caramore

‘Mad Pride’ Fights a Stigma

2008-05-12T23:04:00.003-04:00

A great article on Mad Pride…

Advice from CNN

2008-05-06T18:55:00.006-04:00

CNN has a good informative page on mental health—below is an example of some of their stuff:

Stigma has four components:

Labeling someone with a condition
Stereotyping people with that condition
Creating a division — a superior "us" group and a devalued "them" group, resulting in loss of status in the community
Discriminating against someone on the basis of their label

Some ways you can cope with and help end stigma:

Get appropriate treatment. Don't let the fear or anticipation of being stigmatized prevent you from seeking treatment for your illness. For some people, a specific diagnosis provides relief because it lifts the burden of keeping silent and also underscores that you aren't alone — that many others share your same illness and issues.
Surround yourself with supportive people. Because stigma can lead to social isolation, it's important to stay in touch with family and friends who are understanding. Isolation can make you feel even worse.
Make your expectations known. People may not know how to support you, even if they want to help. Offer specific suggestions and remind people of appropriate language.
Don't equate yourself with your illness. You are not an illness. So instead of saying "I'm bipolar," say "I have bipolar disorder." Instead of calling yourself "a schizophrenic," call yourself "a person with schizophrenia." Don't say you "are depressed." Say you "have depression."
Share your own experiences. Speaking at events can help instill courage in others facing similar challenges and also educate the public about mental illness. Until you gain confidence, you may want to start at small events, such as talks at a support group or a local chapter of a national advocacy group.
Monitor the media. If you spot stigmatizing stories, comic strips, movies, television shows or even greeting cards, write letters of protest that identify the problem and offer solutions.
Join an advocacy group. Some local and national groups have programs to watch for and correct archaic stereotypes, misinformation and disrespectful portrayals of people with mental illnesses.

The End of an Era

2008-04-29T09:04:00.004-04:00

Elaine and husband Steve

Elaine Cummings (The National Association of Social Workers North Carolina Chapter’s 2006 Social Worker of the Year) is retiring from her position as Admissions Director of Caramore, leaving a legacy that will be hard to match. In over 7 years as our direct liaison to the mental health community, Elaine has been responsible for introducing Caramore to hundreds of clients and their families, paving the way for the realization of countless hopes and aspirations.

As the song once said "Nobody does it better"; and in truth nobody has --- we will all miss Elaine's professionalism, clinical knowledge, and guiding concern for our clients. Perhaps Elaine's most memorable contribution to Caramore was her tireless pursuit for what was best for every single individual who came to Caramore. No client ever received anything less that Elaine's total dedication for what would be best for them. She shared people's dreams and often fought through the mental health regulatory maze for all of her admissions.

Elaine showed everyone at Caramore a heart that was boundless in its capacity for providing opportunity and hope to adults with mental illness. Sadly, we will miss her, but we're happy for her personal opportunity to spend more time with family and friends, and maybe just kick back a little and relax.

Cheers to you Elaine ... and thank you for the impact you have made on so many lives.

B Shanley

A Caramore Wedding

2008-04-26T17:32:00.007-04:00

Our own Josh and Shannon got married today in a beautiful ceremony at Orange United Methodist Church in Chapel Hill.

It was particularly touching knowing both so well, having worked with both of them separately, back when they were struggling in the most difficult years of their illness—and to see them now, clearly very much in love, and neither able to imagine living their lives without the other.

Many couldn’t help but to comment on the fact that their own lives have been touched by Josh and Shannon, including Caramore—and that increased the pleasure all take in their happiness.

Congratulations Josh and Shannon!

