This year’s NAMI North Carolina annual spring conference in Raleigh was a tremendous success with attendance at an all-time high. Our presenters included such nationally known speakers as Dr. E. Fuller Torrey, research scientist Dr. Jeffery Lieberman of the University of North Carolina at Chapel Hill, Dr. Marvin Swartz of Duke University, and Carmen Hooker Odom, Secretary of the North Carolina Department of Health and Human Services. Mental health reform and its implementation, new insights into the treatment of mental illness, advance directives, valuable medication updates, and NAMI National’s state monitoring project were just a few of the topics that stimulated spirited discussion. Other speakers shared their stories as consumers. Accounts of their struggles to lead normal and fulfilling lives inspired us all.

I would like to express my sincere thanks to our outgoing board members, Gerale Condron and Grace Davis, who gave much of themselves in their service to NAMI North Carolina. Grace was our secretary and served on the executive committee; Gerale served on the public policy committee.

Congratulations to our newly elected board members Jane Burdick, Ed Masters, Carol Mathieu, Floyd McCullouch, Moira Pearson, and Bill Wesse, and welcome to K. Hardy, our consumer council representative. I look forward to working with the entire board and staff in the coming year.

It is my privilege to report to you that all three proposed changes to our bylaws sent to members on this year’s ballot were overwhelmingly approved prior to this year’s conference.

Finally, I would like to express my gratitude to everyone who attended this year’s conference and helped make it so successful. It is exceptionally clear to me that NAMI North Carolina remains North Carolina’s voice on mental illness!

Thanking you,
Ken Farrington

Who to call? Your affiliate coordinator or Beth Greb, Director of Affiliate Relations for NAMI North Carolina, at 919-788-0801.

What are we offering? Training to be Family-to-Family teachers with certified trainers Jim and Sue Rider.

When? August 1-3, 2003.

Where? North Topsail Beach, North Carolina.

Why? Teaching Family-to-Family is a fantastic experience.

How? Final arrangements are being made by John Gaskill, Eastern Regional Manager for Family-to-Family, at 252-838-0017.

It was with great sadness—but also with great pride in the extraordinary range of her achievements on behalf of NAMI North Carolina—that we announced recently that Beth Melcher, Director of Public Policy, had resigned her position with NAMI North Carolina. She has moved on to a position as project director of a federal grant on implementation of best-practice services for people with mental illness in North Carolina.

Beth has selflessly given so much to help so many in her nine years with NAMI North Carolina. She has been a continuing inspiration to all of us who work so hard to make a difference for those with brain disorders. We know that Beth will continue to support NAMI North Carolina’s policy program just as we will continue to support her in her new position. We wish her the very best and know that she will continue to make a critical difference for people and their families living with mental illness in the state of North Carolina.

Please join us in thanking Beth for her significant contributions to NAMI North Carolina. She will be deeply missed.

Ken Farrington, President
Kay Flaminio, Executive Director

NAMI North Carolina has been a central part of my life for nine years. I am proud of my tenure with NAMI and of all the things we have accomplished together. You will always have a special place in my heart. As I move on to a new opportunity, I take all that you have taught me about dealing with mental illness, and about hope, courage, perseverance, and friendship. Thank you for the opportunity to work with you and for the times we have spent together. This is not "good-bye," just "until we meet again." Best wishes to you all.

Beth

It is a pleasure to report that we have received many, many positive comments about our nineteenth annual spring conference with most people agreeing it was our best one ever. It was held April 25-26 at the North Raleigh Hilton and there were 350 people in attendance, up from our previous highest number of 260. It is clear from conference evaluations that the variety and high caliber of this year’s speakers were the overwhelming reason for our success, and we are most grateful to them for taking valuable time from their busy schedules to help our advocates gain greater understanding of so many complex issues. We are also grateful to our affiliate leaders across the state for encouraging attendance, and to our board and staff who helped ensure that things ran so smoothly.

