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UNIT 3 ■ Care of Patients With Psychiatric Disorders
Real People, Real Stories: Dr. Fred Frese
Karyn: So since you were knowledgeable about the laws, you could essentially be your own self-advocate and argue your case, so to speak? Dr. Frese: Yes, and by that time, I was in grad school and had secured a job at what is now the Department of Mental Health and Addiction Services. I remember I was living in the hallway of some university housing, and one of the students, who saw me day after day just hanging around and not really doing anything, suggested that I might be eligible for a government job because of my military background. When I applied, the receptionist saw my history of mental health commitments and said I would never get the job, but I did. The last time I went to the hospital, I went voluntarily because I knew I needed more medication, but they thought I needed to be hospitalized and I didn’t; so I ran away. Karyn: Sounds like you were managing a lot of stuff—grad school, working—and, at the same time, episodically struggling with symptoms of illness. You were working in the field of mental health, too. Was the work environ- ment supportive? Dr. Frese: Not always. It seemed like even among my coworkers, when something strange happened, they thought it was something wrong with me. Karyn: What do you mean by “something strange”? Dr. Frese: Like one time when they perceived I was spending too much time interacting with patients, they assumed I was “going off again,” and next thing I knew, they called a “blue alert” and wanted to hospitalize me. But that time, the medical director just told me to take some time off. I never did find out why they called that blue alert. Karyn: So you haven’t been hospitalized for a very long time, and you are internationally renowned for all of your work and advocacy in the field of mental health. What do you think has contributed most to your recovery? Dr. Frese: No, I haven’t been hospitalized since I got mar- ried. I think that has been central in my recovery: having a person who you trust to give you feedback and let me know when I need more medication. Karyn: What role do medications play in recovery? Dr. Frese: It’s very individual. We need more research to identify who, among people with schizophrenia, will benefit most by continuous medication versus episodic, reduced doses, or no medication. Genetic research is hopeful, but we’re not there yet. It’s hard to advise any individual what to do without knowing their individual circumstances, and even knowing, it can be very hard. Karyn: What do you think is most important for future nurses to know about what they should do or say when they encounter someone with schizophrenia in a health- care setting, such as ER, for example?
People with schizophrenia continue to be disenfranchised, misunderstood, and stigmatized. Even within health care, evidence has shown that some settings have been very hostile to people with serious mental illnesses. One way to begin combating stigmatization of people with mental illness is to get to know them personally. Dr. Fred Frese is a licensed psychologist and an internationally renowned speaker, writer, and advocate in the field of mental illness. Karyn: Could you share a little bit about your history with the illness of schizophrenia? Dr. Frese: I was 25 when I had my first episode. I was in the Marines and—I know I had seen the movie The Manchurian Candidate previously—and I began to think that the Vietnamese were using the same strategies from the movie to control us. When I let my com- manding officer know my theories, I was hospitalized involuntarily, and for the next 10 years I was in and out of hospitals—mostly involuntarily—taking various medica- tions, living many different places, and not employed. Karyn: Were you getting any treatments or intervention that you thought were helpful to your recovery? Dr. Frese: Well, at that time it was thought that schizophre- nia was not an illness from which one could recover. Even recently, I’ve heard some folks who have a family member with schizophrenia say, “There’s no way that anyone with this illness can get better.” But that’s start- ing to change, and now that the government, through SAMHSA (Substance Abuse and Mental Health Services Administration) is backing the recovery model approach, I think health care will improve. I remember being told that my brain was going to progressively deteriorate and that I would never be able to function on my own. All in all, I probably spent about a year of my life in hospi- talizations. Once the laws changed and I knew you had to be of imminent harm to yourself or others in order to be hospitalized involuntarily, I talked some of the health professionals out of admitting me. During the last attempt to hospitalize me, I actually escaped and ran away, even though I was in pretty bad shape.
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