Become a fan of Caramore on Facebook

2008-04-16T08:48:00.001-04:00

Madness: A Bipolar Life, by Marya Hornbacher

2008-04-13T20:19:00.006-04:00

This book comes heavily recommended from our NAMI folks; here's the Publishers Weekly papragraph:
Hornbacher, who detailed her struggle with bulimia and anorexia in Wasted, now shares the story of her lifelong battle with mental illness, finally diagnosed as rapid cycling type 1 bipolar disorder. Even as a toddler, Hornbacher couldn't sleep at night and jabbered endlessly, trying to talk her parents into going outside to play in the dark. Other schoolchildren called her crazy. When she was just 10, she discovered alcohol was a good mood stabilizer; by age 14, she was trading sex for pills. In her late teens, her eating disorder landed her in the hospital, followed by another body obsession, cutting. An alcoholic by this point, she was alternating between mania and depression, with frequent hospitalizations. Her doctor explained that not only did the alcohol block her medications, it was up to her to control her mental illness, which would always be with her. This truth didn't sink in for a long, long time, but when it did, she had a chance for a life outside her local hospital's psychiatric unit. Hornbacher ends on a cautiously optimistic note—she knows she'll never lead a normal life, but maybe she could live with the life she does have. Although painfully self-absorbed, Hornbacher will touch a nerve with readers struggling to cope with mental illness. (Apr.)

Or, listen to the excellent Diane Rehm’s interview of the author here…

Really Outsider Art

2008-04-06T17:22:00.003-04:00

Here’s nice little piece from Lee Smith in today's Sunday NY Times that mentions Caramore and our resident celeb, Kwami Jackson.

Challenge Accomplished

2008-03-25T20:52:00.004-04:00

David Chapaman, CEO of Caramore and Hank Humphrey from RTI

Thanks to all of you—on the web, through the mail, and at our banquet—who contributed to us meeting our latest fundraising intention. We met our goal to raise $5,000 to upgrade and refurbish both group homes—and even surpassed it, with donations coming in at over $6,000.

Work will begin in April to:

Contemporize, modernize, upgrade, and compliment rooms and living areas with new lighting, furniture, rugs, wall colors, art work, and layouts.

Our clients begin their recovery in our two homes. Often these homes are the first environments that our clients are exposed to after exiting a hospital—meaning that it is a critically important first step.

Your donations—including a generous donation from RTI—will directly go towards these improvements to revamp lives in our homes. Thank you to all who donated.

David Cooley

Program Description

2008-03-17T14:12:00.012-04:00

Caramore is a non profit that has been operating in Carrboro and Chapel Hill for 30 years. We are 24 hour a day structured support program restoring rich and satisfying lives to adults with mental illness.

We exist for the purposes of promoting wellness, managing illness, and facilitating the skills needed to live and work in the community.

We’re a program that treats psychiatric brain disorders and diseases through providing comforting, pleasant, stimulating, and normalized real-world settings where individuals can begin to recover.

Caramore coordinates mental health treatment and offers a highly structured daily living regimen where individuals attain successful employment, suitable housing, financial stability, and achieve independent living.

Mental illness can entail cognitive, emotional, and interpersonal impairments that can severely limit insight. Our rehabilitative setting—involving socialization and employment—works to restore those impairments and behaviors through concentration on daily living skills, medication management, food and nutrition, health and hygiene, and social interaction. The path of rehabilitation is gradual and predicated on time and the individual’s particular needs.

For individuals with severe psychiatric diseases and disorders—where impairments are

disabling—the combined approach of medical treatment and 24 hour a day vocational, residential, and social rehabilitative support, is the road to recovery.

Practical concerns that exhaust families—such as navigating doctor’s visits, dealing with pharmacies, consistently and correctly taking prescribed medication, handling SSA benefits or health insurance, teaching budgeting skills and managing money, encouraging good hygiene, paying rent, paying attention to nutrition, encouraging movement and exercise, landing and keeping a job—are all supervised by Caramore counselors.

Many of us define ourselves by our work. Work is a critical source of our identity, and so it is with Caramore clients. Caramore clients begin a real job for real money from day one of entering the program. Gradual progression through the program hones disciplined and hard working employees who feel good about themselves, are defined less by their illness, and freed with confidence to pursue their own dreams.

Some successful Caramore clients can participate in “Tier 3,” a long term living situation that entails Caramore’s as-needed support. Tier 3 clients benefit from freedom and independence while knowing that if they need help, they’ll get it. Tier 3 is an excellent solution for the recidivism and episodic nature of mental illness—when things go wrong, Caramore is there to ensure jobs are kept, bank accounts preserved, and apartment leases are maintained.

Caramore exists for the sole purpose of our clients, and the ultimate worth of our services derives from the value and special abilities of our clients—their strengths and talents are needed and utilized. We need help and frequently “peers” are employed to fulfill the Caramore mission. Many past clients actively work for us—helping form meaningful relationships with individuals who are in the same seemingly hopeless spot they were once in.