High ratings went to all of our speakers, notably to our Friday afternoon speakers Dr. Rick Birkel, Executive Director of NAMI National, Dr. Suzanne Vogel-Scibilia, also of NAMI National, and keynote speaker Dr. E. Fuller Torrey. Dr. Birkel presented a thorough overview of NAMI National’s current major project to measure the quality of mental health services across states, a project that promises to take NAMI to the next level as the nation’s voice on mental illness. Dr. Vogel-Scibilia described many of her personal experiences with medical providers as she was coming to terms with her mental illness and also training to become a provider herself. Her insights about the communication barriers between patients and their providers were both deeply moving and profoundly funny.

Dr. Torrey, the final speaker on Friday afternoon, had many thought-provoking comments to make about the pharmaceutical industry, research on serious and persistent mental illness conducted by the National Institute of Mental Health, and the possibility that mental illness is caused by a virus. Dr. Torrey was kind enough to remain with us throughout Friday afternoon, and ended the day by signing copies of his books and answering questions from many of our attendees. It was truly an honor to have him with us.

The host for our lead speakers was the incomparable Eileen Silber, former president of NAMI North Carolina and currently serving on the boards of both NAMI National and NAMI North Carolina.

The presentations on Friday morning also went well. Carmen Hooker Odom, Secretary of The North Carolina Department of Health and Human Services, opened the conference and answered some tough questions from the audience about the state’s commitment to making sure community services are in place before hospital beds are closed. A panel discussion on implementation of mental health reform followed, moderated by Beth Melcher, Director of Public Policy for NAMI North Carolina. Panelists were Dr. Harold Carmel, Clinical Director, John Umstead Hospital; Tom Maynard, Director, Orange-Person- Chatham Area Program; Christopher Phillips, Chief, Advocacy and Customer Services Section, North Carolina Division of Mental Health; Dr. Brian Sheitman, Clinical Director, Dorothea Dix Hospital; and Sheldon Silk, Consultant, Telecare Corporation.

The highlight on Friday was the awards luncheon, the time each year when NAMI North Carolina recognizes the extraordinary contributions made by its dedicated volunteers across the state. Award winners this year were all people treasured by their local communities, as well as clear favorites for our largest-ever awards luncheon audience. The winners were Lucille Clontz and Roselynd Myers, Advocates of the Year, nominated by NAMI Union County; Bob Geary of The Independent Weekly, winner of the Media Award, nominated by NAMI North Carolina; Karl Schroeder, MD, Mental Health Professional of the Year, nominated by NAMI Western Carolina; and Shirley Vann, President’s Award, nominated by NAMI Guilford County. On June 30 following the conference, Lucille Clontz and Roselynd Myers were pictured on the front page of their local newspaper, The Enquirer-Journal of Monroe, North Carolina, with their award plaques in hand! We are so proud of all our winners this year and thank them again for all their efforts on behalf of people and their families living with mental illness.

Saturday’s schedule opened with the NAMI North Carolina Annual Meeting and Question-and Answer Session With Board and Staff. Meeting facilitators Ken Farrington, President, and Kay Flaminio, Executive Director, opened the meeting by introducing board and staff members in attendance. On behalf of the board and staff, Kay presented flowers to long-time staff member Linda Buzard for her work on the conference.

Ken announced that all three bylaws changes on this year’s ballot were passed overwhelmingly by the NAMI North Carolina membership, and the following individuals were elected or reelected to the board by a very close vote: Jane Burdick, Rich Greb, Tom Hadley, Beth Garriss Hardy, Ed Masters, Carol Matthieu, Floyd McCullouch, Moira Pearson, William Wesse, and Mary Ann Widenhouse. Ken also thanked outgoing board members Gerale Condron and Grace Davis for their dedicated service to NAMI North Carolina.

Kay reported on initiatives over the past year including: (1) the hosting of our first regional meetings for affiliate leaders so that we can provide stronger technical assistance to our affiliates and work toward having the strongest affiliates in the country; (2) development of a plan to double the number of people served through the Family-to- Family Program over the next two years; (3) establishment of the NAMI North Carolina Consumer Council, an advisory group to the NAMI North Carolina Board of Directors; (4) development of a comprehensive public policy agenda published on our website along with technical assistance bulletins to facilitate understanding of mental health reform at the local level; and (5) development of a stronger fundraising program and financial management practices to ensure that NAMI North Carolina will prosper in the future. Thanks to our friends and supporters, NAMI North Carolina receives more financial support from individual donors than any other state office in the country, making us financially independent of our state division of mental health and pharmaceutical companies—an achievement we can all be proud of. Tom Hadley, Treasurer, noted, however, that this year’s fundraising climate had been difficult due to the state of the economy and that NAMI North Carolina would therefore have continued work to do in this area in the coming year. The annual meeting closed with questions from the audience.

