I banged my 27.07.94 drum to Town Hill madhouse superintendent Dr. Ross:
"Please note the correct spelling of my surname. I agree Fraser should be encouraged to cope with life away from Town Hill. I have reservations about his ability to do so. I doubt whether he has been taught the skills, and developed the skills at Town Hill, to enable him to survive away from Town Hill.
I've heard only negative reports about Fraser this year. Town Hill is generating a crisis to facilitate his rapid transfer from Town Hill. This is unfair and not good for Fraser's self esteem.
My impression is that Town Hill no longer wants the responsibility of professionally dealing with Fraser's problematic behaviour. Town Hill wants to foist him onto Durban Mental Health Society, without adequately preparing Fraser for such a proposed move.
After Fraser was certified by Durban Addington Hospital, Dr Luiz informed me that, 'further management is best carried out at Town Hill Hospital.' (See letter copy).
Fraser has lived at Town Hill as a certified patient for more than 5 years. You're now telling me that:
- Fraser's a thief. He sold hospital appropriated goods in Maritzburg. (You omit to say who 'found' Fraser and what the goods were.)
- Fraser continues to attempt absconding, and periodically absconds. (Town Hill didn't keep me regularly updated on the matter).
- Fraser's running is not a good idea, due to the failure of Town Hill to provide facilities for such a healthy past-time. [I feared akathisia or restless leg syndrome].
- Fraser hangs about a children's creche - with the insinuation that the children could be at risk. (You omit to name the creche, nor its child control procedures). Fraser has often said he wants to get married and have children.
- Fraser absconded from Durban Mental Health Society before. Your's is the first notification I have had of such an occurrence. I assume you refer to Fraser's drinking beers at a Florida Road hotel, prior to his certification to Town Hill. The social workers I spoke to at the halfway house and Addington, did not mention he had absconded.
You conclude, despite the above, that it would be advisable to send Fraser to be controlled again by Durban Mental Health Society.
Addington's Dr. Luiz and his team used the same blaming Fraser tactics to certify Fraser, sending him to Town Hill in the first place. He was certified so he could be 'managed' by Town Hill. Your letter implies failure in the management of Fraser. It resorts to blaming Fraser for Town Hill's inadequate management.
I'm devastated that the combined expertise and facilities at Town Hill, after Fraser has been there for over 5 years, should result in such a response from you.
Fraser is caught in a hospital - patient vicious circle. Fraser breaks Town Hill rules. He's locked up in a closed ward. He periodically absconds, interspersed with time in open wards for good behaviour. He repeats his erring, and the vicious circle continues.
A proposal, similar to yours, was raised by a Town Hill social worker a while ago. The outcome of my queries was Dr. Kaf's opinion:
'* In our opinion Fraser's condition is not such that he would be able to maintain himself in society without appropriate support.
* Our object is always to rehabilitate patients, if this is at all practical. As stated above, there is no urgency in Fraser's case to do this.'
THESE QUOTED WORDS AND YOUR LETTER DON'T ENCOURAGE ME TO BELIEVE FRASER HAS BEEN ADEQUATELY PREPARED BY TOWN HILL FOR YOUR PROPOSED SENDING FRASER TO DURBAN.
[Those clowns considered it not OK to rehabilitate brother Fraser, but considered it OK to gaol him for months in closed wards and Impala forensic block, after he was brain damaged and after he was certified for management at Town Hill].
Before I seriously consider your proposal of sending Fraser to Durban, please answer the following questions by return of post:
1. What can be done to improve Fraser's behavior at Town Hill?
2. What other methods of behaviour modification does Town Hill have besides closed wards, seclusion rooms and forensic security block? (The options sound heavy-handed and unimaginative, considering the professional expertise available.)
3. What has Town Hill done to adequately prepare Fraser for survival under control of Durban Mental Health Society, especially in view of your complaints about him and points in your Dr. Kaf's letter, above?
4. What life coping skills has Fraser been taught by Town Hill, during his tenure, to enable him to survive outside Town Hill? viz:
- Sense of purpose?
- Sense of community?
- Internal locus of control?
- Sound body, sound mind?
- Problem solving, strategic thinking, and self evaluation?
- Positive relationships?
- Positive attitudes?
- Team values?
- Work ethic?
5. In what way is Durban Mental Health Society better able to resolve Fraser's behaviour problems than Town Hill?
6. Who decides that Fraser should go to Durban?
7. Would Fraser go to Durban as a certified patient or a decertified patient?
8. How long will Fraser reside in Durban with the Mental Health Society?
9. If Fraser fails at Durban Mental Health Society, where would he go from there?
10. Who would pay for Fraser's stay in Durban in the Mental Health facility?
11. Who would pay for Fraser's medication?
12. Should Fraser acquire a disability pension, would the pension cover his living expenses and medical costs?
13. Who would be legally liable should Fraser continue stealing and selling stolen goods; hanging about children's creches; and other perhaps criminal activities in Durban while living at the Mental Health Facility?
14. Who is responsible for managing Fraser's physical health, mental health, and medication at Town Hill?
15. Who would be responsible for managing Fraser's physical health, mental health, and medication at Durban Mental Health?
16. What medication is presently being given to Fraser at Town Hill?
17. Has Fraser fully recovered from the low white-blood-cell count, resulting from years of clozapine medication at Town Hill?
18. What is Fraser's present physical condition?
19. What is Fraser's present mental condition?
20. What was the occupational therapist's programme which was worked out for Fraser?
I asked you this question in my 27.06.94 letter.
21. What efforts have been made by Town Hill to improve Fraser's appearance (clothes and shoes) since my 25.03.94 query?
22. What meaningful work has been provided for Fraser, besides tree climbing and fruit-picking (which Town Hill initiated then complained about), since my 25.03.94 letter query?
I wouldn't like Fraser's life to be wrecked more than it is at the moment. I need to be convinced that sending Fraser to Durban is in Fraser's best interests, and not Town Hill's best interests.
Please immediately reply, in writing."
No immediate reply from Dr. Ross.
Madhouse keepers had legally belittled Fraser to infant status, denying Fraser adult pleasures of looking at infants. Madhouse keepers objected to Fraser making adult decisions.
Superintendent Dr. Ross gave new meaning to fantasies and delusions. Fantasy: Dr. Ross wanted to send Fraser to Durban to fend for himself, without adequately preparing Fraser for such a fantasy. Delusion: Why did Dr. Ross mention the criminal forensic block, except to try to impress or intimidate? Forcing Fraser into brutally isolating seclusion rooms and the forensic security block were based on the perceived "IF" of Fraser's madhouse keepers: "IF" Fraser was a danger to himself and others, madhouse keepers would make Fraser safe, by locking him away from normal people. "IF" Fraser was perceived to be "violent" by his madhouse keepers, they locked him away from normal people. Considering the criminal and political violence in SA, that delusion was ridiculous.
To me, Fraser wasn't a violent man. "IF" Fraser was locked away for his own safety, then madhouse keepers were lazy and structurally violent, and weren't doing their caregiver jobs properly.
Copyright Mark JS Esslemont.