until now, we only had theories that epigenetic changes were important to understanding what causes major psychosis," explains Dr. Petronis. "Now we have the tools and expertise to support our theories and we can look at conducting larger studies, which will hopefully give us an even better understanding of psychiatric illnesses. And once we understand the primary molecular causes of an illness, we can advance diagnosis and treatment approaches, and possibly even prevent illness."

CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre.

Journal reference: Epigenomic Profiling Reveals DNA-Methylation Changes Associated with Major Psychosis. The American Journal of Human Genetics, Volume 82, Issue 3, 696-711, 3 March 2008. doi:10.1016/j.ajhg.2008.01.008 http://www.ajhg.org/AJHG/fulltext/S0002-9297(08)00148-1

Another example of who are the victims?

This article voices another side of the mental illness coin. I understand and try to see all sides of these issues. This man is entitled to his own feelings. His wife, I am sure, is suffering. She, in my opinion, should also realize that she is not the only one in the house who is having a problem. What do you think the children would say if they were old enough to be able to voice a reliable opinion? Who are the victims of any kind of mental disorder or illness? Everyone involved, not just the diagnosed person.

From The Times

March 12, 2008

I resent my depressed wife

A reader and his wife had it all: a thriving business, a good income and two children. Then she began to suffer from depression

The only thing that I used to hate about my job was having to be away from home a couple of nights a week, but there are times now when I welcome it, though I would never say so to my wife, Katie. I miss my daughters, and hearing them chirp “goodnight” down the phone makes me feel bad. But then Katie comes on with a brave, long-suffering sigh and says “Don't worry, we're fine”, and it takes every effort not to snap at her and slam the phone down.

For nearly a year now I've been tiptoeing around Katie's depression, though I didn't start off being as unsympathetic as I sound now. We have been together for nearly 15 years and have always been a team, until recently. Our backgrounds and personalities are similar - both the first child in the family to go to university, perfectionists and hard workers - and being in business together could have been a total disaster but we played to each other's strengths, with fantastic results.

The first few years of marriage were mostly about work, although we loved our twice-yearly holidays and a couple of nights out a month. Turning 30 within weeks of each other was a significant milestone, as we could quantify how far we'd come businesswise, not just by our healthy bank balance, but also by the awards we'd won along the way. We had always planned to have a family, and now seemed the perfect time, so we were thrilled when Katie became pregnant. Everything was great until the 18th week when a routine scan showed that the baby had died. Katie had to go through a labour because she hadn't had a spontaneous miscarriage. Throughout that time and for weeks later we simply clung to each other, both of us unable to cope with something going wrong in our charmed lives.

We went away for a break and when we came back Katie was soon pregnant again, but this time the pregnancy was ectopic and our despair seemed never-ending. However, the next pregnancy, though a nerve-racking experience, resulted in a perfect baby girl, followed by her sister two years later. Katie came back to work part-time when our second daughter was 18 months old. Everything seemed fine for another two years. My wife is very good at what she does and, although we both still worked hard, I thought we had the balance about right. It came as total shock when she started suffering from depression.

My initial feelings were of total sympathy. I thought it must relate back to the loss of our first two babies, so I urged Katie to see our GP, who was excellent. She prescribed some low-dosage medication and counselling. But to begin with things continued to worsen. Katie had to drag herself out of bed after dreadful wakeful nights and it was as much as she could do to spend time with the girls, never mind make it to work.

We have an excellent nanny and a very capable housekeeper who does everything from food shopping to the laundry, so my wife has no responsibilities there. I took over her main roles in the business, delegating less important issues to staff. It took months, many changes in medication and hours of counselling before Katie started to show some progress, but eventually she seemed to be on the mend. To begin with she hadn't wanted to tell anyone what was happening, seeing depression as a sign of weakness but, as she started to recover a bit, she decided to tell family, close friends and the main management staff in our business. I left that decision up to her, just grateful that she felt better, and everyone was very supportive. I think women build incredible support networks and I was very touched by the way her closest friends were unobtrusively there whenever she needed them.

There were a couple of moments that did give me pause for thought, such as when she decided that everyone was talking about her and saying she couldn't cope. Then she got cross and quite challenging with someone who not only works with us, but has been a good friend to both of us for years. Katie demanded to know what she had been saying about her to other people, when all she had done was respond to a question about her health, and said that Katie had had a tough couple of months but was on the mend. My wife totally lost the plot, saying that she wanted no one to know that she was depressed and wanted life to go on as normal. What is strange about that is how often she refers to being ill in public. If anyone asks how she is, she does a sort of martyred “Oh well, no choice but to soldier on” sort of response, while hinting that everyone has a much easier life than she does. She picks what she wants to tackle in work and, despite claiming that she finds public speaking a real strain, she is always accepting invitations to chair events, or to be a guest speaker at a big dinner. At the same time she keeps turning down invitations from friends, saying that she's not quite up to socialising yet.

