Family Views of Stigma

VOL. 15, NO. 1, 1989

by Otto F. Wahl and Charles R. Harman

Family Views of Stigma

Abstract

There has been substantial documentation of the fact that mental illness tends to be viewed unfavorably by the general public (e.g., Rabkin et al. 1980; Rabkin and Crawford 1987). Most studies of the stigma of mental illness have focused on the views expressed directly or indirectly by the public, with consequent inferences about the impact of such views on psychiatric patients and their families. A subset of stigma investigations has focused on mental health professionals and their attitudes toward psychiatric patients (e.g., Manis et al. 1965; Rabkin 1977; Morrison 1979; Mirabi et al. 1985). Considerably less attention has been paid to the actual experiences and perceptions of stigma by families of mentally ill individuals. Current clinical observations and personal accounts of family members suggest that stigma is a significant problem for families, particularly for those with a severely mentally ill member. A number of consumer-oriented books—often by clinicians who have worked with families (e.g., Bernheim and Lehman 1985; Walsh 1985; Torrey 1988)—have emphasized the shame and guilt that plague parents of persons with severe mental illnesses like schizophrenia, partly as a result of public beliefs about parental roles in producing the disorder. Anecdotal accounts of personal experiences, such as those now regularly printed in the Schizophrenia Bulletin, often

stress stigma as a burden to families as well as to their ill relatives (e.g., Anonymous 1983; Mittleman 1985; Fuchs 1986). Moreover, even Reprint requests should be sent to Dr. O. Wahl, Dept. of Psychology, George Mason University, 4400 University Drive, Fairfax, VA 22030.

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The views of 487 members of the National Alliance for the Mentally 111 (NAMI) concerning stigma were surveyed in 20 different States. Almost all identified stigma as a problem for their mentally ill relatives and for families in general. The most frequently cited effects of stigma on ill relatives were damage to self-esteem, difficulty making and keeping friends, difficulty finding a job, and reluctance to admit mental illness. The most frequently cited effects on families were lowered self-esteem and damaged family relationships. NAMI respondents identified popular movies about mentally ill killers, news coverage of tragedies caused by mentally ill people, casual use of terms like "crazy" and "psycho," and jokes about mental illness as prominent sources of stigma. The things families reportedly found most helpful in dealing with stigma were factual information about mental illness, interaction with other families with mentally ill relatives, support within the family, and research findings that establish a biological basis for mental illness. Mental health professionals received mixed reviews from family members. While not generally viewed as contributing to stigma, mental health professionals were seen as least helpful in dealing with stigma. Overall, survey results indicate that considerable concern about stigma exists among families with mentally ill relatives and that substantial numbers of family members experience the stigma of mental illness in one form or another and perceive that their ill relatives experience it as well.

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Methods A questionnaire was developed asking respondents to report their views about stigma and its impact. Stigma was defined for subjects using a dictionary definition of "a mark of disgrace or infamy, a stain or reproach, as on one's reputation." Questions fell into one of several categories. First of all, there were several general questions asking subjects the extent to which they felt stigma was associated with mental illness and the extent to which stigma unfavorably affected

ill individuals and their families. The questionnaire also listed a number of ways stigma might affect families and might affect the ill member (e.g., impairing selfesteem, ability to make and keep friends, and success in getting a job), and respondents were asked to rate the extent of these possible effects. Next, a number of possible contributors to stigma were listed (e.g., popular movies about mentally ill killers, jokes about mental illness, and the insanity defense), and respondents were requested to rate how much each of them contributed. Finally, possible sources of emotional support or refutation of stigma were listed for family members to indicate how helpful each was in dealing with stigma and its effects (e.g., factual information about mental illness, talking with mental health professionals, and interaction with other families). Responses involved Likert-type ratings with choices "not at all," "little," "somewhat," "much," and "very much." Tables 1-5 show all items included in the questionnaire apart from demographic items. A total of 1,475 questionnaires were mailed to 26 affiliates of the National Alliance for the Mentally 111 (NAMI), a rapidly growing selfhelp and advocacy organization of families of individuals with (mostly severe) mental illnesses. Affiliate leaders were asked to distribute questionnaires at regular affiliate meetings and to return both completed and undistributed questionnaires. Affiliates were selected to represent a variety of geographical areas (26 different States) and group sizes (the largest has a reported membership of 389, the smallest 21). A total of 487 correctly completed questionnaires were returned and are included in these results. Figuring in the num-

