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Most accidents are unpredictable, but the accident involving a Senegalese ferryboat that capsized off the coast of Gambia on September 26, 2002, was not. It might have been avoided if the officials in charge had not been negligent. The boat was in need of repairs and overloaded to more than three times its capacity.

Almost 2,000 passengers were crammed onto a boat designed for 550. When a storm came up, they all rushed to the same side of the ship for protection and caused it to tip. There were few survivors. The boat capsized in the evening, but the alarm was not sounded until the following day. Divers who arrived nine hours after the alarm heard people banging inside the upturned hull. Passing fishing boats rescued 64 passengers clinging to the sides of the boat. A total of 1,863 people died, but only 352 bodies have been retrieved. It was one of the worst maritime disasters in history. The Titanic disaster claimed 1,513 lives. Little was said about the accident in Senegal. A country with no infrastructure is always on the brink of disaster.

There were 30 Europeans on board. One was saved; six bodies were identified, and 23 are missing. My husband's 21-year-old granddaughter is among the missing. She was on her way to Dakar with a friend to fly home to Paris to start her third year as a psychology student at a university there. She was a good student, and we thought she might come to New York for graduate studies. The boat trip was her choice. No one forced her to take it. Even if she had been warned of the lack of infrastructure and disregard of rules in a developing country such as Senegal, she would not have listened. Taking advantage of her budding independence, she did as she pleased.

My husband and I were in France at the time of the accident. We had planned to meet our daughter and her husband at a party, but after they received the news, they were too upset to attend. We hoped to put our arms around them and share their mourning before we returned to New York, but overcome with grief, they refused to see or talk with anyone. Unable to share their sorrow, they withdrew from contact with family and friends.

What can be sadder for parents than the loss of children? Time stops; the future is nonexistent; lives are unfulfilled. There was no memorial service. A loss without a body is not real. Bodies are testimonials of death. When we returned to France a month later we hoped to see our daughter and her husband, but still they were not communicating. It was impossible for them to accept the loss without a body, without tangible proof of death.

Our granddaughter's death was also a tragedy for us, but loss is not new. We had already suffered the loss of a child. Although he did not die, we lost our son to schizophrenia almost 30 years ago, when he was 15 years old. Once attractive, intelligent, and articulate, his change into an unshaven, dirty, irritable, hallucinatory, and delusional boy, estranged from loved ones, caused endless suffering. Like our daughter and her husband, at first we could not talk to anyone or show our grief. We withdrew from our friends.

Parents' pain from the loss of a child to mental illness is often not understood by parents of children who die from an accident or illness, because the mentally ill child still exists. Dead children are lost forever. After the diagnosis is finalized, parents are overwhelmed by confusion and feelings of helplessness. The knowledge that there is no complete cure for severe mental illnesses, such as bipolar disorder and schizophrenia, gradually erodes parents' initial enthusiasm over a new medication, a different treatment, or a change in behavior, however small. Knowing that one's child will almost always be dependent on medication, yet ready to stop taking it because of side effects or the belief that it is no longer necessary, adds to the depression. When a person with a psychotic mental illness stops taking medication, there is always a chance that he or she may become violent and dangerous.

Our son was misdiagnosed as a teenager in the turmoil of an adolescent revolt, and the treating psychiatrist labeled us as intrusive and rigid parents with chaotic thinking. The fact that my mother, brother, and several cousins have schizophrenia carried no weight. The psychiatrist continued to accuse us of emotional abuse and said that if we insisted that our son return to school, we would provoke him into running away or harming himself and others. We were told to wait patiently until he made the decision to go back, and we ignored the smell of marijuana under his door.

At first his father and I were ashamed. How could our good middle-class son drop out of school, smoke pot, and hang out with delinquent kids in the neighborhood? Initially I was relieved by the diagnosis of incipient schizophrenia made at the Payne Whitney Clinic. Unrealistic hope that our son would recover made me forget that after my mother became ill at age 27, she remained ill the rest of her life. Our son will be ill the rest of his life too. Adolescence has a time limit; schizophrenia does not. My son is now 44 years old. He has perhaps 40 years of mental illness ahead of him.

I am not bitter, only sad. I have been in mourning for more than 25 years. The anguish of bereavement never lessens, and the death of our granddaughter has increased the pain. Infrequently our son Serge makes a comment that he might have made if he were not mentally ill, and flashes of our former son emerge briefly before retreating into his damaged brain, reactivating the mourning process. He is fairly stable now, but years of psychosis have resulted in severe regression. His future? Displaying outsider art in the yearly art show of his treatment program.

Two years before Serge's birth, I had a stillbirth during the ninth month of pregnancy, a result of the Asiatic flu. I rue my decision not to have another child after Serge, one to look after a sick brother when his parents are no longer able. Serge's half-sister is too far away to help, and by now she hardly knows him. When her daughter decided to study psychology, my husband and I had hopes that she might be interested in her uncle's problems. Will time lessen the pain, leaving only fond memories? Or will her parents be like parents of a child with mental illness, whose mourning begins anew with each reminder of the lost child?

Ms. Lanquetot is a writer and retired psychologist and teacher, who worked with children on the inpatient children's service of Bellevue Hospital in New York City for 27 years. She is on the leadership council of NARSAD, the Mental Health Research Association. Send correspondence to her at 315 West 106th Street, Apartment 10F, New York, New York 10025 (e-mail, [email protected]). Jeffrey L. Geller, M.D., M.P.H., is editor of this column.