I know nothing about depression, but I'm starting to feel very resentful. I also feel that Katie's milking it a bit. Our mothers worked long, hard hours while bringing up big families, but neither of them ever had the luxury of being depressed. Katie went through a lot in losing our babies, but we have to move on and enjoy what we have. Maybe if we didn't have the nanny and housekeeper and the luxury that we now take for granted, she wouldn't have the time to be depressed.

I can't say anything about this as I'm scared it would trigger a relapse, whether real or imagined. Once, Katie got really angry at me and said that I simply wasn't sensitive enough, which I resent enormously.

I was absolutely shattered when we lost the first two babies, and she's perfectly happy for me to get out of the house and work every day so she that can lie around telling everyone how terrible she feels. I want my wife back for my daughters as well as myself, but sometimes I imagine life without her as she is now, and it is a relief.

Wrong Laws

It is commendable that we have new laws trying to stop the mentally ill from being able to purchase guns. But all they have to do is lie about whether they have been in a mental institute. Maybe the background checks will get better. I still think that if a person has been diagnosed by a licensed medical doctor to have a mental illness, and stops taking his/her prescribed medications, then that should be enough to have them involuntarily placed into a mental health facility for long term observation and made to take their medicine. I am sorry if that sounds harsh and a turn into the past, but if it were your child sitting in a lecture room at college getting an education, and a gunman walks into the hall and kills your child, then I think you would be ready to vote for these laws to be more stringent. This has been the saddest line of stories posted. One after another of people shooting others because they are probably in a manic phase and are acting out a delusion that lives only in their individual sick minds. Enough already!

Law enforcement sources confirm that Northern Illinois University shooter Stephen Kazmierczak struggled with persistent mental illness that, at times, had the potential to make him a danger to himself, but he was, nevertheless, able to legally purchase the guns he used in his campus rampage.

Story

Funerals for NIU Victims Draw Crowds

After the shootings, NIU parents expressed outrage and disbelief over his access to guns, echoing grievances brought up by parents after last April's shootings at Virginia Tech.

"Why was this tormented young man able to carry out this massacre?" NIU parent Connie Catellani asked. "How could he legally obtain a weapon, designed to kill so many people in such a short time?"

Law enforcement officials told ABC News that Kazmierczak's parents placed him in a Chicago mental institution, for months of intensive treatment, when he was a teenager, and that he remained on medication as an adult.

Despite past treatment for mental health problems, Kazmierczak, 27, was able to purchase four guns in three visits to a gun store in Champaign, Ill., over a six-month period. Each time, he filled out a federal form, which asks two critical questions:

"Have you ever been adjudicated mentally defective (which includes a determination by a court, board, commission or other lawful authority that you are a danger to yourself or to others, or are incompetent to manage your own affairs)?" the form asks, "or have you ever been committed to a mental institution?"

Story

Shootings Unlikely to Trigger Fresh Debate

Federal law says that if a court orders a person's commitment to a mental institution, that information is supposed to go into a federal database. A background check against that database would flag such a gun buyer, who would not be legally allowed to buy a firearm.

Police believe Kazmierczak's parents — not a judge — voluntarily committed him. Under current law, that voluntary commitment by his family would not make it illegal for him to purchase guns.

Gun control advocates say the law presents a gaping, potentially dangerous loophole.

Campus Shooting Highlights Legal Loophole

123Next

Mental Illness with Families

Improving Knowledge About Mental Illness Through Family-Led Education: The Journey of Hope

Susan A. Pickett-Schenk, Ph.D., Richard C. Lippincott, M.D., Cynthia Bennett, M.A. and Pamela J. Steigman, M.A. OBJECTIVE: Families often do not receive the information that they need to care for their adult relatives with mental illness. This study examined the effectiveness of a family-led education intervention, the Journey of Hope, in improving participants' knowledge about mental illness and its treatment and decreasing their information needs. METHODS: A total of 462 family members of adults with mental illness in Louisiana participated in the study; 231 were randomly assigned to immediate receipt of the Journey of Hope course (intervention group), and 231 were randomly assigned to a nine-month waiting list for the course (control group). Participants completed in-person, structured interviews assessing their knowledge of mental illness and problem-solving skills and their information needs at study enrollment (baseline), three months postbaseline, and eight months postbaseline. RESULTS: Random regression analyses indicate that at three and eight months postbaseline, compared with participants assigned to the control group, those in the intervention group reported greater knowledge gains (beta=.84, p.01) and fewer needs for information on coping with positive symptoms (beta=-.63, p.05), coping with negative symptoms (beta=-.80, p.001), problem management (beta=-1.00, p.001), basic facts about mental illness and its treatment (beta=-.73, p.01), and community resources (beta=-.07, p.05). These significant differences in knowledge and information needs were maintained over time and were significant even when controlling for participants' demographic characteristics and their relatives' clinical characteristics. CONCLUSIONS: Participation in family-led education interventions, such as the Journey of Hope, may provide families with the information they need to better cope with their relative's mental illness.