Knightsbridge medical review - mental health history

[Two Lost Souls 45]

I had my medical appointment at Knightsbridge today and I thought my experience might be useful to others, particularly those with mental health issues in their past.

 

I arrived at Knightsbridge at 1.30pm for a 1.50pm appointment. I found the location instructions in the e-mail they sent me to be very useful and I found it easily (I walked, using google maps as a guide). The receptionist told me to wait in the waiting room as I was a bit early, and return to the counter when it was my appointment time. I was SUPER NERVOUS, I can't even begin to tell you. The waiting room is quite comfortable, and it was quite busy when I was in there. at 1.50pm I returned to the counter, and the receptionist requested all my documents (they give you a list of what to bring in the e-mail) so that she could photocopy them. She photocopied everything and returned it all to me, except my passport and ID photographs. She gave me a urine sample bottle and some more paperwork to fill out, which was mainly general medical questions. When I was done, I returned that to the counter and went back to the waiting room.

 

Almost immediately I was called to have my chest X ray. The technician was friendly and gave me clear instructions on what to do. You have to remove all clothing from neck to waist, but they give you a gown to wear and you're never exposed. It was very straightforward. He then took me straight to the nurse to go over my vaccinations, however I didn't even sit down with her as she said she'd looked over my immunisation record and everything was in order, and she had signed me off. (For reference, I'd gotten a flu jab, MMR 2nd dose, and DTaP at my GP prior to the appointment, and I had chickenpox as a child which they took my word for).

 

After this I went straight to the bathroom to do my urine sample. As I came out of the bathrooms, the doctor was already waiting for me! I handed my urine sample in to reception and went straight in with the doctor. She did some ID checks, and then asked me some medical questions about my general health and medical history. I don't have much significant history, just mental health issues which I'll go onto in a minute. She took my blood pressure, and asked me if I was nervous, and I said I was very nervous! I'm guessing my pulse was high. She was very reassuring and said there were lots of horror stories online, but that it was simple process and I shouldn't worry. She was really friendly and reassuring and put me at ease as much as possible. She said all the information I had brought with me looked good. We then talked about my past mental health problems.

 

(Warning: discussion of depression & self harm ahead)

 

I had depression for most of my late teens and early twenties (I'm 32 now). I was a self-harmer for many of those years, which caused me significant physical scarring that is still very visible on my arms to this day. I was diagnosed with Depressive Disorder NEC, and I was on medications for a number of years. I didn't make any suicide attempts, and I was never hospitalised for depression, but I was treated by a GP, psychiatrist and mental health team. I've been off antidepressants since 2015 and have been stable since then. I had read lots of posts about the medical on VisaJourney, so in advance I spoke to my doctors and requested a patient summary, my medical notes relating to my depression, as well as a summary letter regarding my depressive illness from my current GP. It cost me £75 as it was classed as a "complex letter/report" by my surgery, but I figured it would be worth it if it meant there were no hitches with my visa medical. I'll post an example of what the doctor wrote for me at the end of this post.

 

After I answered her questions about my mental health history, she said she thinks the documents I provided will be sufficient. She said they *may* want copies of old letters between my GP and mental health services, and if they do (I'm not sure who "they" is! I should have asked), then they will contact me in the next few days. However, she said in her opinion the GP letter and report was enough. She said what they are mainly looking for is whether the illness is resolved or still ongoing.

 

After this, she took my height and weight and did some brief physical checks like lymph nodes, eyes/ears/mouth. I then had to undress to underwear and sit on the examination table (she said I could wear a gown if I wanted). She checked my chest, lungs, tummy, joint movement, and reflexes. I then dressed again and she took a blood sample. She said the blood and urine sample are to check for syphilis and gonorrhea, and the chest X ray for TB. After this she said I was all done, and I just needed to head to reception in order to complete payment! I had only been in there for 55 minutes total and I was expecting it to take longer.

 

I paid the £330 fee at the reception counter, and the receptionist gave me my immunisation record (that I need to keep safe for the Adjustment of Status phase), and my passport back.

 

And that was it! I was in and out of there in just under an hour. I'm hoping that they don't request any more information from me about my mental health history. If they do, I'll update this so that in future people might know exactly what they want for mental health history, as in the instructions e-mail they send it doesn't specify - indeed the doctor asked me how I knew to get the letter from my GP and I said I had read about it on web forums.

 

I hope this is helpful! In the end it was a lot less painful than I expected. I'm glad I had prepared by reading online about what documents to take with me, but equally doing all that research probably contributed to me feeling so anxious about the whole process. All the staff at Knightsbridge were friendly and gave good clear instructions about what to do so I didn't feel confused at any point. With mental health issues, it seems that they are looking to collect the full picture of diagnosis/treatment/prognosis in order to be sure that the issue has been dealt with. I imagine they ask further questions or want a bit extra info if you ever had suicidal intent. It seems you just need to have enough evidence to back up that you are now well and not a risk to anyone so it's probably worth collating that some time before the appointment to avoid the inevitable long wait for the GP surgery to get it all together.