Environment matters, and Caramore hopes that society’s gradual reducing of the stigma of the illness will reduce the stigma of the recovery process. Nobody wants to be sick, but people can get better and do get better at Caramore. It can mean allowing oneself to be helped by a considerable number of people. It can take a lot of time, and can be punctuated with many failures. But inside the supportive, encouraging, and safe environment of Caramore, risks can be taken; mistakes and miscues absorbed, and a new life can start. Caramore is hope, movement, action, and being involved—it’s a life re-start.

D. Cooley

North Carolina Mental Health Disaster and Caramore

2008-02-26T16:28:00.004-05:00

Concerned and confused as we are over the failure of North Carolina’s mental health reform? It’s worth mentioning, with all the terrible news, that Caramore has been operating for 30 years. We’re a not-for-profit organization tied to Vocational Rehabilitation and receive a large amount of our funding for the employment, housing, and stability we help our clients attain.

We offer our program as a valid and successful response to severe mental illness. We battle stigma in the hopes of not only demystifying the illness, but also to demystify the path of treatment. For many people stricken with psychiatric diseases, our 24 hour-a-day structure and support—combined with medication, doctors, and therapy—is an essential element towards managing the illness for life.

Although we provide “community support” in that we are a “structured support” program, we are not a private community support provider presently seeing disgrace in the N&O this week.

We do not bill Medicaid for any services. The money we do get for helping individuals suffering from mental illness restore their lives is well spent tax money. Indeed, the current uproar in the press is over the very fact that private companies have profiteered from the sick and poor. Some of our tax dollars should be appropriately funneled as a safety net for the vulnerable, and that’s what happens at Caramore. Unfortunately, that truth might escape notice in the current storm of criticism over mental health in North Carolina. Even though we serve a statistically small number of people, and we’re not always applicable for everyone, Caramore’s model should be better known (we’re trying!), and held up as an example of what does and has worked in this state.

We’re unique, we’re here for the long haul, and no one does what we do as well as we do. Please email me with any questions, and Caramore is always open for tours and information.

Thank you,

David Cooley
Vice President
dcooley@caramore.org

Kwami Jackson

2008-02-03T15:06:00.000-05:00

Our own Kwami Jackson was recently featured in “West End Poetry” with the following poem…

Made for you

As you turn it on it brushes against the flesh

Then falls into creeks and streams

Put it in a cup as it ravels down the throats many

Where? Ashes spread, guns are thrown, and decomposed bodies float aside.

Thrown garbage in the sea lies here

Where piers are guilt for you and me

A mother in a unexpected place. Water breaks!

As drops of rain falls for growth.

It is most of the body. Human, mammal or animal.

At times it can be frozen

Materials were made to repel because of it.

Some beds have it

You could not clean dishes without it.

Nothings can live without it

You brush your teeth and wash your face and then turn off the water.

Robert Kwami Jackson

Kwami is also featured in this month’s documentary movie,“
Brushes with Life: Art, Artists and Mental Illness.”

Brushes with Life: The Journey of Art

2008-01-17T06:49:00.000-05:00

Everyone who’s ever picked up a paintbrush and touched a canvas knows the thrill and release of creation. The joy of pressing the shutter on an old Leica camera and hearing that click as you immortalize the look of a stranger or a towering building or golden-hued sunlight resting on the treetops. The nurture of knitting, the mood of music, the praise of poetry; these are the pleasures of being an artist.

There are artists who have spent hundreds of hours, thousands of dollars and millions of moments of inspiration to be what they considered to be ‘artists.’ Some measure their success in canvases sold, or number of exhibitions or word of mouth in their community. Many other artists don’t consider themselves artists. They do their drawings in notebooks that never see the light of day, instead hibernating in bedside table drawers. They write poetry that plumbs the depths of angst and despair like Sylvia Plath. They create paintings that, like Van Gogh’s, never get sold in their lifetime.

Anyone who can afford the materials can be an artist. Getting your art shown is another matter. The trick to getting your art shown is two-fold: You must have the confidence to put yourself out there and try and make a deal. And you must make someone believe in your art enough to display it to the world.

We mentally ill can be a shy bunch. Aside from bipolar mania, we generally keep to ourselves. But our dreams of being artists are realized with the Brushes With Life gallery. Here is a gallery that shows folk art, amateur art, outsider art, classically trained art, abstract art. The only way to have your work shown is to have a mental illness which is seldom an asset.

