Independent Medical Evaluation

[sammills89 2]

Hello again! Some of you reading this may remember my post about my fiance's medical condition (bi polar disorder) and after doing some digging it seems the best way to go is to get a psychiatric evaluation done prior to the visa medical so that he can get a letter from a doctor stating that he is no threat to himself or others etc.

I'm just wondering if anyone from the UK was in a similar situation and if so, where did you go to get the psychiatric evaluation done? Between us we can't find anywhere on the internet, even his old psychiatric team are impossible to track down! Would a letter from his old psychiatrist (possibly 3-4 years ago now) suffice, simply stating the outline of treatment he received while under their care and that he is now mentally stable? Or would something more recent be appropriate (if so, where can we get something like this?!)

Thank you again for all your help!

Samantha.

[payxibka 10,044]

Hello again! Some of you reading this may remember my post about my fiance's medical condition (bi polar disorder) and after doing some digging it seems the best way to go is to get a psychiatric evaluation done prior to the visa medical so that he can get a letter from a doctor stating that he is no threat to himself or others etc.

I'm just wondering if anyone from the UK was in a similar situation and if so, where did you go to get the psychiatric evaluation done? Between us we can't find anywhere on the internet, even his old psychiatric team are impossible to track down! Would a letter from his old psychiatrist (possibly 3-4 years ago now) suffice, simply stating the outline of treatment he received while under their care and that he is now mentally stable? Or would something more recent be appropriate (if so, where can we get something like this?!)

Thank you again for all your help!

Samantha.

better chance of an answer may come if posted in the UK forum.... moving

[JeremyR 8]

Please consider this entire post to be labelled 'Your Mileage May Vary' and 'I Am Not A Lawyer' because I don't have bi-polar disorder. That said I do have some long-term depression issues and can share my medical experiences and the process that was outlined to me by the panel physician.

I declared my depression and the anti-depressants that I was on at the time (not any more ) as well as some CBT that I did about a year prior on the medical questionnaire. This is obvious but cannot be understated - be totally honest on that form. When I went in to see the doctor and we got around to the subject of mental health, she said that she would ask me some questions and decide if my condition warranted "further investigation to determine my eligibility for a visa" and that the further investigation would be writing to my GP to get a report regarding whether or not I was a danger to myself or others. She asked what treatment I had received and when, then went over all the standard 'have you ever tried to harm yourself' type questions . Fortunately, she decided I'm not dangerous so she tip-ex'd out my 'Yes' on the questionnaire and ticked 'No' instead and that was that.

My issues were/are not bi-polar disorder as I said but I can only assume the principle will be the same where there's a history of depression-related illness - they will write to the GP for more info if they can't decide for themselves. I would hazard a guess that an exchange of letters between GP and Knightsbridge Doctors could take a few weeks so you might want to suggest your fiancé schedule his medical as early as possible to maximise the time available before his visa interview at the embassy. Also, I believe that NHS GPs are allowed to charge a covering fee for this sort of disclosure report/letter but it shouldn't be expensive.

Sorry I don't have any advice on what exactly happens if it gets referred to his GP (I'd imagine it varies from GP to GP in any case) but I wanted to just outline what the process was for me, just over a year ago.

Oh, one more thing - be absolutely certain to fully disclose any medications including dosages on the medical questionnaire - taking a photocopy of the most recent prescription to the medical might be a good idea.

Good luck

[sammills89 2]

That was incredibly helpful and reassuring, thank you! On the down side, he has had some self-inflicted harm issues way in his past, only the once but he was hospitalised for it. We're hoping that because he has not had an 'episode' in many years, and only really ever had the one major one it will be viewed as a low level problem. He has contacted his psychiatric nurse to request his treatment and discharge information so hopefully that will come in handy.

What sort of questions did they ask you at the extended interview? We would love for him to book the medical asap but unfortunately he can't do that until we get the letter from the embassy. It's killing us! Thank you for the extensive reply though!

[Talyss 0]

That was incredibly helpful and reassuring, thank you! On the down side, he has had some self-inflicted harm issues way in his past, only the once but he was hospitalised for it. We're hoping that because he has not had an 'episode' in many years, and only really ever had the one major one it will be viewed as a low level problem. He has contacted his psychiatric nurse to request his treatment and discharge information so hopefully that will come in handy.

What sort of questions did they ask you at the extended interview? We would love for him to book the medical asap but unfortunately he can't do that until we get the letter from the embassy. It's killing us! Thank you for the extensive reply though!

If you have the case number you can book the medical in advance - no need to wait for packet 3. You can download all the forms you need from the embassy website.

Edited March 4, 2009 by Talyss

[JeremyR 8]

I'm not sure what you mean by extended interview - my K-1 interview at the embassy was over in less than 5 minutes If you get an 'OK' from the medical, no questions about it should come up at the interview.

Perhaps in your fiancé's case, he could consider pre-emptively obtaining a letter from his GP and taking them (with the discharge papers he's getting) to his medical. Total transparency, a willingness to openly discuss it with the panel physician and consenting to them obtaining his medical history are what is most important. That way, he will show that he has nothing to hide.

[sammills89 2]

Sorry I didn't mean to type that! I meant extended medical (with other tests etc). He is going to e-mail his psychiatric nurse now as I mentioned, but I think your advice about being entirely open and willing to give them information is the best I've heard so far! Slowly putting our troubled minds at ease! We can't wait until this is all over!