The annual meeting was followed by a comprehensive presentation on advance directives by Dr. Marvin Swartz, Professor and Head, Division of Social and Community Psychiatry, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center. Dr. Rick Birkel introduced the final conference speakers who provided research updates on schizophrenia and mental illness in children and adolescents, followed by ask-the-doctor sessions on manic depression, mental illness in children and adolescents, and schizophrenia. Dr. Jeffrey Lieberman, Thad and Alice Eure Distinguished Professor of Psychiatry, Director of the Mental Health and Neuroscience Clinical Research Center, University of North Carolina School of Medicine, covered the topic of schizophrenia. Dr. Lin Sikich, Assistant Professor of Psychiatry, Division of Child Psychiatry, University of North Carolina at Chapel Hill, addressed mental illness in children and adolescents, while Dr. Swartz answered questions about manic depression. NAMI North Carolina is fortunate to have such renowned experts on mental illness as friends and colleagues.

Without financial support from outside organizations, NAMI North Carolina would not have been able to put on such a high-quality conference. Our corporate sponsors and exhibitors made it possible for us to keep down our registration costs. This year for the first time, NAMI North Carolina was also able to provide scholarship assistance to ten percent of its conference attendees. We are grateful to the North Carolina Division of Mental Health for helping us make our conference a reality for people who would not have been able to come otherwise.

Corporate sponsors this year were Eli Lilly, special sponsor of our reception on Friday evening, Abbott Laboratories, Bristol-Myers Squibb, and Janssen Pharmaceutica. Exhibitors were Abbott Laboratories, AstraZeneca, Barium Springs Home for Children, Bristol-Myers Squibb, CooperRiis: A Healing Farm, Dix Hospital Clinical Research Unit, Janssen Pharmaceutica, Eli Lilly, NAMI National (Featuring In Our Own Voice From Western North Carolina), NAMI North Carolina (Featuring the Exceptional Children’s Assistance Center/Families United, Life Plan Trust, and the North Carolina Division of Mental Health), NAMI Wake County, the North Carolina Council of Community Programs, the North Carolina Mental Health Consumer Organization, Novartis Pharmaceuticals, Pfizer Inc., Telecare Corporation, and the Vocational Rehabilitation Services Client Assistance Program. There was also a special display from the STEP Art Gallery of the University of North Carolina at Chapel Hill Department of Psychiatry.

We thank everyone who attended our conference this year. It was an inspiring experience.

Kay Flaminio
Executive Director

"I don’t feel alone or helpless anymore."

"The most outstanding NAMI North Carolina conference I have attended since joining in 1997."

"Sore rear end, but worth it!"

"Absolutely first-class conference. First-class panels, experts, etc."

"This has been a great weekend!"

"Best conference ever!"

"Kay and staff, best NAMI North Carolina conference I’ve ever attended!"

"It was good to have the mix of national and state perspectives on the current state of mental health . . . "

"Information on reform was especially good. I finally understand what is going on!"

"I enjoyed personal stories told throughout conference and at awards luncheon."

"Great to have so many points of view represented."

"The 'In Our Own Voice' presentation at the end of the day was excellent! Please have more of these!"

As the new chair of the NAMI North Carolina Consumer Council, I am pleased to have this opportunity to introduce myself to the members of NAMI North Carolina. I live in Burlington with my husband of 18 years, my 10-year-old son, and two Labrador retrievers. I have enjoyed meeting many of you already and look forward to meeting many others as the reach of the consumer council expands across the state.

The NAMI North Carolina Consumer Council held a very productive organizational meeting during the NAMI North Carolina Annual Spring Conference in April. A record number of consumers convened during the conference and were able to meet and mingle with other consumers from all over the state. Consumers had their first-ever "hospitality room."

