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.

Mummyofmytribe so very sorry for your loss. Heartbreaking chain of events.

@Catslovepies On paper, you are right that she'll do better here. In reality, it will take a decent amount of time and a lot of support to get her to where she needs to be. Can you or your mum commit to that for a few years?

I have a sister with bipolar. She also disengages from medical help, so although she's always been here, she's largely left to her own devices. She lives with me for two years while she was waiting to be housed, in the priority banding, and eventually got a council house - but her benders broke the terms and she lost it. I couldn't have her back to live with me, she was a nightmare and although I tried to be patient and kind, she was constantly self destructing.

I wouldn't move her over from another country if someone over here isn't in a position to look after her for an extended period while she navigates the various systems, even if that's really hard on her dad. Saving money on prescriptions and things will only help if she's actually taking them.

@catslovepies, I think your dilemma is not about your sister.

PPs have pointed out that services are not what you ‘imagine’ them to be. I suggest, as have others, you contact your local CAB - if there is one, no guarantee these days - & the local MIND for some factual advice.

Also, I suggest you contact your local carers hub - CAB, MIND, Carers UK prolly can signpost - & ask if there is a MH carers support group. If you are fortunate, you may be able have a chat with them about their experiences & realities. If you encourage your sister to come here, this is the life you, & mostly your mother, will be leading.

Does your father have family in the US? Have you spoken with them?

Oops, posted too quickly.

I think your dilemma is about your father.
Pay attention to his situation.

This is not about money, although there is some financial urgency.

My father is kind of a bastard and one of the reasons my sister has MH issues but that's a different post. He has family and friends in the US.

OP, You talk about her being ble to work, or to study in the UK. But if she is not well enough to work or study in the US, goes on benders periodically, refuses to engage with support services what makes you think that this situation will magically improve in the UK? she has already almost dragged your father into homelessness and penury, I can only see the same thing happening to you and your mother if she comes to the UK.

Realistically, she will not be well enough to work or study.

She is unlikely to get , or be able to cope with independent accommodation.

The drink and drug dependency will continue.

If she does manage to access mental health care then the efficacy of that will be reduced because she will not engage.

If by some miracle she gets financial support it will be at a very minimal level,certainly not enough to finance drinking and substance abuse. You will need to make up the shortfall, maybe for many years.

All the above means that she will drag you and your mother into a morass of frustration, emotional pain and financial drain, much as she has done for your father.

I feel sorry for your sister, her problems are not all of her own making, I can understand how desperately worried you are feeling for her, but you do need to protect yourself from being sucked into this whirlpool of despair. Is there any way you could go over to the US for a while and try to access better support for her there through charities and mental health foundations?

‘She needs medication for asthma and she can't get it in the US. This is life threatening and is reason enough for her to come to the UK.’

Yes, asthma can be life threatening.
Even with medication & NHS emergency care, people die from asthma every day in the UK.

But your sister’s asthma - & she smokes which cannot help at all - is not reason enough for her to come to the UK.

@viques, good points, well made.

Many councils have over 55 ex sheltered accomodation spare since they cut the wardens. Still have to prove local connection, housing need. Social services can sometimes nominate for supported housing but it's a long waiting list. Do your homework op, shelter and dwp websites, mind helpline.

I wouldn't have her live with you or your mum if she is not prepared to engage with services and get help - it will just drag you down without helping her

Could you and your mother send your father some money instead?

If you want to help?

Is it just the financial aspect that’s ‘killing him’?

She would need to prove 'local connection' for housing including temporary/ emergency. In my borough this is a minimum of 6 out of 12 months as a resident before they'd even consider assisting. Even then it's not a quick process and she could be waiting a while for any sort of accommodation. Temporary accommodation can be pretty dismal, I can't imagine it's much good for ones mental health. And you can't choose the location, unless you go down the private rented route funded by housing benefit. If she's considered 'priority' due to MH she may get a permanent council property eventually but will most likely be waiting months / years. If not considered priority .. well here in London the wait is at 15-18 years!! (I've worked in council housing previously).

smallereveryday - she'd have to claim Universal Credit now, no new ESA claims except for people who get the severe disability premium.

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

Most councils now won't accept a duty unless the applicant has lived in their area for 2 years.

Bipolar sufferers are eligible for the higher band of PIP

Not true. The fluctuating nature of BPD often rules out PIP entitlement, because of the "majority of the time" rule: unless you are unable to carry out an activity at least 50% of the time, you count as being able to do it.

I doubt she’d get a council flat. You might find she would be expected to live with you. Could you cope with that?