ber of returned undistributed questionnaires and the incorrectly completed ones received, our estimated return rate was 35 percent (or better, since not all target affiliates returned undistributed forms as requested). It is also worth noting that results are not dominated by responses from only a few large affiliates. Responses were received from affiliates in 20 different States; the largest number received from any one affiliate was 69 (New York City); the smallest was 4 (Denver, CO, and Eugene, OR). Several limitations of our survey are immediately apparent. First of all, our survey was deliberately skewed toward articulation of the undesirable consequences of stigma for families, asking about the extent rather than the existence of stigma and stigma effects. On the basis of the many clinical reports of family concerns, our survey sought to document more specifically and systematically the nature and extent of those concerns. Although such a survey cannot supply a full view of mental illness stigma, including possible positive consequences (such as increased family solidarity) or stigma's importance relative to other problems, we felt that survey responses could nevertheless provide valuable information about family views of this often-mentioned problem. A second obvious limitation is that we do not have a random sample of families with mentally ill relatives. The responses we obtained came from individuals who have chosen to join a self-help organization, who have been exposed to the principles and philosophies of that organization, and who, typically, have severely ill relatives. The implications of these factors will be discussed later in the context of obtained results. In addi-


Clausen (1980), in studies questioning the extent and importance of negative public attitudes about mental illness, noted that spouses in his studies were reluctant to define their partners as mentally ill and suggested that families in which a child is the patient may delay seeking help because of fears of stigmatization. Despite these consistent observations that relatives of mentally ill persons also may be stigmatized and adversely affected by public views of mental illness, large-scale, current studies of family views of stigma are lacking. It is the gap in knowledge about the problematic aspects of stigma for families that the current study sought to address. In particular, it attempted to explore family experiences of stigmatization and to describe more specifically, from the family member's point of view, the ways stigma affects family members and their ill relatives. The study also sought information on what families see as major contributors to stigma and what, if anything, has been helpful to them in dealing with the unfavorable public attitudes and views they perceive.

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Results Characteristics of Respondents. The majority of respondents (70 percent) were female and parents of mentally ill persons (73 percent). Only 3 percent of respondents were spouses of mentally ill partners and 11 percent were siblings of ill family members. Many respondents indicated that they had more than one mentally ill relative, including two children, aunts, nephews, and cousins, a child and a stepchild, and even two spouses. A few respondents (6) reported being themselves mentally ill. The largest group of respondents (41 percent) were in the 56-65-year-old age range. A substantial proportion of survey respondents (30 percent) reported being officers in NAMI affiliates, although the majority of respondents, as would be expected, did not hold office in the organization. General Impact of Stigma as Perceived by Respondents. Responses to questions concerning general views of stigma are summarized in table 1. Family members were clear and consistent in indicating their feeling that stigma accompanies mental illness. Approximately 88 percent responded that stigma is

Table 1. General impact of stigma as perceived by respondents Percent responding much or very much

Percent responding little or not at all

To what extent do you feel that stigma is associated with mental illness?

87.6

2.3

To what extent do you feel that your ill relative has been affected by mental illness stigma?

76.6

4.9

To what extent do you feel that other family members are affected by stigma when they have a mentally ill relative?

56.1

11.3

Questionnaire item

Wore.—Total number of respondents = 487, although not all respondents answered all questions.

much or very much associated with mental illness, and 98 percent responded that it is at least somewhat associated. A similarly high proportion of respondents (77 percent) indicated that their ill relative had been much or very much affected by stigma. Thus, whatever debate there is in the literature about the continued existence of stigma, our family respondents strongly perceive and expect such stigma. Respondents indicated that stigma was less of a problem for themselves, only 56 percent saying that it much or very much affected families with mentally ill members; however, 89 percent still reported that stigma was at least somewhat of a problem for families. Thus, mentally ill persons were seen to receive the brunt of negative public attitudes, but relatives of those persons clearly felt stigmatized as well. Perceived Impact of Stigma on 111 Relatives. Table 2 summarizes

responses to items concerning the specific perceived impact of stigma on mentally ill relatives. The negative impact of stigma most often cited was damage to self-esteem, with 76 percent of respondents reporting that their ill relative's selfesteem was much or very much affected by stigma. The abilities of the patient to make and keep friends (65 percent)' and to succeed in finding a job (64 percent) also were cited as significant problems. In addition, many respondents felt that stigma unfavorably affected their relative's willingness to admit his/her mental illness (60 percent) and even had a negative impact on the patient's illness and recovery (48 percent). Thus, most respondents felt strongly that stigma had affected the life of their ill relative in a great many ways. •Unless otherwise indicated, percentages refer to subjects responding "much" or "very much."


tion, as with all mail surveys, respondents are self-selected, and it is difficult to know what are the psychological and motivational attributes that lead some people to respond while others do not. Nevertheless, NAMI is currently the major organization for families of mentally ill persons and, however nonrandom, the responses of a large number of its members provide insights into the ways such families experience mental illness stigma.

