Posted by: John | 2020/02/05

Mental health evaluation

Hi Dr Simpson, My family and I are certain that my dad has a mental illness. We would like to get him evaluated by a professional and receive the right treatment but am certain he won’t go willingly as we have tried in the past. He turns the issue around and insists that we're the ones that need to be evaluated. I would be happy to go if he would agree for us to do it together. This typically turns into a huge amount of verbal abuse. He is very irrational and doesn't seem to apply logic/ common sense to his thoughts & actions. I feel he poses a threat to my mom who he lives with and am often concerned about her well being. He has pushed everyone around him away and doesnt seem to notice this. He never takes ownership of any mistakes he may have made but instead blames others. He feels like everyone in the world is out to get him or is against him What do you think is the best way to handle this? Is there a way to have him evaluated even if he says he won’t go? I live in Cape Town, and he lives in Swaziland but often travels to JHB. Please could you guide me on what my options are? Thank you

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Our expert says:
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- 2020/02/06

Hello John,
Actually, this is indeed a really difficult problem.  If he agreed that there are problems worth sorting out, it shouldn't be difficult for pans to be made for him and your mother to see a suitable specialist in Joburg, say, for an assessment and a discussion of management options. 
Sometimes, a difficult person, sick or not, can agree that there are problems, even if they're not his fault at all ( fault is usually not a fruitful area to begin with ) : and even if he sees other people, in the family or community or wherever, as causing the problems which are unpleasant for him,  he may accept the idea that a suitable expert can help identify the nature of the problems and how they could be better handled. 
But where someone, who may cause distress and difficulties for others,  is certain that he is fine, not in the least troublesome, and absolutely needs no assistance at all,  it is indeed hard to intervene.
The only occasional option, which a lawyer might advise you on, is when members of the immediate family sincerely believe that a person is not mentally well, and is a genuine risk to himself and/or others, and needs assessment and potentially treatment.  Then there is some provision made in the Mental Health Act, for a legal action to be brought in the name of those relatives, for the person to be required to submit to a hospital  admission for a proper assessment by a psychiatrist or a pair of such doctors, who would then report either that there is nothing medically wrong, or that there is and that there is a need for treatment which can even be required to be provided compulsorily. 
Legal advice would be wise, especially as this case involved two countries, and I'm not sure of the equivalent law in Swaziland and the potential for cross-border collaboration such as might be needed.

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