My sister is bipolar, unemployed, broke and suicidal.
June 1, 2017 7:53 AM   Subscribe

My sister is bipolar. She has had some treatment in the past (meds) but it made her too manic so she stopped taking them. She's unemployed and my dad has been paying her rent and bills. He literally cannot afford to keep paying. What can we do?

My Dad has asked my advice on this. He has paid for everything for her for the past 2 years and is in danger of going broke himself. My sister has worked very sporadically but keeps getting fired from jobs. The reasons she gives for getting fired are never her fault but she lies constantly and it's impossible to tell truth from fiction.

My dad is 70 and my sister is 40. He was a terrible, absent father and feels guilty about it so has tried to put this right by paying. Because of this plus other mismanagement of his money he's now had to sell his own house and move into a rental.

My sister has been suicidal off and on since she was a teenager. She goes through up and down cycles and we're really afraid that if she loses her apartment and her cats it will send her into a severe downward spiral and that she'll have nothing to live for.

My dad has got to stop paying because he simply doesn't have the money. I've said to tell my sister she can stay with him in his small rental apartment in Atlanta where they both live. Or she can move to England and stay with me and my husband. I've said either of these should be made conditional on her seeking treatment - but how do we enforce this?? My sister is a UK citizen and if she moves here she will be entitled to health care and possibly benefits and a council house.

What do I tell my dad, and what do we do about my sister?
posted by anonymous to Human Relations (10 answers total) 2 users marked this as a favorite
 
I don't know what the laws are nowadays, compared to 15-20 years ago, but if your sister is truly suicidal, then involuntary commitment proceedings would be what I would try first before worrying about the money piece. Others may disagree.

Typically, once someone is in the hospital and being evaluated and/or medicated, a case management staff can begin to work on the client's other needs e.g. housing, applying for disability, setting up aftercare, etc.

You may wish to have her move to England to be with you. That's your call. But if she's as unstable as you say she is, she needs to be seen by someone ASAP to keep her safe. And she may not be willing to seek treatment on her own. Good luck.
posted by strelitzia at 8:47 AM on June 1, 2017 [1 favorite]


Is your sister currently in a manic episode or in a severe depressive episode? Are you acutely concerned for her safety? If you are, the first thing to do is to get her immediate medical attention at a hospital. Moving to England might be a long-term plan, but in the meantime if she is at all unstable, I don't think that moving her overseas would be without additional stressors for all parties involved.

I'm not clear from what you've written in your question, but is your sister followed by a psychiatrist? It sounds like your sister might not be receptive to the idea of seeking psychiatric help and as she is an independent adult, she has the right to decline treatment unless she is unsafe.

Sometimes bipolar patients need to try out a few different medication regimens before they find one that works for them. In the past five years or so, there have been some new medications/research, so if she hasn't tried medication since, it might be worth a shot. Sometimes people need those medications to kick in before they can plan out other life decisions.

As for your father paying... is there any way your sister could get on disability? I know it's a lot of red tape to get through, but it would at least eventually ease some of the financial burden.
posted by gemutlichkeit at 8:54 AM on June 1, 2017 [2 favorites]


She should probably be on long-term disability but it's not a quick or easy process. If she is ever hospitalized because of her mental health, social workers who work on discharge should have resources for helping to stabilize her after she leaves such that she is less your father's problem. These may include disability and housing and some kind of case management if she's really not able to take care of herself. People may require some prodding to set this stuff up because capitalist systems profit from the social safety net being difficult to access and so it is.
posted by Smearcase at 9:08 AM on June 1, 2017 [6 favorites]


She has had some treatment in the past (meds) but it made her too manic so she stopped taking them.

