To think my mentally ill sister would be better off in the UK?

[Catslovepies]

Name changed for this as its outing.

My sister and I are dual US/UK citizens. I live in England and she lives in the US. She suffers from bipolar disorder and has been unable to hold down a job. She has no health insurance and our father has been supporting her - however this cannot continue as he is elderly and going broke. If she stays in the US they could both end up homeless.

AIBU to think that she would be better off in the UK? She could get treatment, a small council flat (in the northwest near me), benefits, and support to return to work - couldn't she?

I have no experience with the benefit system or mental health provision as I haven't needed either of these - I am very fortunate to have a good job and good mental health. So it is difficult for me to advise her. I know under austerity there have been a lot of cutbacks but if she came over and stayed with me for a while would there be help available to her? I cannot support her indefinitely but I can provide temporary housing and food. Thank you to anyone who can advise, we are pretty desperate.

There are areas of the north west where social housing isnt particularly difficult to get. I don't know if OP lives in one of them but these things are very locally specific.

She isnt necessarily going to be eligible for benefits on arrival though OP. Its theoretically possible to pass the habitual residence test more quickly but in practice usually 3 months. She could potentially access free NHS GP care straight away but is likely to be liable for costs of any hospital treatment within the first few months.

I know it's bad here, clutterqu33n. It's even worse in the US sadly.

The idea of having my sister live with me and having to support her for a long period of time is really daunting. She is disruptive due to her mental health, she drinks and smokes marijuana...she has actually told me she identifies as a psychopath. We aren't very close. But the idea of her (and possibly also my father) becoming homeless is unbearable. Our mother lives in the UK too. She can't help financially my sister could possibly stay with her for a while although my stepfather and sister don't get on. It's such a mess!

I think your view is a little rosy.
A precious poster is woefully incorrect when they say there is a good supply of housing in the north west- where I am if you are in the top band of priority and are deemed urgent then the average wait is still a year. You’ll be coasting through b&bs in the meantime- if you’re lucky. She won’t be eligible for benefits for some time- you’d have to check. And when she is you’ll probably find that it’s not a lot. Also she won’t be ‘supported’ to get a job, she would just have to sign on and get on with it.
In terms of mental health care, it depends how severe her disorder is- bipolar 2 as opposed to 1 and she’ll be less likely to get secondary services. Does she have a lot of manic episodes? She is unlikely to have to pay for NHS care- I’ve never heard of it happen ever in mental health services. If she does have a severe and enduring mental illness then she can probably be taken on by a community mental health team.

That is a depressing take, but it’s the reality. It will probably be better in the long term but she would need a lot of support to bridge the gap. I don’t know to what extent your dad has been helping out but could he front a deposit and six months rent? And would you be a guarantor? Getting her into a modest private rental and then sorting out benefits from there might be a better bet. If she lives with you she will never ever get a council property as she will be considered safely housed.

How quickly does this all need to happen?

There's no way a private rent would have her.

It must depend where in the NW. Near where I grew up there is loads of social housing, but it's in pretty shite areas TBF.

Just seen the last post- the drink and drugs will be a big problem. She will get told to go to drug and alcohol services rather than mental health services unless she is really unwell and manic/psychotic.

I will definitely not be a guarantor, that would basically be me signing up to pay her rent for her forever. Also she refuses to get treatment or do anything to help her situation so it will be very difficult to get everything set up for her even if it is actually possible. I think she is possibly just waiting for our dad to quit paying so she can then commit suicide. I feel really despairing.

Itwouldtakemuchmorethanthis my father has said he will pay her expenses through June and that's it (he will probably capitulate and pay for longer though). She then said she had found a job but that appears to have fallen through.

Well, unless there is family money, you'd likely end up supporting her at least initially OP. I wouldn't necessarily rule out her getting a private rental if there is though, and if you pay upfront.

In terms of SH I think we need to know where you're talking about. There is considerable variation in supply in the NW.

@Catslovepies

Do you think she would benefit from in-patient treatment? Each state offers free psychiatric inpatient care- you can check online what the provision is in her state.

or therapy?
Lots of therapists will offer v low cost treatment to people without means to pay.

More generally, I would go against the grain and say leave her where she is, but you clearly need to intervene in terms of your father... is it possible for you to go there for a time to try and get things on an even keel?

Also she refuses to get treatment or do anything to help her situation

If she refuses to help herself then I would let her get on with it. You can help, your dad can help, your mum, friends and other family can help, but if she is determined to carry on down such a destructive path then nothing with change.