The NAMI North Carolina Consumer Council annual business meeting resulted in the election of John “Chim” Maddox as vice chair. Chim represents the NAMI Western Carolina affiliate. During the business meeting, the council had the opportunity to establish working committees in two important areas: (1) the creation of a NAMI North Carolina Consumer Council website, and (2) the development of operating procedures, which will establish guiding principles by which the council will operate. Flowing from the results of these two hard-working committees, the consumer council will make recommendations to the NAMI North Carolina Board of Directors regarding procedures, activities, and initiatives that will help the council to become fully operational.

Tom Lane, Director of NAMI (National) Consumer Affairs, has been providing invaluable technical assistance and leadership skills to NAMI North Carolina Consumer Council members through the use of emails, teleconferences, trainings, and personal meetings at various conferences. Tom is serving as a member of both the operating procedures and website development committees. During the spring conference, he presented council members with consumer leadership toolkit modules to help consumers develop awareness in coalition building and action planning. These modules addressed various topics related to skill building for council members, including brainstorming, information sharing, action planning, timelines, reaching goals, reporting, and recommendations.

An expert in technical assistance related to consumer leadership development, Tom also developed a needs assessment tool for use with the NAMI North Carolina Consumer Council during the April meeting. The needs assessment was used to identify individual skills and leadership needs, communication preferences, and areas of interest for council members. The results are being analyzed, with customized results expected in July.

For purposes of ensuring support and encouragement from the NAMI North Carolina Board of Directors, Ken Farrington, President, established the NAMI North Carolina Joint Task Force on Consumer Inclusion. Approved by the board on March 29, this task force is chaired by Dr. Beth Garriss Hardy, President Elect. Beth spoke to the consumer council at the spring conference. She provided an overview and scope of work for the joint task force, which is charged with: (1) serving as liaison to strengthen communications between the consumer council and board/staff, (2) providing technical assistance to the council in addressing issues as they arise, and (3) collaborating with the council to identify potential resources to enhance support for the development and successful functioning of the NAMI North Carolina Consumer Council. While this is clearly an ambitious agenda, this approach to assisting the consumer council in its early stages of development seems promising, and is gladly embraced by all those involved!

I look forward to working closely with the board, task force, and consumers in the coming year, and hope to meet more NAMI North Carolina members in the future.

K. Hardy, Chair, NAMI North Carolina Consumer Council

NAMI North Carolina, in association with experts from the University of North Carolina School of Social Work, Duke Psychiatry, and the University of North Carolina Shepps Center, has completed a review of the Local Business Plans submitted by programs identified as being in the first phase of reform efforts.

North Carolina is in the midst of a comprehensive effort to reform its public MH/DD/SA system. While there are many reasons for this reform, central to it are a number of principles that form the vision for a better service system. Among these principles are a personal recovery focus; consumer/family involvement and choice; community collaboration, integration, and involvement; clinical, administrative, and fiscal accountability; and identification and provision of best practice services to those populations most in need, i.e., "target populations."

The initial mechanism through which reform is operationalized is in the development and implementation of Local Business Plans. Local Business Plans were to be developed through a community-based inclusive and interactive strategic planning process led by the Area Programs/Local Management Entities (LMEs). The plans detail how communities will meet state expectations around the goals and vision of reform.

This review focuses on the underlying question of whether the submitted Local Business Plans reflect a move toward meaningful reform and underlying principles articulated in the state reform plan. In short, the question behind the review is, "By implementing these plans, to what extent will communities achieve the goals of reform?"

