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This qualitative study was designed to elicit the family's perspective of their experience of the first hospitalization of a relative. A major focus of the study was the process by which families developed an understanding of mental illness and its treatment. During unstructured interviews, seven families explained how they interpreted unfamiliar events and surroundings. They identified their needs and concerns related to their interpretation of ‘mental illness', and they described their efforts to understand the patient from this perspective. The study identified processes by which families attached meaning to events: they reviewed past experiences and beliefs to make sense of the present experience; they examined their own behaviour as a contributor to the development of the illness; they observed and evaluated the hospitalization as treatment; and they asked questions about the future. The direction for nursing practice was identified in terms of providing support and information to families, as well as being aware of the emotional responses of families at all stages of the patient's illness.