Stand-up for schizophrenia

Social Innovation Generation @ MaRS (SiG@MaRS) is a program that is interested in understanding and promoting social innovations, particularly those featuring resilience and vulnerability.

Recently Dr. Fred Frese, a world-renowned psychologist who is also a person diagnosed with schizophrenia, spoke here at MaRS about an approach to care used by Dr. Rohan Ganguli of the Centre for Addiction and Mental Health (CAMH) that would see psychiatry re-evaluating the process of hospitalization of persons with schizophrenia – something that Canada seems to excel at.

Dr. Frese has been described the “Stand-Up Schizophrenic” (he is very funny) and early in his presentation he asks people to stand up and identify themselves as persons with schizophrenia (there were several in the audience who were brave enough to do this) and thus the double entendre of the title.

Dr. Frese describes himself as a psychologist, a former US Marine and person with schizophrenia – he has credentials for one and two but wonders how to prove his credentials as someone who was “diagnosed as insane”.

There are not necessarily any visible signs of this disability; no special parking spots for those with mental illness (he’s checked)–and yet the stigma associated with this illness is profound.

So what are some of the symptoms? Well, he says he finds it difficult to stay on topic – yours – not his but I’m afraid the line up forms to the right on this one.

He examines popular culture, particularly films, and in reviewing a list of the top 100 heroes and villains of all time (think Atticus Fitch, from To Kill a Mockingbird as the top hero versus Hannibal Lecture, as the top villain from Silence of the Lambs), he finds that 50% are mentally ill or associated with those with mental illness – enter Nurse Ratchet from One Flew Over the Cuckoos Nest.

But there is hope. In more recent films we see people with schizophrenia profiled as challenged but not dangerous as in A Beautiful Mind and The Soloist.

Dr. Frese was a Marine Corps Captain when he had his schizophrenic break. It was in Vietnam and he was convinced the US was not winning the war because their opponents were brainwashing them. After sharing his theory with the unit psychologist, he was taken away by people in white coats and he spent the next ten years in and out of mental institutions. He also managed to go back to school and completed a doctorate in psychology and eventually became the director of the largest psychiatric institution in Ohio.

He spoke eloquently about the importance of family; people who can help you when you are “getting too far out there”. Dr. Frese himself has four children.

He spoke about how he thought things would never change for people with mental illness because they could never organize for themselves but in fact they did. They watched how other movements succeeded and they adopted the language that seemed to work for them, like “inclusion”.

And although they were pleased with the developments in deinstitutionalization they realized that ultimately what it meant was that, through misplaced social policy, we moved people from institutions to the streets. So Dr. Frese and his colleagues realized they had better train police officers and social security staff and establish mental health courts – all incredible social innovations in their own right.

And now they are working for integrated care, emphasizing the need for primary care physicians to work with psychologists.

He was out there – in a good way – inspiring, informative and “in our face” and he offered hope that anyone with a mental illness, even a very serious one, is capable of living a full and productive life.

Here’s to the next Dr. Frese! And to the innovators who will take up the cause and make life better for this part of the population.