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Table 2. Perceived impact of stigma on ill relatives Percent responding little or not at all

Self-esteem

76.4

4.9

Ability to make & keep friends

65.1

12.0

Success in getting a job

64.0

16.9

Willingness to admit mental illness

59.9

18.6

Illness & recovery

47.8

18.2

Success in finding a place to live

40.7

34.4

Acceptance by mental health professionals

23.3

42.8

To what extent do you feel that stigma has had an unfavorable impact on your relative's

Note.—Total number of respondents = 487, although not all respondents answered all questions.

Perceived Impact of Stigma on Non-Ill Family Members. Table 3 presents respondents' views as to how stigma had affected themselves, as relatives of a mentally ill person. There was a considerable variety of opinion about the specific impact of stigma on the family. The negative influence most cited by respondents involved disrupted family relationships. Twenty-two percent reported that their relationship with other family members had been much or very much affected by stigma; 20 percent said their relationship with their ill relative had been similarly affected. About one-fifth (21 percent) of respondents reported that their selfesteem had been much or very much damaged by stigma. Since parents, mothers in particular, have long been characterized as responsible for serious psychopathology in their children, it is not surprising that respondents in this study sample, which was composed largely of

Perceived Contributors to Mental Illness Stigma. As shown in table 4, family members were consistent in their beliefs about the kinds of things that contribute to stigma. Most identified popular movies about mentally ill killers (86 percent), news coverage of tragedies caused by mentally ill people (82

Table 3. Perceived impact of stigma on non-ill family members Percent responding much or very much

Percent responding little or not at all

Relationship with other family members

22.1

48.9

Self-esteem

20.8

49.4

Relationship with your mentally ill relative

20.4

49.8

Willingness to acknowledge your relative's mental illness

15.3

59.7

Acceptance by mental health professionals

13.4

60.9

7.8

74.8

Questionnaire item As someone with a mentally ill relative, to what extent do you feel that stigma has had an unfavorable impact on your

Ability to make and keep friends



Percent responding much or very much

Questionnaire item

mothers of severely ill individuals, felt that negative public views lowered their self-esteem. Similarly, the guilt, shame, and embarrassment that other authors have noted may account for some of the relationship disruption which respondents attribute to stigma. Whatever the explanation, it seems clear that family members not only perceived stigma as a problem but many could identify specific ways it had an unfavorable impact on their lives.

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Table 4. Perceived contributors to mental illness stigma Percent responding little or not at all

Popular movies about mentally ill killers

85.6

5.0

News coverage of tragedies caused by mentally ill people

81.8

4.4

Violence by mentally ill people

77.3

9.0

To what extent do you think each of the following contributes to the stigma of mental illness?

Casual use of terms like "crazy," "psycho," etc.

74.1

7.7

Jokes about mental illness

70.6

5.7

The insanity defense

62.7

11.7

References to mental illness on commercial products (e.g., toys, T-shirts, mugs)

62.6

14.1

News coverage of homelessness

51.7

15.8

Unfavorable personal experiences with mentally ill people

46.1

19.2

Efforts to reduce the population of psychiatric hospitals

43.9

11.0

Attitudes expressed in the home

33.4

33.6

Teaching by mental health professionals

22.0

40.0


percent), and violence by mentally ill people (77 percent) as contributing much or very much to stigma. A reasonable inference is that families are particularly concerned about stereotypes of mentally ill persons as violent and dangerous

and about media depictions that support this stereotype. Families also saw stigma as coming from other less spectacular sources: 74 percent of respondents reported that casual use of terms like "crazy" or "psycho" contributed signifi-

