It seems we hear about bipolar disorder more and more these days. Personally, I do not think it is because more people have it; my belief is that we have better diagnostic tools and the stigma against mental illness is fading. Our law, 8 U.S.C. Section 1182(a)(1)(A)(iii), prohibits certain individuals with mental illness from immigrating to the United States. These individuals include persons who:
- Have a current physical or mental disorder with associated harmful behavior;
- Have a past physical or mental disorder with associated harmful behavior if the harmful behavior is likely to recur or lead to other harmful behavior in the future.
Not everyone with bipolar disorder is inadmissible. Your illness has to meet the definition such that it makes you inadmissible. The determination of whether or not you have a mental illness is made by a physician at the time you have a medical exam. (A medical exam is necessary for every immigrant who is entering the United States and is performed by a panel physician – a physician authorized by the State Department (abroad) or by USCIS (in the United States) to conduct these examinations.
As part of the medical evaluation, panel physicians are instructed to
- identify and diagnose any physical or mental disorder;
- identify any harmful behavior associated with a disorder;
- determine the remission status of any disorder previously diagnosed;
- determine the likelihood of recurrence of harmful behaviors associated with a mental disorder.
A harmful disorder is defined as an action with a mental or physical disorder that is or has caused -
- Serious psychological or physical injury to the applicant or to others (e.g., a suicide attempt or pedophilia);
- A Serious threat to health or safety (e.g. driving while intoxicated or verbally threatening to kill someone);
- Major property damage.
The Centers for Disease Control and Prevention recently published technical instructions to assist physicians in evaluating physical and mental disorders.
To determine if a person is engaging in current harmful behavior, the physician is instructed to ask about harmful behavior and determine if it has continuously occurred and seems ongoing. If so, the physician is required to evaluate whether the actions may be indicative of a mental disorder.
To determine if a person is likely to engage in future harmful behavior, the physician has to determine whether the behavior is likely to recur. According to the guidance issued by the CDC, harmful behavior is less likely to recur when a mental disorder has a favorable prognosis and is in remission or under control and if there was harmful behavior, it has been more than 12 months since the harmful behavior occurred.
Remission is defined as a period of 12 months in which no mental disorder-associated behaviors have occurred.
The best way to handle this issue is to argue that your bipolar disorder does not make you inadmissible. If you have not already sought mental health treatment, you must do so. If you have current harmful behavior, I would advise you to wait 12 months before applying. At the time of your medical exam, I would encourage you to obtain a letter from your current mental health professional which you can give to the doctor. Your letter should indicate the diagnosis, what treatment you have received, whether you are compliant with treatment and the medications you are taking. If everything is under control and there have been no harmful episodes within the last 12 months the letter should say so.
If USCIS determines that you are inadmissible despite your doctor’s letter, you may file a waiver (Form I-601). It would be better not to have to go that route so I would advise you to build a good case before you apply so as not to be considered inadmissible at all.