Major report identifies people with mental illness are being left without support in the transition to the National Disability Insurance Scheme (NDIS).

The University of Sydney Faculty of Health Sciences and Community Mental Health Australia engaged with 58 stakeholders from across Australia for the ‘Mind the Gap’ project. Many of the challenges that have been raised previously by peak bodies and government inquiries were reinforced and extended in this report.

A key concern to emerge was that the sector continued to report significant obstacles relating to the implementation of the NDIS and the people they work with who have a psychosocial disability, report author associate professor Jennifer Smith-Merry, told F2L.

“The report has a range of solutions that those in the sector have identified in relation to these gaps,” she said.  Among them was the training of NDIS-related staff in psychosocial disability and the creation of a Medicare number for developing assessment reports.  “There also needs to be increasing involvement of carers and family members in assessment and planning, ongoing pricing reviews and Federal Government assistance for services transitioning to the NDIS.  Action on these solutions is the responsibility of State, Territory and Federal Governments working with the National Disability Insurance Agency (NDIA),” she said.

The report found there is poor knowledge of the NDIS among people with psychosocial disability and the NDIA is failing to engage appropriately with people experiencing psychosocial disability. The report also showed that people entering the scheme frequently received inappropriate plans and are unable to find services to carry out their NDIS plan. It also identified gaps in administration of the NDIS for people living with psychosocial disability who are potentially eligible; and service delivery to those living with severe mental illness not eligible for the scheme, or who are not applying, and need to keep receiving services outside the NDIS. This dramatic loss of services for the vast majority of people living with mental illness, is creating a second class tier who are now receiving poorer support because they are not eligible for the NDIS.

A solution would be that the NDIA establish a strategy for monitoring and reporting publicly on rates of application, acceptance, plan activation, timeframes, plan contents and rates of review so effective short and long term strategies can be developed to increase applications and address implementation issues as these arise.  Also, that the Department of Social Services work to better equip existing services in order to manage the transition to the NDIS.

Current participation in the NDIS of people with a primary psychosocial disability is low and indicates multiple difficulties in its implementation. Latest NDIA figures show that only 6.4 per cent of NDIS participants have a primary psychosocial disability which is less than half the expected numbers. To date, 81.4 per cent of people with psychosocial disability who requested access were accepted into the NDIS compared to over 97 per cent for people with cerebral palsy, autism or intellectual disability.

Service gaps are appearing in and around the NDIS that stem from both a lack of NDIA expertise and understanding of the unique needs and challenges associated with psychosocial disability.  Further, as funding from existing programs transferred into the NDIS people outside it are losing the services for which they were previously eligible. There is significant concern that the existing services whose program funding will be transferred to the NDIS will leave people without support when they are forced to close. In the ACT where Partners in Recovery (PIR) was terminated as the NDIS was introduced it was estimated that 63 PIR participants would not be eligible for the NDIS out of a total of around 160 previously accessing PIR. Services for this group of people living with psychosocial disability are drying up in order to fund the NDIS. Pricing-related issues were also seen as a cause of gaps because services were unable to provide appropriate and fully funded services for the prices indicated in the NDIS price guide.

People were also unaware that current services will terminate. Stakeholders relayed stories of people stating that they didn’t want to apply because they were happy with their current services and did not understand, or believe, that funding for these services were being transitioned into the NDIS and would therefore not be available to them in the future.

The NDIA needs to work with Centrelink to address these problems or provide an alternative access point. Psychosocial disability-specific peer workers should be available to support and translate the NDIS at point of assessment and planning, especially when a person does not have a known service worker or informal family support present. There should be a dedicated phone information line handling psychosocial disability-related enquiries and a change in the wording of eligibility requirements within NDIS information for psychosocial disability from “permanent” to “persistent, chronic or enduring”. These alternative terms would be more suitable in the mental health context.

The report recognises that while the NDIS is still in its implementation phases it was important that gaps identified are viewed as a way to improve the scheme rather than condemn it.