The review concludes that the current Local Business Plans reflect good first steps toward a comprehensive reform effort. For reform to be successful, however, these plans will need to be refined and improved over time through a partnership among the state, LMEs, and community stakeholders. Policy and operations will need to change at both the state and local levels. Key elements that need additional attention:

• In the absence of financial data, clear financial objectives, and lack of programmatic direction from the state, the Local Business Plans are difficult to evaluate and are in themselves not appropriately termed "business plans." Fully articulated business plans should be requested soon after LMEs are given the financial data and other direction with which to complete them.
• The structure of the Local Business Plan itself should be reviewed and refined. There is a need to reduce redundancy, particularly in the areas of quality management/quality improvement, non-target populations, and the development of community supports. Clarity of the information requested also needs to be refined. Throughout this review we identify a number of areas in the Local Business Plans that need improvement. Often what is needed is more clarity in expectations.
• To provide clarity, the Division of MH/DD/SA will need to provide leadership to better define its expectations, particularly in areas that have cross-program and statewide implications. Specifically, the division needs to clearly articulate expectations for quality indicators, provider profile dimensions and provider technical assistance, outcome measures (system and individual), best practices, development of community supports, and client rights. We strongly believe that the development of these expectations needs to come from the state, not 20-30 different programs.
• The establishment of a statewide appeals and grievance process for all clients and the support and integration of client rights activities into quality management processes are essential. The state should immediately address these issues.
• At the present time there is no consensus around the critical areas of qualified provider network development and quality management and far too much variability around how these are defined and how they should be operationalized. The division needs to facilitate the development of this consensus and should consider involving not only LME staff, but also national consultants to develop state-of-the-art protocols in these areas.
• At the state and local levels there must be an investment in meaningful technical assistance in all areas. We are concerned that the massive changes created by reform efforts are being undertaken without the resources and expertise to make the change positive and successful.
• The Local Business Plans themselves should become vehicles for system quality improvement. The written Local Business Plans should be updated and refined based on division feedback and further clarification and development as noted above.

It is hoped that leaders at the state and local levels will use the observations and recommendations contained in this review to move forward to the next level of implementing meaningful reform of the MH/DD/SA system.

The full review can be found at: http://www.naminc.org/RTR/RTRhome.htm.

Beth Melcher

CooperRiis, a Healing Farm Community, is open! We are so pleased to announce to you that the comprehensive recovery program of CooperRiis, a healing farm community in western North Carolina, is now accepting its first residents. An incredible journey has led us to this moment.

It began several years ago as my daughter first experienced the anguish of mental illness. Like many of you, I have seen my daughter live through dis-integration, dis-ease, noise, anguish, torn relationships, anger, loss of self, and despair. As my husband Don and I looked for help for her, we met fragmented care, which was never enough. It was guided by the dictates of (un)managed care, and too often managed by providers who focused only on the dis-embodied mind. We began to join the ranks of isolated, frustrated families, who were always left with the pieces and no peace.

Instead of succumbing to anger, Don and I began to imagine a place of integration for individuals with mental illness, where wholeness could be recovered, where isolation could be replaced by relationship, where the mind and the body and spirit could be nurtured within nature. The concepts for CooperRiis began to emerge, and we incorporated as a 501(c)(3) nonprofit. We filled our hearts with the desire to be well as a family and began to empty our wallets, and those of others, through a groundswell of philanthropy.

Over a four-year period, Don and I raised almost $10 million! Together, we have guided the process of discovering land, designing and building our campus, and engaging our staff. Our dream is becoming reality and our joy is now increased as we also see our daughter Danie’le joining as an active CooperRiis volunteer after her recent successful semester of college.

We envision CooperRiis as:

• A "healing farm community" which gets its approach and structure from a therapeutic community model that has been in practice for eighty years. The central concept is a living environment where staff and residents live, learn, recreate, and work together as a functioning community.
• A new paradigm of psychiatric care, with an emphasis on relationship-centered care and a strong holistic component that affirms and honors the “whole” person.
• A comprehensive residential program utilizing multiple opportunities:
  • service and work training
  • recreational, cultural, and arts experiences
  • nutritional and physical exercise coaching
  • psychotherapy and psycho-education
  • access to expert psychopharmacology
  • smoking cessation guidance
  • massage therapy, reflexology, and access to complementary modalities such as acupuncture
• A process that considers the physical, mental, emotional, and spiritual dimensions of life, not just the disembodied mind.
• A modern complex on an 80-acre farm in the town of Mill Spring, North Carolina, about 40 miles southeast of Asheville, North Carolina.