Perceived Aids in Coping With Stigma. Table 5 shows what families felt were helpful to them in coping with mental illness stigma. Almost all of the listed possible aids in dealing with stigma were said to have been helpful by most of the respondents. The one most universally seen as helpful, however, was factual information about mental illness; 86 percent rated this as much or very much helpful to them. Knowledge about mental illness apparently helps families to overcome the negative perceptions the public (and possibly the families themselves) may have about psychiatric disorder. Most respondents (78 percent) also saw interaction with other families with mentally ill relatives as of much or very much help in overcoming stigma. Thus, NAMI's central functions—as an information resource and a means of linking families—appear to be helpful to its members, at least in aiding them to deal with the stigma of mental illness. In addition, many respondents (73 percent) said that research findings which establish a biological basis for mental illness were helpful to them. This would make sense in terms of relieving the guilt that may accrue from the gen-



Questionnaire item

cantly to stigma; 71 percent cited jokes about mental illness; and 63 percent indicated that reference to mental illness on toys, T-shirts, and drinking mugs added to stigma. However innocuous others may perceive casual terms, jokes, or joking slogans on commercial products, families of mentally ill persons view them very seriously, as mechanisms that support the stigma with which they and their ill relatives are burdened. In addition, a number of respondents (10) spontaneously added public ignorance or lack of information as very much contributing to stigma.

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Table 5. Perceived aids in coping with stigma Percent responding little or not at all

Factual information about mental illness

86.0

4.0

Interaction with other families with mentally ill relatives

77.9

5.7

Mutual support within the family

74.7

12.8

Research findings which establish a biological basis for mental illness

73.2

7.1

Advances in the treatment of mental illness

66.3

12.4

Active involvement in efforts to reduce stigma

64.6

13.7

Positive media depictions of mentally ill persons

63.5

14.2

Talking with mental health professionals

49.0

19.6

To what extent do you think each of the following has helped you to deal with stigma you have encountered?

Wote.—Total number of respondents = 487, although not all respondents answered all questions.

eral public's view that bad parenting is what causes mental illness. Not surprisingly, mutual support within the family was also seen as very helpful by a large proportion of respondents (75 percent). Of all the options presented (which included positive media depictions of mentally ill persons, advances in treatment, and active involvement in antistigma efforts), the one that was least often rated as helpful (49 percent) was talking with a mental health professional. Role of Mental Health Professionals. Some self-help organizations arise because of dis-

satisfaction with current professional help efforts. This was certainly true of NAMI groups which, historically, have expressed disappointment, anger, and even mistrust of mental health professionals whom, they believe, have served families poorly. It is interesting to note, then, how mental health professionals fare currently, at least with respect to issues of stigma, in the eyes of families. Results indicate considerable divergence of opinion. Overall, mental health professionals fare well: Substantial proportions of respondents indicated that stigma had little or no effect on their acceptance by

Discussion The results cited previously provide important information about the experience of relatives of mentally ill people. Most family members felt that not only their ill relative but the family as a whole was stigmatized by mental illness, and many could point to specific harmful effects. The fact that a majority of respondents (56 percent) identified stigma as having a large negative impact on the lives of family members but a much smaller proportion (8 to 22 percent; see table 3) identified specific ways stigma had affected them personally is a curious result. This result may indicate that families have a diffuse



Questionnaire item

mental health professionals (61 percent), that current psychiatric education does not contribute to stigma (40 percent), and that talking with mental health professionals was helpful to them in dealing with stigma (49 percent). However, there were still a good many family members who reported that stigma unfavorably influenced their acceptance by mental health professionals (13 percent). Approximately onefifth (20 percent) indicated that talking with a mental health professional helped little or not at all in dealing with stigma, and 22 percent felt that the teachings of mental health professionals actually contributed to stigma. It seems clear, then, that while views about mental health practitioners were generally favorable within NAMI groups, there was still a significant undercurrent of dissatisfaction and distrust. Far from being universally perceived as accepting allies, mental health professionals were often perceived as adding to the stigma that troubles families.

