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Dr. Michael
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience:  Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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I have a 24year old son who is mentally ill. As a result he

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I have a 24year old son who is mentally ill. As a result he becomes quite aggressive at home and it is very difficult to manage him. He is at home all day and receives a disability grant. He has been in and out of Alexandra hospital in cape town many times. Each time the psychiatrists release him saying that they do not have the facilities to care for him full time, but after a while he is admitted once more after some violent incident at home. I am a single parent and live with my own mother who is almost 80. We both are at our wits end about what to do as we cannot care for him with the aggression, yet the doctors do not want to institutionalize him permanently. The last time he was at home he broke a window and cut his arms quite badly, but he has a history of being violent with myself and my mom. No homes or workshops will accept him due to his aggression. He is on medication, this does help, but not completely. What can we do to get him admitted to Alexandra full time?
Hello. I believe I can be of help to you with this issue.

There might be a legal angle here, depending on how mental health laws are written in SA. I have two lines of thought about why you son hasn't been properly cared for and institutionalized at this point. First, there may actually be a way for your son to be placed in a permanent institution but none of the doctors or public health administrators want to take on the huge workload getting him there would entail. So you are being 'put off' and your request is being ignored; they are free of the problem of your son as soon as they release him, and can then give the matter no further thought.

Another line of thought is to consider the idea that public health administrators, doctors, etc., WILL NOT act as they should UNLESS they feel it in their personal interest to do so. How do we make this situation something they WANT to take more seriously? We attempt to change your approach to the issues you have with your son and frame the problem to the Alexandra hospital from the standpoint of your safety and public safety. That is, if he has been hospitalized and then released by them repeatedly, but you can document he is getting worse over time, you may be able to to level of a threat that will prompt them to act. That is, you will need to communicate the idea in writing to them, and repeatedly, that you have taken steps to hospitalize him over and over in the past, and will continue to do so in the coming months, primarily because you see him as a physical danger to himself and to you and your mother. If they continue to release him, and at some point he harms you or your mother, after they have been repeatedly warned about how dangerous he is becoming, you and other family members will hold the hospital responsible, and they will then be subject to a lawsuit for negligent medical practice or "malpractice". You might also suggest that you wish to warn them that they are now acting imprudently in continuing to release a patient they have been warned s a danger to society, and they know him to be so, based on his behavior during inpatient stays. Along with this letter, I'd also submit a formal request for copies of all of his medical records; you can get him to sign a release so you can obtain them and include that signed release from him with the letter and your request for records. Asking for the records along with leveling this threat will almost certainly cause the administrator to quickly meet with their legal counsel to figure out what to do. They will infer that you intent to proceed to dissect and study every line of every hospital note, looking for evidence of aggressive or dangerous behavior while your son was an inpatient, and that you might then use that information in a future lawsuit the hospital. So this is the inference they will make if you do these two things together.

What this means of course, is that yyou will want to make an appointment with an attorney who is familiar with mental health law in your country and specifically, laws applicable to Alexandra. It will ONLY be through a meeting with you and your attorney, and formal letter of warning and threat that the hospital will act; and they WILL act if they feel professionally threatened by your situation. I'll pause here and solicit your reaction and comments. The time zone difference between us is extreme so we may need to communicate over the course of a few days, back and forth, as day and night time is opposite for us.
I see you have read my last post. Any comments or follow up? If not, please click on the green Accept button at the bottom of the screen. Thanks.
Dr. Michael and other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
Dear DoctorMichael,
Please follow up with my 2/20/2012 8:30:29 PM UTC accepted question.
Original Question URL:
thanks. If you have another comment or question, please let me know.