CooperRiis accommodates up to 36 residents in three lodges where each resident has a private bedroom and private bathroom. Residents are 18 or over, are treatment-compliant, and desire to improve their mental health. They are usually diagnosed with schizophrenia or schizoaffective disorder, bipolar disorder, depression, or personality disorders.

After an average stay of six months, residents may transfer to the CooperRiis Graduate Program, which will provide long-term supportive housing and growth and employment opportunities in Asheville. Given that residents may come to CooperRiis from anywhere in the world, we also assist in the planning of smooth transitions for those who wish to return to their home communities.

The hope that Don and I have is that CooperRiis will serve thousands in the years to come and that our demonstration of successful outcomes will kindle hope far beyond CooperRiis and in the hearts of others with the will to be well and the resolve to be creative. Please visit us. We hope that we may be of help to your family member.

We have also managed to open CooperRiis with a method for providing significant scholarships. Please call our executive director at 828-894-5557 to learn more or visit our website at www.CooperRiis.org. By the way, we are not finished fundraising. Don and I are determined not to stop until CooperRiis is truly financially need-blind for all who may benefit from its services.

Sincerely yours,
Lisbeth Riis Cooper
Mother

To contact us personally, please call 828-625-1589 or email:
Lisbeth@CooperRiis.org
Don@CooperRiis.org

The board of CooperRiis, a Healing Farm Community for individuals with mental illness founded by Lisbeth Riis Cooper and Donald R. Cooper, has hired its executive director team, Virgil and Lis Stucker, who have recently moved from Massachusetts to their newly renovated home on CooperRiis.

According to board chairman Donald Cooper, "We are blessed that Virgil and Lis Stucker have agreed to join us. They lived, worked, and raised four children during fourteen years at Gould Farm in Massachusetts, which is one of the models we have been following. Additionally, they co-founded Rose Hill in the Midwest. Their commitment to our dream is personal and emotional and their skills and experience bring wonderful expectations for us all. This has truly been a very special development that speaks so well for our future."

Virgil Stucker was recently President of the REACH Community Health Foundation, Vice President of Planning and Development for Northern Berkshire Health Systems, President of the Berkshire Taconic Community Foundation, and Adjunct Professor of Philanthropy for the Visionaries Institute of Suffolk University. His wife Lis has been a special education teacher and is now a nationally certified and licensed massage therapist.

According to Mr. Stucker, "We feel privileged to join Don and Lisbeth and the CooperRiis Board in their efforts to help individuals with mental illness to recover hope, creativity, and fulfilled lives. Lis and I are truly amazed at the progress that CooperRiis has made already and believe that this new and special therapeutic community promises to become a regional and national leader in the mental health field. We are excited about beginning to serve our first residents in June."

CooperRiis will have 30 staff to serve its 36 residents. Its clinical team includes psychiatrist Robert Jolley, MD, MSPH, clinical psychologist Sharon Leigh Young, PhD, and psychiatric and family nurse practitioner Robin Baskin. Their bios and those of other lead staff can be found at www.CooperRiis.org.

Brushes with Life: Art, Artists, and Mental Illness is a patient art gallery located on the third floor of the University of North Carolina (UNC) at Chapel Hill Neuroscience Hospital in the halls approaching the psychotic disorders inpatient unit. The gallery features artwork from former third-floor inpatients, current STEP clinic outpatients, or members from Club Nova, a local clubhouse in Carrboro. The psychotic disorders inpatient unit is a part of the Schizophrenia Treatment and Evaluation Program (STEP). The gallery first opened in December 2000. We change the entire gallery exhibition every six months and are currently housing our fifth exhibition which was installed in April 2003. Approximately 120 artists have had their artwork displayed in the five exhibitions of the permanent gallery.

The initial goal of the STEP art gallery was to give our patients a permanent art space to display their creativity and art to a wider audience. Additionally we hoped to promote art and healing. We also target stigma associated with mental illness, demonstrating that people with serious mental illnesses such as schizophrenia, schizoaffective disorder, and bipolar disorder can be productive and creative. It has also brightened the hallways in the space leading up to the STEP inpatient unit where we work each day and made the unit more appealing to patients, friends, and families. Feedback from staff, artists, and their families has been very positive about boosting our patients' self-esteem, encouraging creativity, and promoting a better treatment atmosphere on our inpatient unit.