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tainly have a negative impact on family relations. The views of stigma, its extent and impacts, its contributors, and its solutions could be colored by membership in an organization (NAMI) that effectively asserts its views and indoctrinates its members well—in which case the views being expressed by NAMI members could be views they have learned from NAMI. However, if respondents' views are being shaped by NAMI dogma, that dogma has, in turn, been shaped by families' experiences, as NAMI is a grassroots organization whose officers and founding members all have mentally ill relatives and whose policies reflect the needs and experiences of the families who make those policies. Moreover, whether NAMI has created or merely represented family views (and the latter seems more likely), the practical fact remains that families are currently concerned about stigma and see it as significantly affecting their lives and the lives of their ill relatives. It is also possible that the sources of stigma are not as these families see them. Once again, their expressed views that media depictions—film portrayals and news coverage—are the most significant contributors to stigma may be colored not by their experience but by their organization's forceful suggestion that this is the case. Or, families may be focused on the most visible and offensive communications about mental illness but be wrong that these are the most influential. However, family views of the sources of stigma are consistent with those of others (e.g., Gerbner 1980; Wahl 1980; Wahl and Roth 1982) who have singled out the mass media as influential reinforcers of persisting negative conceptions of mental ill-

ness. Moreover, once again, the concerns of families, whatever their source or accuracy, remain. Families are troubled by psycho-killer films and news headlines of crimes associated with mental illness; they see jokes about mental illness and commercial use of mental illness in T-shirt and coffee mug slogans to be adding to the stigma of mental illness. The establishment of "media watch" committees by NAMI and other organizations to monitor and react to stigmatizing public images would seem an appropriate response to the kind of concerns these families are expressing. As noted earlier, the generalizability of our results is limited by the nonrandom nature of our subject selection. Our respondents, for example, are those whose ill members typically suffer from severe mental illnesses like schizophrenia or bipolar depression. Given the literature suggesting that negative reactions are greater toward those with more severe and overt psychopathology, it is very possible that the families studied have experienced more stigma than families with less severely ill relatives. It is also the case that these families have joined a support organization like NAMI. It could be that their greater experience of stigma is one of the things which led them to join. It is equally possible, as some NAMI representatives have suggested, that the experience of stigma prevents rather than encourages people to acknowledge the illness of their relative by joining such an organization or that involvement with other people who also have mentally ill relatives has lessened their perceptions of stigma. Finally, respondents are further self-selected by choosing to fill out and return our survey; it


sense of being stigmatized without being able to put its specific consequences into words. It may be also that the questions selected for the questionnaire, although done with the consultation of NAMI representatives, do not tap into the correct areas of stigmatization effects. Or, it is possible that the expectation of stigma is greater than the actual experience of it. Asked if families, in general, are affected adversely by stigma, more than half the respondents say "yes, much or very much"; asked to describe the effects they have personally experienced, most (49 to 75 percent; see table 3) say stigma has affected them "little or not at all" with respect to the categories offered. Individual family members may expect that, even though they have not experienced loss of self-esteem, family relationship disruption, etc., as a result of stigma, other families frequently do. The possibility that the actual experience of stigma is often less than what people expect is, in many ways, an optimistic finding. However, the expectation itself— the perception of stigma—may be enough to produce problems for families with those expectations. Previous research has shown that expectations of mental illness stigma can and do undermine interpersonal and other performance (e.g., Farina et al. 1971). Although such research has focused on the person labeled as mentally ill, similar processes based on expectations of negative public reactions likely apply to families as well. Belief that others may look down on you and blame you could certainly affect self-esteem regardless of the truth of that belief. Belief that your spouse or children see you as responsible for the mental disability of your family member could cer-


138

relieving them from the burden of stigma—greater attention to the issue of stigma and to its impact on all the members of families of those with mental illnesses will be needed.

References Anonymous. First person account: The quiet discrimination. Schizophrenia Bulletin, 7:736-738, 1983. Bernheim, K.F., and Lehman, A.F. Working With Families of the Mentally III. New York: W.W. Norton & Company, Inc., 1985. Clausen, J. The family, stigma, and help-seeking behavior. In: Rabkin J.G.; Gelb, L.; and Lazar, J.B., eds. Attitudes Toward the Mentally III: Research Perspectives. (DHHS Publication No. ADM 80-1031) Washington, DC: Superintendent of Documents, U.S. Government Printing Office, 1980. pp. 31-34. Farina, A.; Gliha, D.; Boudreau, L.A.; Allen, J.C.; and Sherman, M. Mental illness and the impact of believing others know about it. Journal of Abnormal Psychology, 77:15, 1971. Fuchs, L. First person account: Three generations of schizophrenia. Schizophrenia Bulletin, 12:744-747, 1986. Gerbner, G. Dreams that hurt: Mental illness in the mass media. In: Baron R.; Rutman I.; and Klaczynska, B., eds. The Community Imperative. Philadelphia: Horizon House Institute, 1980. pp. 19-23. Manis, M.; Hunt, C.L.; Brewer, M.; and Kercher, L. Public and psychiatric conceptions of mental illness. journal of Health and Social Behavior,

6:48-55, 1965.