@teachingiswank

I think it depends if it’s nearer city or not- honestly it’s atrocious around Manchester- you’ve no chance whatsoever.
A letting agents would never have her however there are private rentals in less desirable areas advertised on Facebook/ gumtree where the landlords are more flexible and the idea of having six months rent at once is appealing. I rented that way myself not so long ago for different reasons.

@RussianSpamBot our mother and I live in Merseyside.

Ah just realised she is also bipolar....
Complicates things rather, but I still think better to leave her in the US.

Also- how much of this do you think is illness- and how much is it that she’s an unpleasant person? It doesn’t necessarily follow that all of her behaviours are a result of her mental health issues (I say that as someone with direct experience of MH issues including bipolar as a family member and carer).

Ah ok I dont know how it is there. Hopefully some people living in the area will have up to date local knowledge.

I must say though, if she's not engaging at all I wouldn't be keen to make her my problem. Sorry if that sounds callous.

With you saying she doesn’t want treatment and more things about her- it sounds like you’d be taking a lot on if she moved here. Does she even want to consider moving to the U.K.?

Obviously I don’t know enough background in this situation but bipolar diagnoses are handed out like candy in the US- it’s to do with billing. A new assessment in the U.K. may produce a different outcome.

Er bipolar isn't "curable", is it?

I would avoid the UK like the plague. This could ONLY be uttered by someone who has no experience of living without the NHS !!

Yes it might not be fantastic at all times (though personally they have saved my life six times) .. but perhaps someone who wants to 'avoid the uk like the plague' could try living in the US with no insurance.. the situation this lady is in .

Don't knock something unless you know of better options .

Yes OP you are right . She will be eligible for all the things you mention . However there are 'time' eligibilities for some of them but the sooner she gets here the sooner they start !

Do not let people confuse her with an overseas visitor.
A & E and acute MH services are free at the point of need from day 1.
Register for a GP immediately. No charge if she is living in the UK. (AND intends to be habitually resident)
Benefits . With BiPolar she will be entitled to PIP after 2 yrs but Employment and Support allowance immediately if she can prove she will be habitually resident - if not then a 13 week wait.

All doable. If she lives with you, gets in the MH system and engages with support , she could find a place to live in a year/18 months . However due to benefit help long before that point, the costs to your dad should greatly reduce to a negligible amount.

Yes, it's the right thing to do.

God how awful for you.

The main question is do you really think you can cope with her in your life full time. It’s a huge burden to put on yourself.

In the longer term, yes she will be better off in the UK. The USA does not have a good safety net when people hit bottom. It won’t be easy though, lots of benefits now have a habitual residence test where you need to show that you’ve been living in the UK for about 2 years. You can’t just walk into social housing, especially as a single person. Mental health care, in my experience, is also pretty crap in this country. These long waits for an initial assessment then a few sessions of therapy but if she’s got no insurance in the US then probably still better here.

I’d maybe talk to citizens advice to see if they can give you an idea of what she could expect if she moved back here.

I echo that it will not be easy. I'm sorry for your predicament.

Also, almost everywhere in the UK you need to local connection to apply for council housing (eg job/family/previously living in area) and this can be as much as requiring 2 years local residency. It can be different with statutory homelessness and even then there are ways councils to wriggle out of helping. So it probably isn't a matter of just trying your luck in the NW, you will have to check the local criteria.

Also, in the south and areas with a severe shortage + high demand for housing, it isn't even as easy as saying you will guarantor for a non-working person, often this isn't accepted either.

MH is very underfunded and often short term. Its extremely difficult for many, many people to get help.

I wish I could give you more hope OP but it is better to be realistic.

She's not helping herself one bit; if she was, I'd say then yes help her.

Until she stops taking drugs, I'd back the hell off.

So is it all about money?

Can she not access health insurance at all?

Where would the treatment be better?

As a pp puts though, difficult if she refuses treatment.

@teachingiswank

No, it’s not, but the criteria, diagnosis, assessment, mental health systems are different between US and U.K.

A UK team could assess and reach the conclusion that mood issues/ psychosis are due to alcohol and substance use. I cannot possibly say if that’s the case or not obviously, I’m just saying that some of this might be to do with drugs/alcohol/underlying personality rather than bipolar, which would mean that she would be less likely to get help. I’ve seen plenty of bipolar diagnoses rescinded.