 

 

 

---------------

 

Documents I requested from my GP 4 weeks prior to the appointment:

 

* Medical records relating to my Depressive Disorder NEC diagnosis. This was 2 and a bit A4 pages which just describes the visits to medical professionals that I made, that related to my diagnosis. It spanned 10 years, from my diagnosis in 2005 to my last visit when I was weaning off medication in 2015. It didn't include any details about visits to minor injury units after episodes of self-harm, though I did disclose these to the doctor when she asked. It also didn't include any info about the counselling I received, and I don't think there's anything on there from the psychiatrist either (though I think I only saw them once or twice - they only oversaw the changing of my meds, I can't really remember too well).

 

* Patient summary (everyone needs this, not just those with prior mental health issues)

 

* A letter detailing my mental health diagnosis, treatment, and prognosis from my GP containing a few key phrases (like that I am currently well and healthy, and I am not a risk to self or others). Here's what the GP wrote:

 

"Dear sir/madam,

 

I write in my capacity as GP at [GP surgery] where this patient is registered.

 

[Patient] was diagnosed with Depression in 2005 aged 19 years. She was treated with [medication]. At this time she was self-harming by making cuts to her arms. She was switched to several different SSRI antidepressants - [medication], then [medication]. She also received some counselling. She was referred to see a psychiatrist in 2009 and her antidepressant was switched to [medication]. She was stable until 2012 when she was referred back to mental health services and was again quickly stabilised back on antidepressants. She has never made a suicide attempt.

 

She has been off antidepressants since July 2015 and her mood has been stable since this time with no more episodes of self-harm or depression. There is no indication that we should expect her to have further episodes of depression. It is of my opinion that [patient] is of no risk to herself or others.

 

Yours faithfully,

 

[GP]"

 

 

[Crazy Cat 39,227]

Nice report.  Thanks for posting......

[Two Lost Souls 45]

As an update, Knightsbridge did not require anything further from me, and my medical has been sent to the embassy ready for my interview tomorrow

[yuna628 9,528]

Thanks for the update on this OP. You came into Knightsbridge fully prepared and it's a good example of what others should try and do to avoid any issues if they have a past history. Glad it worked out for you. Good luck with the interview, you'll be with your loved one soon!

[Whanlin 42]

My fiance has his medical Jan 17th. No one has any records of his treatment for depression. The only note in anything is a tiny little blurb about "was depressed". He saw a therapist and took medicine for under a year, he too has self harm scars. His GP doctor refused to write a letter for him. He did write a little snip-it on his actual summery that says he doesn't feel my fiance is a threat to himself or others, but added he wrote this at the request of my fiance who wants to immigrate. The clinic where he attended has went out of business and after contacting others (going down the chain) its clear his records have just vanished. We know this would be his biggest obstacle so we have been actively trying to get his stuff together since September. Now a month before the interview we have very very little to give Knightsbridge. We are heart sick. We are looking at an out right refusal at worst or a very expensive Psych Eval at best. Any advice? 

[Wuozopo 4,285]

1 hour ago, Whanlin said:

We are looking at an out right refusal at worst or a very expensive Psych Eval at best. Any advice? 

It seems like you have done your due diligence and now you just wait and find out. No point in working yourself up with a lot of speculation. Explain to the doctor doing the exam the efforts made to document his treatment and his GP's reluctance to stick his neck out and predict future behavior. That's why Knightsbridge wants another doctor to say it...to cover their #######.  Be calm and rational because they are evaluating demeanor when they seem  to be just gabbing about the weather. Then they accept what they have or invite him back to see their psychiatrist.  I have known several self harm people to get through without much ado. An outright denial seems unlikely unless he went in with freshly made cuts to indicate he still has an active problem. That won't be the case, so nothing screaming denial at them. Practice acting calm and self assured. Poker face. You got this.

[Two Lost Souls 45]

4 hours ago, Whanlin said:

My fiance has his medical Jan 17th. No one has any records of his treatment for depression. The only note in anything is a tiny little blurb about "was depressed". He saw a therapist and took medicine for under a year, he too has self harm scars. His GP doctor refused to write a letter for him. He did write a little snip-it on his actual summery that says he doesn't feel my fiance is a threat to himself or others, but added he wrote this at the request of my fiance who wants to immigrate. The clinic where he attended has went out of business and after contacting others (going down the chain) its clear his records have just vanished. We know this would be his biggest obstacle so we have been actively trying to get his stuff together since September. Now a month before the interview we have very very little to give Knightsbridge. We are heart sick. We are looking at an out right refusal at worst or a very expensive Psych Eval at best. Any advice? 