Mirabi, M.; Weinman, M.; Magnetti, S.; and Keppler, K. Professional attitudes toward the chronically mentally ill. Hospital & Community Psychiatry, 36:404-^05, 1985. Mittleman, G. First person account: The pain of parenthood of the mentally ill. Schizophrenia Bulletin, 11: 300-303, 1985. Morrison, J. Attitudes of community gatekeepers and psychiatric social workers toward mental illness. Journal of Community Psychology, 7:147-150, 1979. Rabkin, J. Therapists' attitudes toward mental illness and health. In: Gurman, A., and Razin, A., eds. Effective Psychotherapy: A Handbook of Research. Oxford: Pergamon Press, 1977. pp. 162-168. Rabkin, J.G., and Crawford, M.Z. "How the General Public and Mental Health Specialists View Mental Illness." Unpublished manuscript prepared for the NIMH Depression Awareness, Recognition, and Treatment (D/ART) Program, Rockville, MD, 1987. Rabkin, J.G.; Gelb, L.; and Lazar, J., eds. Attitudes Toward the Mentally III: Research Perspectives (DHHS Publication No. ADM 80-1031) Washington, DC: Superintendent of Documents, U.S. Government Printing Office, 1980. Torrey, E.F. Surviving Schizophrenia: A Family Manual. Rev. ed. New York: Harper & Row Publishers, Inc., 1988. Wahl, O. Mental illness in the media: An unhealthy condition. In: Baron, R.; Rutman I.; and Klaczynska, B., eds. The Community Imperative. Philadelphia: Horizon House Institute, 1980. pp. 95-103. Wahl, O., and Roth, R. Television images of mental illness: Results of a Metropolitan Washington Media


may be that only those most sensitive to and concerned about stigma responded; those who did not see it as a problem may not have responded. All of these possibilities suggest that this sample's strong concerns about stigma cannot be taken to characterize all families with mentally ill relatives, especially those whose family members may have milder disorders. This study's data also do not speak to the mechanisms of stigma's impact on families. Are family relationships disrupted, for example, because of actual experiences with nonaccepting others, because of the ill relative's feelings of being blamed and rejected, or because of the family's expectations of judgmental responses from others? Similarly, the study does not clarify what aspects of professional responses are seen as helpful or harmful. Such information would certainly be useful, and further study to obtain this type of information is recommended. Despite the above-mentioned limitations, results from this large sample of families with mentally ill relatives provide clear evidence that substantial concerns about stigma exist among such families. Moreover, the concerns are not only for the harmful effects of stigma on mentally ill persons but also for the ways stigma hurts the other members of that mentally ill person's family. Whatever arguments continue about the existence and extent of mental illness stigma, many families of mentally ill individuals perceive it, feel it, and expect it— both for themselves and their ill relatives. If mental health professionals are to better serve the needs of these families—and to overcome the apparent feeling among many family members that mental health professionals are not very helpful in

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Watch. Journal of Broadcasting, 26:

599-605, 1982.

The Authors

Walsh, M. Schizophrenia: Straight Talk for Family and Friends. New

Otto F. Wahl, Ph.D., is Associate Professor, Department of Psychology, George Mason University,

York: Warner Books, 1985.

The annual meeting of the New Clinical Drug Evaluation Unit (NCDEU), sponsored by the Pharmacologic and Somatic Treatments Research Consortium, Division of Clinical Research of the National Institute of Mental Health (NIMH), will take place on May 30-June 2, 1989, in Key Biscayne, FL. This will be the 29th annual meeting of the NCDEU program. The program was established in 1959 by the NIMH as the Early Clinical Drug Evaluation Unit (ECDEU) program with 15 grantees. It has developed into the current format of planned symposia and

free communications. Sessions focus on recent research findings in psychopharmacology, methodologic problems and advances in clinical trials in this area, and updates or reviews of significant issues in the field. For further information, please contact: Elaine G. Pearl NCDEU Coordinator Pharmacologic and Somatic Treatments Research Consortium, NIMH Room 10C-06 5600 Fishers Lane Rockville, MD 20857


Announcement

Fairfax, VA. Charles R. Harman, M.S., is Director of Public Relations, National Alliance for the Mentally 111, Arlington, VA.
