Dr. Penny Frese has a Ph.D. in Comparative Arts and an M.F.A. in Directing from Ohio University. With her husband and children, she is active in the mental health movement, often presenting at statewide and national conferences in the United States and Canada. The Frese family has been featured on local and national television, including pieces on CNN and ABC. Dr. Frese is also the producer of an award winning video on children's depression called Claire's Story.
Whatever is human concerns the law. This Article arises in experiences outside the law with the hope of bringing greater clarity and understanding to those areas where the law is not clear and there is some room for flexibility. The National Symposium on Mental Illness and the Criminal Justice System invited me, as a member in a household where there is mental illness, to elaborate on the impact that mental illness has on family life. My husband, a practicing psychologist, was diagnosed with schizophrenia at the age of twenty five. Our four children have all been diagnosed with major depression. All continue to take medication for their illnesses, and they occasionally experience symptoms. Unless one has been there, it can be difficult to understand how insidious these illnesses are and how pervasive their influence on all aspects of daily living. Mental illness can be tremendously disruptive to normal family functioning, and, especially when untreated, it can throw families into turmoil that sometimes brings them into the criminal justice system. Persons who require hospital care find themselves in jail. This Article will outline aspects of recognizing and dealing with mental illness within the family with the hope of providing some insight and direction for those who provide for such individuals.
My husband, in his article on coping,1 explains that for the person with the illness, the part of the brain that would tell him he is sick is the very part of the brain that is impaired. It is therefore very difficult for persons Page 968 with mental illnesses to know they are ill. For others, stigma, shame, and fear contribute to the difficulty of acknowledging that there is mental illness in the family. Mental illness has been traditionally regarded as a character flaw or the result of family dysfunction. Families fear that acknowledging that a family member has a mental illness will invite unfavorable attitudes towards them, resulting in ostracism or criticism. They are afraid that one family member with a mental illness can bring opprobrium down on them when they know that other family members under similar circumstances show no evidence of illness. They know, and rightly so, that the responsibility for difficult behavior by their ill family member is not their fault, and they resent the implication, tacit or otherwise, that it is.
As with other illnesses, when the ill family member is unable to care for himself, responsibility for his care frequently falls to his closest relatives. But treatment for mental illnesses is difficult to access, time consuming, lengthy, and, very often, expensive. Memories of days when the mentally ill were locked away in institutions still prevail. Many people don't even know where to begin. So instead of getting help, the illness is denied. The ill person is treated by family and society alike as if his behavior is deliberate and controllable. The result is condemnation, frustration, resentment, anger, and ultimately exacerbation of the condition to the point where some other entity must step in. Often this is the criminal justice system, and frequently, even here, real help is not available. The fear, shame, and frustration that families experience become self-fulfilling prophecies. Untreated mental illnesses do contribute to family dysfunction, ostracism, and criminal behavior.
Denial gives way to acceptance when no other recourse is available. However, there is much more we can do to accelerate the process. The earlier we deal with mental illness, as with any illness, the better the prognosis. Research in the last fifteen or so years has resulted in vastly improved medications and other treatment modalities which not only improve situations, but can actually restore even severely mentally-ill individuals and allow them to become contributing members of society. In the remainder of this Article, I will examine the three A's of the coping process for families.
Acceptance generally comes gradually, but it can be accelerated. The first stage of acceptance comes with the understanding that what we are dealing with is an illness; that it is long term; and that things will not get better until steps are taken to begin that process. I refer to this type of acceptance with a small "a." It is important in this stage to increase knowledge about mental illness.
When I first started to learn about mental illness about 25 years ago, there was very little information available. Most of it was dry, clinical, and Page 969 hopeless. Today, however, there is a rich body of literature, both clinical and personal, much of it designed for the layman. From it, we can learn that these illnesses are, indeed, physical. Various magnetic imaging techniques have allowed us to actually see a working brain, and have demonstrated that the brains of...