/ 22 May 1998

Subtle signs

of relapse hard to detect

Andy Duffy

Staff at the Valkenberg forensic security unit are busy retracing their steps to see what, if anything, could have been done to prevent the killing of seven people by former state psychiatric patients.

There are common threads. Each patient, despite their usually violent history, seemed to have responded well to rehabilitation treatment at the unit, each responded well to outside treatment at clinics, and then, one by one, each fell from the state’s radar screen … re-emerging only once they had killed.

Names and specific dates remain under wraps, often for legal reasons, often because Valkenberg fears for the safety of the patient. One Cape Flats community is still looking for the man who knifed to death one of its highest-profile women – the aunt who had taken him in when his family in the Eastern Cape refused.

One case, however, seems to sum up what’s gone wrong. Valkenberg had held one violent patient for years, finally deciding early in the 1990s that he could be released.

“He did very well,” says unit head Sean Kaliski. “He found a job, he got married, he was coming to a clinic. And then he stopped coming.”

So nobody picked up the growing friction between the man and his stepdaughter. He wanted her to treat him like a father; she laughed at him for being a former psychiatric patient.

One afternoon, in the family’s lounge, in front of her laughing friends, the girl pushed the ridicule too far. The man fled to his room, and returned with an axe that he swung high and sank deep into her chest.

The ex-patient was initially held at Pollsmoor, apparently because he did not appear sufficiently insane to warrant a place at Valkenberg. In a matter of months he had totally relapsed and was back at Valkenberg.

“We still don’t know what went wrong,” Kaliski says. “The early signs of relapse can be very subtle and you must see these people quite a lot. They should be seen at least once a month.” But when they don’t appear at the clinics little effort is made to find them. “We just don’t have the resources to do that anymore.”

The unit is still chasing details from the Free State police about the abduction, rape and killing of two small girls by one of its ex-patients, early last year. The patient’s case history shows that he too had been a very violent character, but after he had spent years in Valkenberg, staff “felt obliged to start the rehabilitation process”.

He too disappeared after a few clinic visits, only to resurface in the hands of the Bloemfontein police. “We had no way of tracking him down,” Kaliski says. The other cases include a patient stabbing his wife, and a patient who stabbed his mother.

One former patient, who had married and had a daughter, flipped when he was walking down the street, stabbing to death a man he remains convinced was a top gang leader.

Valkenberg has its successes. Kaliski has one patient who was held at the maximum security unit for 16 years after killing three people. The man is still a state patient, but he holds down a job in the city. Kaliski sees him regularly.

“It’s only a very small section of those who become ill that are violent and they need extra care,” Kaliski says. “But when budgets are cut we’re cutting very important and very sensitive services.”