Well eventually yes. Once the money runs out in the US she’ll be screwed but the quality of healthcare in Britain is very low and accessing benefits has become more difficult since the introduction of UC. I suppose it’s a question of whether there is any chance she’ll be able to sort herself out eventually if she lives in the US.

I think viques summary is pretty spot on.

MH services are very under-resourced and have never been brilliant at looking after people who have drug and alcohol issues AND MH problems. In-patient admissions seem only to happen when the patient is very much at risk; I've supported clients who have committed crimes, so that they end up in custody to get assessment/admission.

The housing situation is so grim that we now have MH patients bed-blocking: they can't be discharged because they have nowhere to go but aren't well enough to sleep on the streets.

I know it's still better here than in the US, but I wouldn't want anyone to be under the illusion that getting treatment, housing or benefits here will be easy.

Generally speaking you are right, it is probably better to be poor and mentally ill in the UK than in the US, but it’s not as simple as that is it? The situation as you have described it is that your sister (how old is she?) is a drinker and drug user with mental health problems living off your father. I think you are being optimistic in thinking that a move to the UK will suddenly see her getting a job and living independently. You are in danger of transferring the problem from your dad to you and your mum. The real problem is your sister - not where she is living. Not saying you shouldn’t help her move over - just do it with your eyes open - it will not be a magic solution.

It would be Universal Credit and potentially PIP that she could claim. if she can show that she is settling her permanently then the wait for Universal Credit is quite short england.shelter.org.uk/housing_advice/benefits/universal_credit_immigration_and_residence_conditions

She would have access to a GP and after being accepted by UC would probably get free prescriptions due to low income. She would need to go through a health assessment to show that she has limited capability for work, if she failed in her assessment then she would need to be job search for about 35 hours per week or else face sanctions.

She needs to really really want to make a new start. If she’s not engaged you and your mum will end up supporting her.

Surely she's a UK citizen if she has a UK/US passport? if so she'd be entitled to treatment, looking after someone with a mental illness is hard work ive been there, are you and your mother prepared for that?

I am in the North West OP.
It depends where in the NW obviously but when I left ex and had to move in to my parents we weren't considered homeless so no priority at all and ended up going private let with a deposit loaned from my Mum.

You would have to take her in and then in effect make her homeless. They would try and persuade you not to.
In our area if they did accept she was homeless they would they put her in a manky bedsit with shared facilities, most likely with people who had more serious issues until the deemed if she was intentionally homeless or not and gave her a flat.

I don't know how the benefits would work as someone who hasn't been resident in the UK but mental health support is not great in the UK.
In regards to benefits PIP is horrendous. The assessments are horrendous. The appeals are horrendous.
People who are dying are being declared fit for work.
A family member with MH issues had to go to court to appeal the PIP decision. It was awful.

I'm not saying don't tell her to come but I am saying it's not as rosy as you think.

I feel sorry for your sisters situation, but I’m honestly not sure how I feel about the suggestion that somebody should move here for no other reason than to access free healthcare, housing and benefits that she hasn’t paid a single penny towards.

I will just correct my post as another poster has picked me up on it and she is absolutely right. BiPolar will not make her entitled to PIP it will make her entitled to claim PIP if she has been resident for two of the last three years. Wether she is awarded anything is entirely dependent upon the level of her need for care and/or supervision. (It's the NEED that's relevant - not wether that need is being met or not.

My DH has bipolar and has a PIP award due to his inability to maintain and manage bills/money/appointments etc plus a supervisory need - in that he needs others (me) to monitor his medication and to contact crisis team if things are spiralling. Something he cannot recognise on his own.
It is a case by case assessment.
The fact that she doesn't engage with MH services ( v common with BPD as is substance abuse) will have no affect on a PIP claim . PIP is for care needs and mobility. Regardless of them being treated. In fact has more chance of a successful claim if untreated as there is a greater 'need'.

Still better off in the UK . She is British and as long as she can pass the Habitual Residence Test where she has to show an intention to be permanently settled here - then she has as much right as any other Brit (or settled person) to take advantage of everything the NHS can offer.

"In the US it's often several hundred dollars without a prescription."

Why would she be getting it without a prescription?

OP you haven’t answered questions about manic episodes. This is poor advice but also true; if she has manic episodes then it will be easy to get her into services- take her to A&E and she will get admitted onto a psych ward and they won’t be able to discharge her without sorting accommodation and social stuff. You say though she doesn’t really engage with treatment- does she take medication at all?

You can't save her, you are not responsible for saving her. You are not responsible for your father's attempts to save her.

She has to, to an extent help herself, however impossible that might be with her illness.