Through creation, the mentally ill find peace. Art springs from the heart, but more importantly, the mind. A mind that is heavy with anxiety and pain can get a release from art like nothing else. The gallery is the best kind of therapy there is for those who struggle with mental health challenges. Joy is real when you overhear two strangers gush over a photograph you’ve taken, not realizing the artist is standing right next to them. Brushes With Life has grown over the years, developing a consistent roster of talented artists. Many of these artists you see in my film. Their journey through art is a way to relieve pain. We are all better off that they are expressing their pain. Turning pain into joy is the most productive occupation on Earth.

- Philip Brubaker, January, 14, 2008

See Philip’s documentary at Sunrise Church in Hillsborough
Thursday February 21, 2008
7:30 to 9:00

Mike Hill

2007-12-26T21:44:00.001-05:00

Mike Hill, our long-standing Health Services Director, left Caramore last Friday to complete his MSW. We’re all going to miss Mike for his commitment to Caramore—his rigorous observance of minutia and detail and perfection, not to mention his commitment to our clients.

But most of all we’ll miss his humor. Hill was frequently the originator of Caramore office hijinks, shenanigans, and practical jokes. Mike kept us laughing and his presence will be missed. Thanks Mike for all you’ve done for Caramore!

Dangerous Criteria

2007-12-26T21:01:00.000-05:00

One of the big stories from 2007 in Mental illness revolved around “dangerous criteria,” that is, whether or not to require that individuals be dangerous before treating them for mental illness.

That criterion is meant to protect the public while protecting an individual’s liberty, a fundamental freedom. In the field of mental health, we’re always quick to point out that statistically, individuals with mental illness are far more likely to be a victim of violence, rather than the perpetrator. But it is also statistically true that up to 40% of mass-shootings have been by people with psychiatric disorders.

Is someone undergoing a significant psychotic episode capable of declining treatment? CPR classes don’t cover debating whether a passed out person is dangerous before treatment can be administered.

The argument then against dangerous criteria is that schizophrenia can lead to violence (rarely mass-shootings—but tragically far more often—suicide of the individual with the illness). Also, a recent study by Matthew Large states that in jurisdictions that demand dangerous-based criteria for intervention, individuals who suffer with mental illness go an average of five additional months with no treatment at all (worsening the illness of the individual and despair of the family).

The eventual answer will lie somewhere in a more sophisticated understanding of the cognitive disruptions and irrationality brought on by psychiatric illness—understanding the process and the familiar signs of the illness, followed by the compassion to provide immediate and appropriate treatment.

Honorary Gift

2007-12-08T15:06:00.001-05:00

Honor a friend or loved one this holiday season with an exclusive gift to Caramore Community. With your gift, your honoree will receive a card from Caramore in your name expressing your appreciation.

If you prefer to mail in a check to Caramore, simply designate the person whom you are honoring, and their address.

If to make the gift on-line, send me, David Cooley (dcooley@caramore.org), a separate email informing me that you are making an honorary gift including your friend or loved one's name and address.

As always, thank you, and have a great holiday from everyone at Caramore!

Reginald Green

2007-12-04T09:43:00.000-05:00

I’m Free

Don’t grieve for me now, for now I’m free.
I’m following the path God laid for me,
I took His hand when I heard His call,
I turned my back and left it all.
I could not stay another day
To laugh, to love, to work or play.
Tasks left undone must stay that way,
I found peace at the close of the day.

If my parting has left a void,
Then fill it with remembered joys.
A friendship shared, a laugh, a kiss,
Oh yes, these things I too will miss.
Do not be burdened with times of sorrow,
I wish you the sunshine of tomorrow.
My life’s been full, I savored much.
Good friends, good times, a loved one’s touch.

Perhaps my time seemed all too brief,
Don’t lengthen it now with undue grief.

Give your heart and peace to thee—
God wanted me now, He set me free!

Reginald Green—a Caramore family member—passed peacefully in November. Reginald’s humorous and good-natured personality made Caramore a more cheerful place, and it’s not the same around here without him.

Beth Kurtz

2007-11-18T17:18:00.000-05:00

Yesterday Caramore said goodbye to our friend Beth Kurtz in a memorial service in Chapel Hill. Beth died suddenly on November 11, 2007 leaving us confused and grieving.

