Experience at Visa Medicals, London with ongoing/active mental health issues

[Hanxa 9]

I posted this on Reddit, but it may help people here as well. If the doctor who saw me today looks at this forum, hi!! And thank you again. I hope to put more people's mind at ease as you did for me. 

 

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Trigger warning: depression, self-harm, SA

UK to USA CR-1/IR-1

I want to preface this with a bit about why I'm writing this post. In the run up to my appointment, I have been made increasingly worried by the prospect of 'failing' the medical aspect due to my very long history of self harm and my ongoing depression. Everywhere I looked, people were asking questions about what to do and were met with lots of suggestions and also a lot of scaremongering. It has been stressful and if I can help anyone else alleviate that stress, I will.

 

I will list out my recommendations at the end if you want to skip over the long experience stuff. This doesn't have to be a big scary process and I want to offer some reassurances that I couldn't find. Heads up, I am writing this on my phone on the tube home, so please forgive typos... I'll fix them when I see them or they are pointed out. 

 

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My experience

My history

It's important to give a little context to the experience as this won't apply to everyone. For example, this will likely not apply to drug users. But for people either with a history of SH or ongoing mental health issues, it might be of use. 

I have engaged in SH behaviours for much of my life, both as a child for nearly a decade and relatively recently. The last time I did was a year ago, but I am very aware that this may not last as I had one break of about three years.

I have been with mental health services on and off since I was 15. First with CAMHS until I aged out. Then a few years later with NHS talking therapies. Then with a rapid response team two years ago, my GP and again now with NHS talking therapies. I am also on a waiting list for trauma counselling with the Havens in London due to very recent events that have expedited my immigration case. 

I have been on medication for the past 2 years and 3 months. 

I have never been hospitalised for my mental health. 

This is all relevant for the medical. 

 

Preparation: before the appointment.

Right from the get go, filing the I-130, I was worried about this part of the process. I know there is a lot of stress around proving a relationship and all that jazz, but there is so much speculation around the medical.

In hindsight and under different circumstances, I would have started getting what I needed while at NVC. By the time we were preparing, I was at crunch point which added so much extra stress. My GP took a very long time.

First thing I did with my GP was fill out an SAR for my medical records, vaccination records and a letter regarding my mental health. This took them six weeks to fulfil. I booked the medical once they gave me a collection date and then had a ton of stress around that because they missed the collection date. I finally picked everything up yesterday. My appointment was today.

I also arranged a consultation with a second doctor privately (I used GoGoDoc with a telephone consultation) to request a second letter from them regarding my current state. I didn't need this, but I felt it would be beneficial to have two professional opinions. If I had had my first appointment with the most recent TT, I would have requested one from the therapist as well.

I'll post the wording of the letters in a comment thread after this post. I had to be VERY explicit with both my surgery and the second doctor that the wording no 'risk to herself or others' had to be there if they felt it was accurate. The GP letter has quite a bit of detail that proved helpful.

I filled in the questionnaire and ticked yes for 1 hospitalisations (three surgeries, not related to mental health), yes for 5 mental health disorders/depression, yes for 9 deliberate injury to myself or others and yes for 11 medication. I then wrote up a paragraph for each part (expect the last on which just stated my medication and dosage). The supplementary page was one side of A4. I will post a redacted version in the comments for an idea of what was included. 

 

The appointment

Visa Medicals is kind of hidden away. It's not far from Bond Street station. I ubered in thanks to the tube strike continuing this morning and gave myself two hours for what would be a 30 minute journey without traffic. It was barely enough. Huge source of stress.

When I arrived, they took my picture as my case is digital - they didn't need the passport photos I brought so I will be taking them to my interview next week. They then took all my documents, removed all staples and photocopied them. The originals were returned to me and they took the questionnaire and supplementary information sheet. I then had to fill out a more detailed questionnaire (yes/no again) and was again honest when asked if I ever had thought about harming myself and if I had ever acted on them.

I then sat in the waiting room for a while. I saw the doctor first (you may see any of the three components in any order). I had requested a female doctor due to the physical examination part and my responses to men coming into contact with me following a recent SA. This was not a problem. I did not request a chaperone, though you have every right to.

First, she asked how I was and I told her I was very nervous. Immediately, she reassured me - she had looked over my records, my own statement and the letters from two doctors and was happy with that. She would need to ask questions, but was very happy I had come prepared and had been very upfront in how recently my situation has changed and adjusted. It wouldn't be a problem from her standpoint or a barrier to the Consulate approving my visa. 