[sammills89 2]

As regards to booking the medical in advance, we're still waiting for our petition to be approved! Should be soon we hope, been waiting a while (not as long as some though!). Can he still book the medical or is it best to wait for it to be approved?

[Talyss 0]

As regards to booking the medical in advance, we're still waiting for our petition to be approved! Should be soon we hope, been waiting a while (not as long as some though!). Can he still book the medical or is it best to wait for it to be approved?

ah my misunderstanding I thought you were waiting on packet 3.

Once you have your NA02 and the case has gone to the NVC you can ring the NVC for the case number. That is the number you will need when booking the medical.

[JeremyR 8]

Can he still book the medical or is it best to wait for it to be approved?

You need to wait until he's approved and the case has been through the NVC (doesn't take that long), when it will be allocated a new case number (starting LND this time). Knightsbridge Doctors won't schedule a medical unless you can give them an LND number. You can obtain the LND number before London send out the forms by calling the Dept. of State, I think but we didn't do this so I don't know the precise details. It's a balancing act though because you don't want the embassy to receive the medical report before they receive the file from NVC (otherwise they'd surely think 'who on earth is this?')

My medical wasn't extended either. Basically they did the normal chest X-ray, blood HIV/syphilis test, checked my vaccinations, eyesight, etc, and that was about it. The discussion about mental health, she just asked me a few basic questions:

'How long have you been depressed?'

'Have you ever tried to harm yourself or others?' (no)

'What treatment have you received?' (told her about an SSRI that I was on at the time and the CBT I went through a year or so earlier)

'Do you think the treatment helped?' (yes)

'Do you still consider yourself depressed?' (explained how my relationship had helped more than any treatment but that I wouldn't be 'better' until I was back with my fiancée )

I think that was about it. Really, she didn't probe too deeply but YMMV from case to case just how in-depth they go, I suppose. Thinking about it a bit, in retrospect, I suspect what she was really looking to answer for herself was 'if he goes downhill again, will he seek help before he becomes a risk to himself/others?'

Remember that having a history of mental health problems is not a block to visa issuance - not being able to safely manage those problems should they come back in the future is what they're looking out for.

[sammills89 2]

Oh okay, yeah as soon as we receive the NOA2 then I'll make sure he gets on it to avoid any delay, London is a fair drive away from him too so it will be good to break it up! The point about them not being worried about the history of depression but more the future of it was quite interesting, shed a whole window of light on this mess! Fingers crossed we wont have a problem though, just take it as it comes for the time being! Thanks for your help though guys, really has done wonders!

[rebeccajo 14]

Is he on any medications for his disorder?

A truly 'bi-polar' patient will be on medication for maintenance.

If he is still medicated, I would hazard an educated guess that he will need a letter from a psychiatrist about his current condition.

[sammills89 2]

Is he on any medications for his disorder?

A truly 'bi-polar' patient will be on medication for maintenance.

If he is still medicated, I would hazard an educated guess that he will need a letter from a psychiatrist about his current condition.

He was on lithium for about 2 years when it was very serious, but we're now contemplating whether to state it or not because after speaking to his psychiatrist no-one ever officially diagnosed him with bi polar. Apparently he was given that diagnosis and then sent for a second opinion which brought up inconclusive results. He is no longer on any medication, so hopefully this wont be a problem. He has been advised by his old psychiatric nurse to get a letter from his GP saying that he's all clear. The wait continues.

[rebeccajo 14]

Is he on any medications for his disorder?

A truly 'bi-polar' patient will be on medication for maintenance.

If he is still medicated, I would hazard an educated guess that he will need a letter from a psychiatrist about his current condition.

He was on lithium for about 2 years when it was very serious, but we're now contemplating whether to state it or not because after speaking to his psychiatrist no-one ever officially diagnosed him with bi polar. Apparently he was given that diagnosis and then sent for a second opinion which brought up inconclusive results. He is no longer on any medication, so hopefully this wont be a problem. He has been advised by his old psychiatric nurse to get a letter from his GP saying that he's all clear. The wait continues.

If your fiance was never put through a battery of psychological tests to narrow down his condition, then any other 'diagnosis' he may have received is indeed inconclusive.

Psychiatrists (despite the fact that they are MD's who actually dispense medication) generally do not perform the in-depth testing that a psychologist performs which can actually pinpoint a disorder.

I think it's best to disclose his entire psychiatric history including prior medications. Personally I would want to go to my medical examination with nothing less than TWO letters - one from a GP and one from a mental health professional (either a psychiatrist or psychologist). In my past readings of similar cases, I do believe he will come out OK if he is both prepared with evidence and forthright in his answers.

Edited March 8, 2009 by rebeccajo

[sammills89 2]

Yeah he was seen by many different mental health professionals and never really had his condition pinpointed, unfortunately between him and his parents they just accepted what everyone thought! It may not be possible for him to get a letter from his psychiatrist as it was a few years ago now, he can however get a letter from his GP no problem. Luckily he's always been open about his illness and willing to discuss it with anyone who asks so that shouldn't be a problem, please bear in mind I mean friends and colleagues who ask! Does anyone know of anywhere to be independently reviewed by a mental health professional in the UK?