The service acknowledged and eulogized how deeply Beth suffered from her mental illness, but how she had—through it all—persevered, had some success, and had done the best that she could.

Beth will be remembered at Caramore for her stoic endurance against mental illness, and she’ll be dearly missed by her friends.

Blake's Story

2007-11-02T13:43:00.000-04:00

Blake, at the head of the table, captivating the audience

Blake Daughtry, a former Caramore client and now employee and Peer, spoke to a NAMI Family-to-Family Program last night.

Blake offered a very personal and experienced account of the potential for recovery.

Blake first experienced symptoms in 2002. Neither he nor his family knew what to make of his bizarre and erratic behavior which culminated in drugs, rehab, jail, and suicide attempts.

In January of 2006 he entered Cherry Hospital and stayed for 8 months. During this period he eventually came to a place where he realized he was hearing voices and that he was sick—he was open to receiving help. Eventually his medication was perfected and he gained some mental stability. He worked on controlling himself and his thoughts—learning to understand the new mental processes that the illness brought and how to function with it.

From the hospital he was released to Caramore which offered him more time to continue his rehabilitation in a structured environment committed to seeing him get better.

Blake credits Caramore with furthering his own goals—attaining friends, an apartment, a job (working at Caramore), educating others on recovery, and starting college classes.

Blake’s message was simple—admit that you need some help from others, take your meds, and pursue your goals, because there’s no reason you can’t achieve them.

D.Cooley

A Testimonial from an Employer of Caramore Clients

2007-10-27T13:37:00.001-04:00

Michael Malek, Carol Woods Retirement Community dining services manager, compliments Caramore for its record with workers with disabilities.

"The presence of Caramore's workers has lent a significant dimension to the Carol Woods community. Caramore has high expectations, just like we have of our own staff. Caramore's values—courtesy, respect, dignity, self-determination—are closely aligned with ours. Ted McCreary and Barry Shanley are phenomenally gifted. With tough love, hands on counseling and unusual acumen, they encourage (client’s) reliability and desire to learn."

Immune to Basic Social Signals

2007-10-26T21:22:00.001-04:00

Here’s a brief article from the “The New Yorker” about individuals suffering from schizophrenia who respond to the social dysfunction of “Curb Your Enthusiasm.”

Facts about mental illness in the United States 2007- Reuters

2007-10-26T21:01:00.000-04:00

Legislation pending in the U.S. Congress would require health plans to cover mental health the same way they cover other medical problems. Here are some facts on the legislation and prevalence of mental illness and substance abuse:

-- The legislation would provide mental health parity for about 113 million Americans who work for employers with 50 or more employees, according to a chief sponsor of the Senate version, New Mexico Republican Pete Domenici.

-- The U.S. National Institute of Mental Health estimates that slightly more than one in four Americans aged 18 and older suffer from a diagnosable mental disorder in a given year -- nearly 58 million people.

-- About 6 percent, or one in 17 people, aged 18 and above have a serious mental illness, the NIMH estimates.

-- Mental disorders are the leading cause of disability in the United States and Canada for people ages 15 to 44.

-- Mental disorders rank among the top 10 illnesses causing disability worldwide, with depression being the leading cause of disability among people ages 15 and older, according to the Global Burden of Disease and Risk Factors published in 2006.

(Compiled by Joanne Kenen in Washington)

Tonight’s Client Celebration

2007-10-25T23:52:00.001-04:00

Thanks Paul E. Jones for the inspirational night and thanks to all of you who came out tonight and made this such a memorable appreciation for the achievements our clients have made this year!

The Center Cannot Hold : My Journey Through Madness

2007-10-22T13:43:00.000-04:00

Here’s a new “courageous and brilliant” memoir that’s getting a lot of attention for countering "the negative stereotypes about mental illness held by both the general public and mental health professionals.”

"I wanted to dispel the myths ... that people with a significant thought disorder cannot live independently, cannot work at challenging jobs, cannot have true friendships, cannot be in meaningful, sexually satisfying love relationships, cannot lead lives of intellectual, spiritual, or emotional richness."
Elyn R. Saks, The Center Cannot Hold : My Journey Through Madness.

