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Help! Sister with Schzioaffective Disorder

My sister is 33 yo and has a diagnosis of schzioaffective disorder. She received this diagnosis almost 2 years ago however is still non accepting and holds a belief that there is nothing wrong with her. She continues to take herself off her medication as soon as she is discharged from the public system because she is fearful the medication will cause brain damage. Even a CTO and depot injection do not help in this situation because my sister has taken to moving interstate, and more recently, taken off overseas. Currently she is in the UK; DFAT found her after being admitted into a public hospital over there. Prior to this she had been listed in Australia as a missing person for 2 months after not appearing to her psychiatric appointments and not being found at the home. DFAT can not force her to return home, she is free to be in the UK.

She has many symptoms and behavioural challenges, but 2 that are my family's biggest concern is impulsivity and risk taking....in particular spending, and now taking herself overseas. My sister has no concept of money, debt, saving etc. She continues to spend, takes herself overseas with no money, puts herself into huge debt using credit cards. Last year my parents gave my sister up to $50,000 to pay off debts and pay for living expenses, ultimately to prevent her from bankruptcy...only for my sister to turn around and put herself in a hole again. My father is now retired and can not afford to continue helping her like this. 

She has recently contacted my mother asking for more money; she went to the UK with nothing but credit cards and says she is living off 35 pounds per week for food, staying in temporary accommodation organised by DFAT after being discharged from hospital. My parents do not have a significant amount of money spare, in fact my father has washed his hands of her and will no longer help her. I had thoughts myself, to go over to the UK and although difficult, try and convince her to come back to Australia, however i do that she does not want to come back because she is fearful of being re-admitted (in the last 2 years she has been in hospital 8 times). She refers to herself as "society's play thing". Friends (with no experience with these types of disorders) have told me to let her fend for herself, not to go over there, she got there herself and she can get herself back, if no one helps her now they guarantee she will get back herself somehow and guarantee she will think twice before getting herself in a terrible situation again, that my sister has to do this on her own. What they don't understand is that this disorder affects the logical, rational and judgemental part of her brain. All of these behaviors are apart of her illness. The fact that she is in denial is also part of her illness because she can't actually see what she is doing due to her impaired awareness. To add to this she is currently alone, in another country, unmedicated, with very limited access to medical resources.

Those who have interacted with this disorder and experienced financial challenges, what do you believe would be the most benefical action to take? 

Help, don't help? Stay or travel to her?

4 REPLIES 4

Re: Help! Sister with Schzioaffective Disorder

Hello @NoMudNoLotus 

I can sense a "damned if you do" and "damned if you dont" feeling there. Perhaps speaking to someone at the Sane Help Centre who might be experienced in these matteres might be useful 1800 187 263, often bailing someone out is not the best solution as giving money does not change behaviour.  As you say often their thinking is often not logical and learning appropriate ways to encourage personal responsibilty is a process. As you mention she might be reluctant to return to Aust given her history of involuntary treatment and family pleas often fall on deaf ears; her "lack of insight" really does complicate matters.

 

Australia has reciprocal health arrangements with the UK so your sister would get free public hospital treatment and the British equivalent of medicare rebate for outpatient services - not sure how that plays out in relation to the practicalities of GP visits. (Here in Aus a Brit could be bulk billed at the discretion of a GP or get back from medicare what we would get for a privately paid visit).   I would also imagine that the UK Mental Health Act would have similar provisions for when a patient can or cannot be treated as an involuntary patient (https://www.nhs.uk/using-the-nhs/nhs-services/mental-health-services/mental-health-act/)

 

The British Royal College of  Psychiatriatrists does have this info which might be helpful for the UK end https://www.rcpsych.ac.uk/mental-health/problems-disorders/debt-and-mental-health

 

 

Re: Help! Sister with Schzioaffective Disorder

Thanks for the details; i followed the links and looked into your information, you are correct! There is an agreement between these 2 countries. The Reciprocal Health Care Agreement (RHCA) we have with the United Kingdom (UK) allows travelling Australians to access:

  • care from a National Health Service (NHS) doctor or nurse at a GP surgery - you need to register there as an NHS patient
  • care in a public ward of an NHS hospital
  • out-patient care at an NHS hospital
  • ambulance travel to an NHS hospital or other NHS facilities
  • prescription medicine if the doctor treats you as an NHS patient - there’s a small fee for this. It is a relief to know that she at least has these services available to her; DFAT didn't advise my family of this info during their contact with us. 

Re: Help! Sister with Schzioaffective Disorder

For anyone following this post or may find helpful in the future,

Where we are at currently is we have spoken to sane.org and Mental Health Carers NSW.

Our advice, if i am willing, my sister is very lucky to have someone drop everything and come to the UK to support her. During a crisis, this is not the time to be teaching lessons and let someone fend for themselves; people with schizophenia/ schizoaffective disorder are 3 times more likely to commit suicide.

My sister has been assigned a DFAT caseworker, looking after her and communicating with us here in Australia. It has been suggested that we ask the caseworker:

  • For more information about what can be done. Do raise concerns about sister's welfare, and provide medical history.
  • For assistance in connecting to whoever is looking after sister in the UK (hospital, case manager etc.).
  • For the contact details of other people or organisations that the caseworker knows of that could give more information.

Sane.org also gave the details of 1 organisation in the UK that may be able to give more info:

Samaritans
United Kingdom & Ireland
116 123
www.samaritans.org
Samaritans is a registered charity aimed at providing emotional support to anyone in distress or at risk of suicide.

Re: Help! Sister with Schzioaffective Disorder

@NoMudNoLotus 

Trust things are becoming a little clearer for you as to what path you should take.

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