The first part of the assessment was mostly talking. She asked about my history with SH, my method and my motivations. She asked when I had last done so, and I told her it was June last year. She asked about the help I have received over the years and we talked about my calling the crisis line two years ago. We discussed my medication and how it has helped but I knew it hadn't solved the problem. I'm in very regular contact with both my GP and various MH services whenever I notice a change in my MH. The last six weeks, I have been in near constant contact due to recent events that have happened very close together. We talked about my support plan and my plans for the US if I am approved. I told her that we had already looked into insurance options and sorting out my prescription to form a plan and I would have a buffer window of my medication with me. My remote support would continue. 

She said that, because I have a clear history of seeking help and support, have remained consistent and am very aware and forthcoming about my current mental health, that she was satisfied. She was happy that I am constantly reflective on my own condition and that I am aware that I will continue to fluctuate and seek out support whenever it is needed. I didn't hide anything. I probably gave more than I needed to, if I'm honest, but I would do so again. I've stabilised as much as I have by being honest. 

I had read that the physical would be in a gown. I don't know if it was due to recent trauma (all in my medical notes) but I didn't. Please be aware this might not be the norm. I had to undo my dress buttons so she could listen to my chest and I had to pull up my leggings so that she could look at my scars and check they were not more recent than said. Beyond that, I remained fully clothed. I showed her all the scars I know I have. She took my blood pressure and drew some blood, took my height and weight and temperature. Then, that part was done. 

The second part was the chest x-ray for TB with a nurse. This did require a gown. The final part was reviewing my vaccinations. I'm up to date on everything so they didn't need to see me for that. I paid the £350, collected my passport, signed more forms and then left. They will contact me if something comes up from the x-ray or the blood tests but other than that, I am good on their end. 

All in all, quite painless. 

 

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Key takeaways

- Be prepared. I can't overstate this. Check everything and make a list of what you need. There are no shortcuts
- Be honest. Trying to hide things or lie make it look like you have more to hide. Honesty really is the best policy.

 

My recommendations

1. Get your records early. Sure, some GPs are faster than others and for the care summary, they don't need to do much, but my initial given time frame of 28 days turned into 6 weeks.
2. Get a second opinion. Be it a therapist or another medical professional, having two people stating you are not a risk is more compelling. This isn't essential, but honestly anything that makes it smoother is worth it. The appointment cost £40 and the letter £25 and I'd pay it again in a heartbeat!
3. Be factual in your supplementary information. Facts and dates. Take out the 'I feel' and all that. It isn't necessary.
4. Be honest and complete in your supplementary information.
5. Don't try to cover scars. They are going to see them and even great coverage won't hold up to close inspection. If you try to hide them, what else are you hiding?
6. Seek out support and document the support you have received, wherever it is from. Phone lines, charities, 111, therapy, GP, specialist services. Document it all.

 

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I hope this is helpful to someone else and puts their mind at ease. Every case is different but there is no need to panic. The doctor said it really well... They aren't trying to go against you. That's not their job. They aren't trying to deny people and split up families. There is a very real risk in the US if you have MH issues, especially with the ready access to lethal weapons. If you are genuinely not a risk to yourself or others, you have nothing to worry about.

 

I'll post the letters when I get home 😊

Edited June 7, 2022 by Hanxa

[Hanxa 9]

So, I fell asleep when I got home. Very drained. 

These are the letters. Disclosure: still on mobile. 

First is from my GP:

6 hours ago, Hanxa said:

 To whom it may concern,
[Hanxa] has been registered at the practice since [DATE].
[Hanxa] has a history and diagnosis of depressive disorder. She has informed me that she was first diagnosed in [DATE (was in a separate area at the time)]. We affirmed this diagnosis in [MONTH YEAR]. She has engaged in self-harming behavioursboth as a teenager and her late 20s and has visible scars as a result. She has always been open with our medical team about her actions and there is no physical evidence to contradict her statement that it has been a year since she has last harmed herself. There is no evidence to suggest she will harm herself again. 
[Hanxa] has engaged well with treatment following treatment with the [local rapid response team]. She was assessed then to not be an immediate risk to herself or others at the time and has maintained regular contact with the practice. [Hanxa] has consistently taken her medication since [MONTH YEAR]. She has self-referred to TT due to a recent bereavement. She is awaiting a [specific local service] appointment for specialised trauma support.
Following her latest appointment, I have no concerns about [Hanxa] posing a threat either to herself or others.

 

The second letter was from GoGoDoc:

6 hours ago, Hanxa said:

To whom it may concern,

I can confirm that I reviewed [Hanxa] on the [DATE]. She does have a diagnosis of depressive disorder with a history of self-harm in 2017 [NOTE: this was the only time I required medical support], since then she has engaged in therapy and is stable on medication, she has remained stable for over 1 year.

I deem her stable from a mental health perspective and not a current risk to herself or others.