Our Latest Fundraising Challenge: Redecorate Our Homes!

2007-10-18T13:45:00.000-04:00

Gloomy—artwork by Bob Ross

Caramore has a particularly exciting project right now that we could use your help with.

As you know, Caramore is a free program for all we serve—clients are not charged for services, nor do we bill Medicaid. The entire program is largely funded by State money—almost, but not quite, and maybe not forever.

We have two homes where our clients begin their rehabilitation. These homes are owned by the Mental Health Association who financially insures that the structures are maintained. But the responsibility for the inside decor and furnishings rests entirely on us.

Caramore actively promotes mental wellness—a philosophy that centers on enhancing the quality of the entire life-recovery experience for our clients—which include living and working environments. With donations, we’ve renovated and enhanced our “Client Lounge” and offices. The environment is modern, inviting and calmingly pleasant to spend time in.

Our homes, while very clean and well maintained, are horribly out of date. The living environment needs updated and refreshed. We're looking to refurbish with multi-colored walls, new lighting, some new furniture, some rugs, plants, and lots of hung art work. We’re after, in our homes, a balanced exposure to nutrition, physical movement, and rich experiences—all in a serene environment that encourages health and wellbeing. Our clients deserve it.

We’re seeking to raise $5000 for this project. Won’t you help us?

Caramore Community, Inc. is a 501(c) (3) private, not for profit organization and your valuable donation is fully tax deductible.

For your convenience, you can easily, safely, and securely, donate right here online using Google Checkout.

Checks may also be sent to our office:
550 Smith level Road
Carrboro, NC 27510

Feel free to contact David Cooley for more information on this project.

And of course, if you’d prefer your donation be targeted for another area of Caramore that’s dear to your heart, don’t hesitate to specify.

Thank you for your gracious support!

An Incredibly Condensed History of Mental Illness

2007-10-14T23:31:00.000-04:00

4000 years ago
The Egyptians and early Greeks saw mental and physical illness as biologically based—resulting from physical causes.

1700
Later in history the conception of the “mind” came to dominate regarding mental illness, and explanations of it centered on possessions of evil spirits, and moral weaknesses. Individuals who suffered from mental illness were not seen as ill but as flawed and were extremely persecuted.

Toward the end of the century “insanity” came to be seen as beyond the control of the individual rather than a possession or demonic. Asylums were created to treat mentally ill patients. Benjamin Rush (America’s first psychiatrist) opened the first mental asylum in America. Treatments were primitive but it was an improvement and essentially based on a medical model.

1800
Dorothea Dix, an activist, dedicated herself to improving conditions and was responsible for more than thirty hospitals built. The hospital in Raleigh that bears her name—Dorothea Dix—opened in 1856.

1936 through 1950s
Twenty thousand frontal lobotomies were performed in America.

1947
Fountain House in New York City opened providing community-based psychosocial rehabilitation.

John Umstead Hospital opened.

1940s and 1950s
New medications—anti psychotics—were discovered that greatly helped but did not cure. ECT and insulin therapies were also used to battle depression.

1960s
Conventional antipsychotic drugs like haloperidol are developed that significantly control the symptoms of psychosis.

1970
Mass deinstitutionalization began but without a lot of rehabilitation or support programs in communities.

Caramore is founded to serve as a residential and vocational rehabilitation and reintegration program for those suffering mental illness or being released from hospitals.

Managed care—short stays in hospitals with community treatment—became the standard of care for mental illness.

Today
Today there is a lot of controversy over North Carolina’s latest attempt at deinstitutionalization and the lack of community support and programs to handle patients who only stay for short periods of time in hospitals.

In addition to the lack of services and health care, the stigma of mental illness remains a painful issue. A lot of effort has been seen in equating mental and physical illnesses as biologically driven, yet the health care industry’s slow acceptance of granting parity is a lingering example of how society has been slow to see depression and psychotic disorders as similar to diabetes or heart disease.

The frightening history combined with the hard-to-grasp emotional and behavioral elements to these diseases still cause us to shy away from fully approaching them without denial or shame.

Advocacy and education are the answers. The more education that can occur dispelling myths and removing the fear and uneasiness; the more it can be shown how similar people’s experiences with the illness are—and the straight-forward nature of treatment—the better the climate will be for those seeking help. Because remember, "the best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports (NAMI).”