Getting meds right for a bipolar person can sometimes be tricky. I know at least one person who had to be hospitalized for their safety during the trial and error process. Take my comment with a grain of salt, as I'm no doc, but just know (as I'm sure you probably do by now) that it's not necessarily like "I have a headache let me pop an aspirin" -- getting meds right can be a roller coaster process.
posted by salvia at 9:09 AM on June 1, 2017 [2 favorites]


Some bipolar diagnoses are eligible conditions for Social Security Disability Insurance, if she's able to apply for that. The amount of the benefits is proportional to income which she would have paid Social Security taxes on, and unless she had a relatively high income while working it probably would not cover all of her living expenses; but it might ease the financial situation, and also would make her eligible for Medicare health insurance.
posted by Sockpuppet Liberation Front at 9:15 AM on June 1, 2017 [5 favorites]


The amount of the benefits is proportional to income which she would have paid Social Security taxes on, and unless she had a relatively high income while working it probably would not cover all of her living expenses

Honestly, it sounds like she may not have worked enough to qualify for SSDI (or, as an alien, may not have been making payments through her paycheck). You can get benefits for SSI as a noncitizen without meeting the work credits test, but the qualifications are complex.

If she has any kind of status irregularity, in the present climate, it would be ill-advised to apply.
posted by praemunire at 10:26 AM on June 1, 2017


Hi, lawyer in the disability field here, not your lawyer, not your sister's lawyer, not legal advice.

She needs to file for Social Security Disability. To get it, she needs to have the following:

1) consistent treatment, including trialing medications

2) a doctor who supports her application or is at least willing to document what's going on - mania, depression, the impact on her, what she's done to try to manage it, why that has failed, what she is unable to do for herself, what she has relied on others to do.

3) she needs to admit she has a problem and seek help. This is the hardest part, especially if she has not accepted what's going on and insists on talking about everything like it's just a run of bad luck.

4) letters from former employers would be very helpful to this process if they are willing to explain why they let her go.

5) if she is a danger to herself or others, she needs to be involuntarily committed until she can be stabilized.

6) getting Social Security Disability is a long and stressful process. In the interim, she needs to sign up for any and all benefits available to her at the state and local level. Food stamps, housing assistance, whatever free medical care is available - check local hospitals and providers, see if there are city or county programs, and check religious hospitals - many have a certain level of charity in their mission statements.

Good luck. I hope very much that she gets the help she needs and is able to keep her cats, I know I would be lost without mine.
posted by bile and syntax at 12:05 PM on June 1, 2017 [2 favorites]


Tell your dad to call NAMI and find out what support they offer and can refer him to for mentally ill people and their families in Atlanta.

If your sister is in a state to be Baker acted, that may sound terrible, but it is actually great; it's a way to get her some help, get social workers involved, and buy the whole family a little time. NAMI can help your father with the logistics.

It would be very wonderful if she could come to you and the national health, but it's probably best not to push for that immediately and make it instead a long-term goal because trying to move while bipolar is an unimaginably daunting undertaking (unless one happens to be manic, when it's easy to do even very difficult things speedily and easily, though often spectacularly badly).

If she talks to you, great. Be patient and listen. It's okay to make gentle suggestions but more important just to listen and be kind. Try not to push or lecture; sounds like she's in a state of overwhelm.

I'm sorry you're going through this: it's hard not to be able to help when you want to help.
posted by Don Pepino at 1:19 PM on June 1, 2017 [2 favorites]


It would be helpful to know if your sister is a US citizen (i.e., dual US and UK citizen) or not (i.e., she has only UK citizenship). A lot of the programs people are suggesting here are not open to non-citizens in the US.
posted by lazuli at 2:43 PM on June 1, 2017 [1 favorite]


I want to caution you about any expectation of council housing. I'm not sure HOW much her mental health will actually move her up the housing ladder and some of the places that people are offered can be very depressing in and of themselves and the papers this morning are splattered with news about people needing to wait 3 weeks to see a doctor. It doesn't sound like a recipe for great mental health frankly. What would she do without housing? live with you? What if she can't get a decent doctor or appointments with a psychiatrist in good time?
posted by catspajammies at 9:32 PM on June 1, 2017


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