That sounds stressful On what grounds did the GP refuse to write a letter for him? On his patient summary, is "depression" or anything like that listed as an active problem/major prior illness/proper diagnosis, or is it just mentioned in passing?

 

As a precaution, he could try to book an assessment appointment with his GP (or a different GP at the same surgery if his isn't being very helpful). That way your fiance could go through his history with the GP and explain all the treatments he's had, and ask that the GP writes him a bit of a summary of his past depression and does an assessment of how he is doing currently. That way you have something concrete to give Knightsbridge. I imagine that will cost you, though - getting my GP surgery to give me my medical notes relating to my depression plus a summary letter from my GP was £75.00 and took about 2 weeks. I didn't have any reports from the psychiatrist I saw once, nor reports from the minor injuries units that patched me up a couple of times, nor did I have any correspondence from places where I'd received counselling. It was a letter from my current GP who had reviewed my notes, summarised them, and made her own judgement about my prognosis.

 

I imagine Knightsbridge will want to look deeper than what you currently have. They are looking for evidence that the depressive illness has been dealt with and is no longer an active problem. As Wuozopo said, worst case would be that they refer your fiance to their own psychiatrist for an assessment that you would need to foot the bill for. It is highly unlikely that they would give an immediate denial based on mental illness on a medical history - they will give you the chance to obtain more documents or to provide them with whatever they need.

 

Has your fiance been quite pushy with his GP surgery? I have found that you need to be quite pushy with them and very direct and clear with requests. For example, "the US Embassy requires that I have a letter from my GP detailing my mental health history and current mental state". They will probably want you to pay for it but at least you will be prepared. You could even show them the e-mail where it asks for a patient summary plus further evidence when major illnesses or mental health problems are involved.

 

I understand how stressful this can be, I was incredibly stressed about the medical as I knew there would be questions about my mental health. The more prepared you can be, the better. I will say that everyone at Knightsbridge is very friendly and reassuring, and they do not appear to be trying to catch you out or cause more stress or make a denial just for the sake of it. The doctor who did my assessment was absolutely lovely and friendly. They just need to cover their bases and make sure they have enough evidence that the mental health issue has been resolved and your fiance is healthy.

 

If you have any other questions and/or need moral support, feel free to inbox me!

 

[Whanlin 42]

Tnanks so much for taking the time to answer me. Honestly, this has been so stressful that we both have just stopped even discussing it and it has really taken the wind out of our sails. 

 

Well to start with Im thinking the GP is getting annoyed with him always asking for more stuff. When his doctor started stonewalling my fiance even went investigating into his actual NHS records and nothing. It is so very strange that someone can be treated for a year and there isn't a scrape of evidence about it, except the scars. If he didn't have the scars I would think "No record" might even work in his favor but having the scars will I'm positive make them want to know more. The depression is not listed as an active medical condition. It was just part of some notes in his summery from back during one of his office visits he attended during his treatment.  this was 16 years ago. He has no fresh scars at all and nothing at present that is indicative of a current mental health issue. He has paid the GP 40 pounds for the little bit he has gotten and when he pushed last time the GP set up a phone consultation in which the GP basically said there wasn't much more he could actually do and that what the US government needs is not his concern. I can't actually blame the doctor because since there is no notes to go on at all he is sort of feeling his way in the dark. My fiance has been pretty firm with his requests but knowing him, probably not that pushy. I feel he should set up his own psych eval and present that to Knightsbridge, but the fear is they will want him seen by their Psychologist and then we have double the expense.  It is what it is and as the very wise Wuozopo has said worrying wont get us no where. I fly in the day after his medical and I'm really hoping for good

[Wuozopo 4,285]

Let's talk reality. The reason (most) people get all caught up in bringing proper documentation is so their visa will not be delayed. The wait has been long , they start acting like one more day is a month. They want to head out the day after the visa arrives.  If you just get your head around the fact that you may not beat the record of the fastest from NOA2 to POE, it may take the stress off. Build an extra month or so into your mental timeline just in case you have to have another appointment. It may not even happen.  Don't let dates you must be together like Valentines, birthdays, the anniversary of meeting, the desired wedding date, etc set up deadlines for you. They are just dates that will roll around again and again. Tell yourself and your friends who constantly ask, "When is he coming?" that you are guessing April. Then if it happens in February, it's a bonus. There is no doubt he will get here. Having perfect documentation on the day of the medical is not a pass/fail situation. It just means you may cross the finish line sooner than the one who is asked for something additional. Both are winners. 

[AmandaandChayne 734]

Windy @Whanlin can’t get into vj but just wanted you all to know from Wayne’s medical that  “ basically Dr said he wished the GP would have included the last time Wayne self harmed but he feels the little bit he was able to get will be enough (his scars are super old looking so that probably helped)”