HONOLULU -- Several recent high-profile murders and suicides have shifted the focus on the state's growing mental health needs.

Last month, Mililani resident Michael James killed his wife and young son and then hung himself. James was diagnosed with bipolar disorder.

On Tuesday, his brother appealed to state lawmakers in a phone call to "allow this to be a wakeup call for Hawaii and the rest of the country."

The dilemma is how do you get help for those who need it before they hurt themselves and others?

"We now have two grieving families who have to grapple with the devastating and destructive effects of mental illness and it is our hope and prayer that no others should have to confront this issue in the painful manner we have had to," said Marya Grambs of Mental Health America of Hawaii.

Early diagnosis and treatment for people with emotional and behavioral disorders is key.

There is still a lot of shame and ignorance associated with mental illness. A House Health Committee hearing drew a single lawmaker and a roomful of mental health experts.

Those mental health advocates sounded the alarm.

Two years after the state settled the costliest mental health lawsuit in Hawaii's history, some say things are slipping.

"We are concerned that children aren't getting services and the families aren't getting access the services they need," Grambs said.

Among the barriers is a serious delay in filling vacant jobs within the Department of Health. There are 62 vacant positions.

While access to services is key, treatment can be complicated. Last month, multimillionaire Steven Thomas, who had the means to access the best health care available, threw himself off the Pali.

Like Michael James, Thomas suffered from bi-polar disorder.

Grambs fears as more and more people fail to get the help they need, "there are going to be more tragedies."