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.

I don't want to pay rent for her (and our mother can't). Partly because that would give her no incentive to help herself. If she was staying with me I know she'd rather have her own place and that provides incentive. Right now my father is enabling her and I don't want to make the mistake of doing the same thing. This is the nub of your problem. Your father is enabling her, but understandably can't find it in himself to put her out on the streets - how would it be any different if she was living in the UK? Would you be happy to make her homeless in the hope that she would then qualify for social housing and that this would be the incentive she needs to get a job? I understand that you feel sorry for your dad, but are you happy to take his place - because that is effectively what you would be doing. You won't really know what help your sister can get in the UK until she actually makes the move - that will also be when you discover the extent of the drinking/smoking/drug taking. Your sister is a grown woman (I still don't know how old she is?) even assuming you can persuade to make the move, I'm not sure that will be enough to help her turn round her life. Would you be happy to see her living in a hostel/b&b waiting to qualify for a home of her own? What effect would that have on her mental health/substance abuse? Your sister has a lot of problems which will not be magically solved by moving the UK - the problems will continue to exist and it will be up to you (and your mum) to sort them out.

This is such a difficult problem for you Catslovepies

I think that you need to think about this very carefully

1. Do you think that your dad will stop enabling your sister even if she moves? Will she still be calling him for money? As long as he continues to give in and enable nothing but geography will change.
2. Does she want to come to the UK and engage with MH services? Will she manage the flight without her substances?
3. Are you prepared to have her living with you long term? She is unlikely to get permanent accommodation fast when she arrives in the UK. She is unlikely to get any sort of priority for housing while you or your mother are seen as options. The type of accommodation she is likely to get offered is likely to be temporary hostel-type rooms.
4. Are you prepared to make her homeless? - this may be required

Cat thank you for your kind thoughts re my brother. He is signed up for a 90 day treatment stay. (Not the first time- he originally sobered up in a Salvation Army programme, who are very active in US in this area). My sister & I have to exercise a lot of tough love. There is a lot of lying & manipulation, and we cannot give him money, although I very occasionally will send him some. It is because of my knowledge that I suggest you think long and hard about bringing her over.

For those that are saying that she wouldn't be better off here, I'm guessing they may not understand the reality of healthcare in the USA. I'm a US/EU dual national living in the UK. I cannot say your sister would get benefits easily here, but I would say that at the very least she would get free general healthcare right? So, £8 or so for prescriptions for her bipolar meds, etc?

I agree with a PP who said if she can come and stay with you and hold down a part time job until she can get access to what she needs may be her best bet.

I'd say in the long-term, she's better here. If your dad cannot afford her healthcare in the USA (which will literally be thousands and thousands of dollars every year), she should come. Can your dad continue to support financially in a small way?

@Purpleartichoke exactly!!!

*I cannot say your sister would get benefits easily here, but I would say that at the very least she would get free general healthcare right? So, £8 or so for prescriptions for her bipolar meds, etc?

I under stand the US healthcare system. Its shocking for people like the ops sister.

However, the sister isnt engaging with HCPs. So the cheaper price wont really make a difference. Being a carer for some one with BP, who refuses to engage with medical help, is soul destroying. I dont think the OP or her mother are prepared and can prepare for it.

The sister also can not hold down a job.

Most of the people who dont think this will make the sister and better, are saying so because the OP doesnt want her living there. So care will fall to the mother, probably damaging her health. The sister doesnt like her mothers husband, that could make her MH worse. But the sisters refusal to engage with services means that any real benefits arent going to translate, but perhaps end up with the ops life or her mothers being ripped apart.

It's not easy and I dont think there is a right answer.

I agree - I think getting the right medication (not as easy as it sounds even when it comes for free) and ensuring the sister takes it is only part of the problem. Finding her somewhere to live and getting her into work are another matter entirely - assuming that access to the NHS will magically make these problems go away is over-optimistic to say the least. The OP needs to accept that she could end up with her sister living with her long-term unless she is prepared to make her homeless (something her dad has understandably found it hard to do). I’m not saying you shouldn’t take your sister in - the impulse is a kind one - but having said you are not close and that you don’t like her smoking, drinking and drug taking, I think you need to think long and hard about how much help you can realistically give her bearing in mind she may not qualify for social housing straightaway (or at all unless you make her homeless) and may find it difficult to get a job.