Fred Frese: A Tribute to a Quintessential Prosumer

In the January 1992 New York State Office on Mental Health News is an article titled “He Was Told You Don’t Recover—Then He Earned Ph.D. and Became Department Head.” The subject of that profile was Frederick J. Frese III, who was then the director of psychology at Western Reserve Psychiatric Hospital and a faculty member of Case Western Reserve and Kent State universities. At age 25, just as Fred was to become a Marine Corps captain, he developed a delusion that the United States’ enemies had hypnotized officers and other influential people. When he called for help to stem the threat, he was hospitalized. Over the following 10 years, Fred accrued multiple hospitalizations across six states. After a period of 3 years employed and stable, Fred entered graduate school. He earned his doctorate but had to take off a total of 6 months because of psychotic episodes. After graduation, Fred began employment with the Ohio Department of Mental Health. He was assigned to Ohio’s largest state hospital in 1976 and became its director of psychology in 1980. He had symptoms intermittently and sometimes needed to take time off from work. He led his life taking medication, watching for warning signs, and accepting his wife’s feedback. As Fred said 25 years ago, “Actually, my wife helps me monitor. Sometimes when I think I have a good idea, she realizes it’s a signal that I should take another pill.”

Dr. Munetz

Fred Frese was a professor of psychiatry at Northeast Ohio Medical University and the only world-famous member of the department I chair at our community-based medical school. I was extremely proud to have Fred in my department. I first met Dr. Frese when I showed up at a psychiatry grand rounds at Akron General Medical Center in 1992, expecting nothing special from a talk called something like Living With Schizophrenia. His talk was remarkable. I came away having met a once-in-a-lifetime friend and colleague. Fred was among the smartest and nicest people I have ever known.

Little did I know that I would hear Fred present essentially the same talk a hundred or more times during the intervening 26 years. The talk evolved; Fred kept up with the changing science and changed from masterfully using very old overhead transparencies to using PowerPoint. Fred mesmerized audiences with his encyclopedic knowledge and his wonderful sense of humor. He always had something new to teach us. He helped reframe thought disorder as “an expanded horizon of meaningfulness” and teased those of us for the deficits we suffered as “the chronically normal.”

There are so many myths about people with schizophrenia that he helped bust. I lack the space here to list everything I learned from Fred. Two things in particular stand out. Despite what I was taught, people with schizophrenia can and do have a wonderful sense of humor, and people with schizophrenia can and do engage in deep and meaningful relationships with others.

But when I think of the most important lessons Fred taught me, I can boil them down to two key messages:

1. Recovery from serious mental illness is real.

There is much to expand upon here and space limits me, but recovery is a process, not an outcome. It is different for everyone. For some people, like Fred, who are incredibly bright, who have great support systems (his wife, Dr. Penny Frese, deserves her own tribute), and who are highly motivated, high levels of success can be achieved. For others, their disability may be greater, but they can live a life with meaning and dignity.

2. One needs courage to speak up.

Fred was a firm and thoughtful voice for individuals with serious mental disorders. When he spoke, he was heard. He exemplified the activist slogan “Nothing about us without us.” He would have been the first to tell you that individuals with mental illness do not always agree. He would explain this with great humor. But his courage to speak on behalf of others with mental illness in front of Congress, state legislators, police officers, judges, rooms full of psychiatrists— in fact, any audience—also included the courage to take positions opposed by many of his peers. Fred appreciated that not everyone with a serious mental illness was able to recover to the same extent as he did. He did not want to abandon his “brothers and sisters” who were not aware of their need for treatment, reminding us that the nature of a delusion is that the person with the delusion does not know that his or her belief is delusional. Fred was courageous in his support for outpatient civil commitment, what we now call assisted outpatient treatment. There is a wonderful YouTube video in which Fred speaks to a group of “consumers.” He says something like, “I believe there should never be forced mental health treatment, ever,” and pauses to loud applause, and at just the right moment he adds, “Unless it is absolutely necessary.”

Fred may be gone, but we continue to feel his impact at NEOMED, in Ohio, and everywhere he went. Because everywhere he went, he transformed perceptions about people living with schizophrenia and other serious mental disorders by being a living example of meaningful recovery.

Fred was a legend. He was a wonderful human being, and I miss him greatly.

Dr. Geller

I sat down at a professional meeting in . . . what seems like a lifetime ago, and the gentleman seated next to me leaned over and introduced himself. “Good morning, I’m Fred.” He didn’t say much about himself, and he came across as quite unassuming. I introduced myself, and neither one of us seemed to have much to say to the other, and we both turned to the person on our opposite side. As the meeting progressed, Fred was quiet. I then heard this kind of guttural sound, and a voice boomed out. Fred was yelling. I thought, “What’s up with this guy?” As he went on, I was impressed not only by what he was saying, but by his willingness to state his position without much regard to what others were going to think of his message. I knew I wanted to know this man better.

There have been hundreds and hundreds of meetings since then. I served on boards with Fred. I invited him to present at conferences I organized. He invited me to national and international conferences he helped organize. And sometimes he did so with so much courage it amazed me. He invited me to speak at one of the CIT International conferences despite my having written an article years earlier, “Is CIT Today’s Lobotomy?” Knowing the audience that I would be facing, Fred offered me a Kevlar vest and a ballistic-proof face mask at the highest level of resistance, NIJ Level IIIA. I declined, but I did arm myself with Fred’s suggestions about how to win over this audience. I started with the lobotomy analogy and then talked about the research that had been done to prove me wrong. Fred’s advice on how to turn a sow’s ear into a silk purse had been brilliant. I received thunderous applause when I finished. I thought, it’s really Fred who should be up here. And in many ways he was.

I had the pleasure to serve with Fred on the Treatment Advocacy Board, a board whose members reflect varied perspectives: a judge, sheriff, psychologist (Fred), person with a history as a state hospital patient who continues to take antipsychotic medication (Fred), psychiatrists, philanthropists, economist, outspoken critic of the status quo (Fred), business person, and family members of persons with serious mental illness. Everyone is highly respectful of everyone else’s perspective—including Fred, who pretended sometimes he wasn’t. We all knew each other well enough to know when Fred was acting. New board members just had to learn—their first time could be quite a shock!

My last assignment with Fred was the most poignant. Having been the editor of the Personal Accounts column since its inception in Psychiatric Services, I had served under three editors. The third and current editor, Lisa B. Dixon, M.D., M.P.H., suggested I might add a coeditor, someone who had been through the trenches as a psychiatric patient. I quickly thought of Fred and asked Dr. Dixon what she thought. She let go a panegyrical cry and asked, “Do you think he’ll do it?” I asked him, and he said he would. Because of his failing health, Fred was unable to perform as he had before, but I kept him updated about submissions and embraced his suggestions. Working this way with Fred was bittersweet, but it was a constant reminder that in these days, we too often overlook not only the knowledge but also the wisdom of those who precede us down the precarious paths of advancing psychiatry. We should never let that happen with Fred Frese, at least not for the ensuing 100 years.

Fred was known and admired by so many of us not because he had schizophrenia, but because of who he was with schizophrenia.