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.

"However, the OP seems to be avoiding questions about her bipolar symptoms."

I'm not avoiding any questions about her symptoms. has depression and then she swings to mania. She tends to lose her jobs because either she gets so depressed she can't leave the house, or she gets manic and stays up all night and then is not in a fit state to work. I don't know her symptoms all that well as we haven't lived in the same country for 20 years and we have never been close.

When she gets manic she posts tons if stuff on Facebook, things that are really really personal. She accused one friend's father of molesting her and then rescinded it, for example, all publically on Facebook. And she posts about her abortions, her rape, etc. And then she deletes everything later. Also she lies constantly. She says she will do something and then she makes up a lie about how it wasn't possible.

We lived together briefly in our twenties. She invited a homeless man to come and live with us. She also stole my credit card and charged a few thousand dollars of travel expenses and meals for her friends.

Writing it all out it sounds like madness that I would have her come and live with me. My husband and I live a very quiet life and I have a stressful job. But I just don't feel like I have a choice and as much as our father has been a bastard in the last he doesn't deserve this. Our mother would definitely help her access whatever she can. Also my sister is likely to get a job at first but then she will probably lose that job quite quickly. That's my guess anyway.

I don't have children- neither does my sister thank god.

The more you post about her the more convinced I am to say you won't be able to help her. I admire you for wanting to, especially as you're not close, but in this situation I don't think you can.

I suspect if she does come to the UK it will only be because of the promise of free accommodation and another source of money. You haven't answered a previous posters question about if anyone else lives with you, partner, children, as they will be massively impacted by her should she come and live with you.

A close family member left the north-west of England to return to Australia, where she grew up, because she would have to wait a year for a referral to mental health services.

I wouldn't have your sister. She will destroy your life, too. It's good of you to want to rescue your father, but I wouldn't do this.

‘If she was truly manic and she tripped up to A&E, she would be admitted, probably detained under the MHA.’

I agree, if the person met the criteria required under the MHA. But it is not a given on the grounds of being in a manic phase alone.

For this thread, the only challenges I wish to make are to the ideas is that it is all so simple & easy, & that it’s A+B=C straightforward for the OP to encourage her sister to relocate as it will be better for her in the UK. It is just not so.

MH services are really stretched. Maybe things getting a little better in A&E with parity of care. The benefit system can be slow & mightily brutal for many, even those who have an obvious need of support. I speak as an advocate for people going through PIP assessment.

I have also expressed my concern that the OP & her mother will become the carers for someone with complex MH problems. This is a really tough gig as I & several other posters have said.

OP is between a rock & a hard place.

I'm no expert on the financial side of things, but my experience of the NHS and mental health care isn't great. My sister struggled with depression for years and was constantly asking for help, only pills were on offer and eventually was told 'we can't do anything for you'. She took her life before the week was out. So my view is pretty negative. But it may be that it wouldn't have been any different anywhere else.

Would she actually be eligible for treatment and benefits given she’s not been resident? Seems unlikely.

@RedSheep73, that's just awful, I'm so sorry for your loss

I probably would not help her directly by her living with you. But indirectly,
And from what you say about your father. She is his responsibility for many reasons it seems.

I think it unfair that she claims any money from GB if she hasn't paid into the system. Too many people are doing this!!

Percheron67 is a baby eligible for care on the NHS? I guess in your view no because it won't have paid into the system 😐. In my view yes because its parents will have paid...same as my sister.

I have schizo affective disorder (bipolar type) & get a 3 monthly psychiatrist appointment plus telephone support from the duty worker / crisis team. I work part time & have support from an occupational therapist linked to the MH services to stay in work.

When I first became unwell I was psychotic & suicidal but never got sectioned, it's actually very hard to get sectioned in the uk it seems!