The idea for a gallery formed in the spring of 2000. Wen Crenshaw, one of the recreational therapists on staff, had the original idea and was the first chairman of the STEP art gallery committee. The committee was formed with representation from staff in the areas of recreational therapy, medicine, nursing, occupational therapy, and social work. We also added the interior designer for UNC Hospitals, the public relations person for the department of psychiatry, and one of our artists. A different artist serves on the committee each six months. The initial installation of permanent frames and lighting and ongoing framing needs was funded by UNC Hospitals. After numerous staff and volunteer hours, the committee celebrated the gallery's opening and first showing with a reception to celebrate with the artists on January 9, 2001. Currently, Paula Mayence, RN, and Nancy Clayton, MD, serve as co-chairs for the STEP art gallery committee.

In addition to our permanent gallery on the third floor of the UNC Neuroscience Hospital, a traveling exhibition has begun. The idea is to reach a broader audience in the community and also provide educational information about mental illness. We have had smaller traveling exhibit displays at a local church in Chapel Hill in January 2002 and Arts United in Lexington from May to June 2002. A larger traveling exhibit display was recently displayed at Raleigh-Durham International Airport in Raleigh from October 2002 to April 2003. We have an even larger planned exhibition at the North Carolina Museum of Art slated for May to August 2004.

Most of the artwork displayed is for sale by our artists. We serve as a contact point for those inquiring about the sale of artwork. All profits from the sale of artwork go back to the artists. If you're interested in purchasing any artwork shown in the STEP art gallery exhibitions, call 919-966-0011 or email us at stepart@med.unc.edu.

The public is free to view the gallery during visiting hours of the UNC Hospitals. Please call the UNC Hospitals operator for visiting hours and directions at 919-966-4131. Information and artwork are featured on the UNC Department of Psychiatry website (www.psychiatry.unc.edu). We recently launched our own website (www.brusheswithlife.org.) which will be expanding in the future.

Nancy Clayton, MD
Assistant Professor
University of North Carolina at Chapel Hill Department of Psychiatry

Researchers at the University of North Carolina (UNC) at Chapel Hill School of Medicine are expanding nationwide clinical trials of antipsychotic medications to include the latest schizophrenia drug to receive approval for market use from the US Food and Drug Administration.

Aripiprazole (Abilify) was added to ensure that study results are relevant to current clinical practices, said Dr. Jeffrey A. Lieberman, principal investigator for the Clinical Antipsychotic Trials of Intervention Effectiveness, or CATIE, project and professor of psychiatry, pharmacology, and radiology at the UNC at Chapel Hill School of Medicine.

"The objective of the CATIE trials is to determine the relative effectiveness of antipsychotic medications, which have never before been extensively compared in the same trial," he said. "It's important to add newly available medications like aripiprazole so that the research is comprehensive. Ultimately, CATIE findings about these medications will enable health-care providers to make more informed and cost-effective choices about treatment."

The National Institute of Mental Health supports the CATIE project, led by the UNC departments of psychiatry and biostatistics. CATIE is the first large-scale comparison study of its kind. UNC was tapped for the project in 1999 and began enrolling participants in December 2000. Currently, 90 clinical sites in 27 states have enrolled more than 1,300 patients; completion of the trials is set for July 2005.

The CATIE trials examine which of the new generation of antipsychotic drugs are best for treating patients with schizophrenia and disruptive behaviors associated with Alzheimer's disease. Aripiprazole has been added to the list of antipsychotics being studied in the schizophrenia trial.

CATIE was originally designed to examine the effectiveness of the various classes of antipsychotic drugs represented by clozapine, risperidone, olanzapine, quetiapine, and perphenazine. Ziprasidone, which received FDA approval in 2001, was added to the schizophrenia trials in January 2002.

Unlike first-generation antipsychotic agents, which act primarily on the brain's dopamine system, the newer drugs being studied by CATIE also act on serotonin and other neurotransmitter systems. They also cost at least ten times more than the first-generation antipsychotics. Project results will help determine if they are effective and whether they are worth the higher price.