I take my tablets every day, don't drink (for the meds to work effectively you can't drink), & don't take drugs. I do get ill occasionally still but because I'm normally stable my employer has (so far) been supportive.
When you have serious MH problems you HAVE to take care of yourself of a normal life is beyond reach.
Your sister will have to give up the drink & drugs & engage with MH services to get better, only she can do that.

It's really hard to get benefits now. I'm on the old DLA low rate still waiting to be reassessed for PIP. People with MH problems are having difficulties getting PIP.
ESA is also hard to get. Universal Credit doesn't have a Disability Component meaning that disabled people can't work part time & top up with tax credits any more.

Housing is difficult to get for single people but basically a room with shared facilities should be enough, it's how I lived for several years.

I think the US is a nightmare for mentally ill people, if it were my sister I'd bring her to the uk.

So she thinks she's a psychopath? She probably isn't, it's more likely that she's very traumatised with her experiences with rape etc & needs counselling as well as psychiatric help.

I think the assumption is that a baby will pay into the system later on.
I feel for you OP. You really are between a rock and a hard place.

@percheron67 don’t be silly the vast majority of children are in the same situation. As are many others who can’t work for one reason or another. OPs sister is British and qualifies for help just like the rest of us. We don’t just look after those that can pay into the system here. We support those who can’t support themselves.

OPs sister can work when she is well.

Itwouldtakemuch - I am not being silly. I have lived and worked in the UK all my life as did my late husband. However, my SN daughter does not receive the amount and quality of care she needs AND deserves because the Health Service is short of money. ONE of the reasons it is short of money is because of folk who haven't paid a penny into the pot taking money out. OP's sister can work when she is well -- bully for her. My daughter would love the chance to work but will never have the chance.

‘OPs sister is British and qualifies for help just like the rest of us.’

As other posters have pointed out, UK residency is the determining factor, not nationality. The standard process when someone registers with a GP to go on their books for everyday health care, they need to present documents that prove their residency -either within the GP catchment area or length of residency.

If you present as a emergency at A&E, you will get emergency care if that is what is needed. It will be free at the point of care & you do not have to produce proof of residency.

Some A&E depts now operate a triage system that has a GP at ‘front of ‘house’ so that non-emergency cases can be dealt with alongside the emergency cases. Because not every one can get back to their GP (away due to work/holidays) & in some cases, people such as those who are homeless or refugees, cannot register with a GP at that time.

@Ladymargarethall
I don’t think that’s the assumption at all.

The basic premise is that if you’re from a certain country /resident/citizen.
You have the right to generalised care paid for by society.
So ergo her sister is perfectly in the right to have care here.

‘...it's actually very hard to get sectioned in the uk it seems!’

This!

People in MH distress do not always meet the criteria for sectioning under the MHA. If people do not meet the criteria, they should not be deprived of their liberty by use of the MHA to detain them.

There is a vast space where people are struggling & in MH distress, & sadly not all MH conditions respond to treatment for a while or some people barely at all. This is hard to see & accept.

‘The basic premise is that if you’re from a certain country /resident/citizen’.

This premise is incorrect.

It is not where you are from.
For the NHS, it is the length of residency in the UK to qualify for free NHS care at point of use. Emergency care in UK A&E, no proof of residency.

Every country has it’s own rules about the provision of medical care, how & when it paid for, & how much/when a refund payment can be made. Every country is different.

If I travel abroad, I take hefty medical insurance, as I aware that any financial liability I may incur during medical emergency might bankrupt me if I had to pay from my own assets.

When travelling to Europe, I used to get an E111 (hazy recall) so that I did not have to pay for my treatment at point of use.

Being a UK citizen does not automatically entitle you to benefits ! Has she ever lived or worked here ? She would need to pass the habitual residency test for a start which can take months and if she has no work history here that's going to be difficult,

They do ask you when you have any hospital appointment now how long you have been a resident here. I think you need to ascertain OP if your sister would be entitled to treatment here or would she have to be here for a certain length of time before she was eligible? I don't know.
Whatever, I hope you manage to work something out for her.