"The development of these new drugs has been like going from a one-size-fits-all Model T to today's many model options," said Dr. John Hsiao, National Institute of Mental Health project officer for CATIE. "The advancement is tremendous, but with so many new treatment options, we don't know which drug to use when. CATIE will show the effects of each medication and help clinicians choose which treatment is best for each patient."

The study is a multi-institutional effort led by UNC and managed by Quintiles Inc. of Research Triangle Park. UNC works with other academic centers to coordinate the trials, involving faculty from Duke University, the University of Southern California, Yale University, and the University of Rochester.

Lieberman and Dr. C. E. Davis, professor and chair of biostatistics at the UNC School of Public Health, are the project's co-principal investigators. Dr. Lon Schneider, professor of psychiatry, neurology, and gerontology at USC, and Dr. Pierre Tariot, professor of psychiatry and neurology at the University of Rochester, direct the Alzheimer's disease trials.

Key UNC investigators are Drs. Scott Stroup and Diana Perkins. Other investigators leading the trial are Drs. Joseph McEvoy, Marvin Swartz, and Richard Keefe at Duke, and Dr. Robert Rosenheck at Yale.

North Carolina sites include UNC, Duke, John Umstead Hospital in Butner, Dorothea Dix Hospital in Raleigh, Wake Forest University School of Medicine in Winston-Salem, and the Behavioral Health Center in Charlotte.

Sheryl W. McKelvey
University of North Carolina at Chapel Hill
Department of Psychiatry

NAMI North Carolina invited Trisha Lester, Vice President of the North Carolina Center for Nonprofit Organizations, Inc., to address affiliate leaders at a special training session held just prior to this year's spring conference. Trisha came to talk about the center's handbook called Standards for Excellence: A Self-Help Tool for Nonprofits' Organizational Effectiveness. This publication provides eight guiding principles related to a nonprofit's mission and program, governing body, conflicts of interest, human resources, financial and legal concerns, openness, fundraising, and public affairs and public policy. In addition, 55 specific standards offer practical steps to help nonprofits strengthen their operations.

Recently, NAMI North Carolina has promoted Standards for Excellence to other affiliate leaders from across the country at the NAMI National leadership conference held this past January, and is doing so again at this year's NAMI National conference in Minneapolis. Kay Flaminio, Executive Director, has also taken this tool on the road to retreats held by the boards of NAMI Western Carolina and NAMI Charlotte. The response has been enthusiastic because small, mostly volunteer-run affiliates need practical advice for their leaders all in one place.

Trisha Lester shared some of the highlights of Standards for Excellence and answered many questions posed by forty representatives from twelve affiliates crowded into a small room at the North Raleigh Hilton. An important topic that came up was conflict of interest. More than half of the affiliates represented at the session had husband-and-wife teams who are the core - and sometimes the only - leaders of their affiliates. Because such teams can give the appearance of possible conflict of interest, this situation should change over time as affiliates grow, Trisha said. In the meantime, the focus should be on leadership succession, and on developing clearly defined job descriptions for board members and other volunteers. She encouraged affiliate leaders to develop conflict-of-interest statements that board members and volunteers can sign on an annual basis. These should be used in conjunction with orientation for new board members and other volunteers.

A mission statement is among the most important elements of a nonprofit organization. Once an affiliate has a mission, it also needs to have clear policies and procedures for its volunteers and members. When there is an appearance of conflict of interest, policies and procedures will help avoid problems and settle disputes. Every year, a nonprofit needs to evaluate how well it is doing, and be willing to change to become more effective over time.

The training session addressed a number of other issues for governing a nonprofit organization. At our regional trainings this fall, more elements of Standards for Excellence will be presented. Our very special thanks go to Trisha Lester for helping us to get the ball rolling.

A copy of Standards for Excellence was given to each affiliate leader who participated in the training session. If you would like to obtain your own copy and learn more about the many wonderful nonprofit management resources the North Carolina Center for Nonprofits Organization has to offer, please visit their website (www.ncnonprofits.org).

Beth Greb
Director of Affiliate Relations