The National Disability Insurance Scheme (NDIS) and mental illness

23 April 2018 | Posted In: 133 - Autumn 2018, Disability – National Disability Insurance Scheme, Health Services, | Author: Jen Smith-Merry

The National Disability Insurance Scheme (NDIS) offers great hope for people who experience ongoing mental illness but knowledge of what it can offer people with mental illness is low. Jen Smith-Merry explains how the NDIS works and addresses some of the issues people applying for the scheme face.

THE NDIS AND PSYCHOSOCIAL DISABILITY: WHO IS ELIGIBLE?

Many people think that the NDIS is only relevant to people with physical disabilities, but it is also open to applications from people with ‘psychosocial disability’. The NDIS uses the phrase ‘psychosocial disability’ to refer to mental illness. People are more likely to be eligible if they have received support for severe mental illness (or should have received support) over an extended period, and their illness significantly disrupts their ability to actively participate in society (including through employment and social experiences).

In order to be eligible for the scheme a person with mental illness must:

  • Be under 65 when they apply.
  • Meet certain residency conditions and be an Australian Citizen, permanent resident or have a protected special category visa.
  • Have a disability, which is likely to last for their whole life (see below for how this fits with the ups and downs of mental illness).
  • Have a disability, which makes it difficult to participate in society, or live the life that an individual wants to live, without the help of other people and technology.

WHAT DOES IT OFFER?

The NDIS does not provide services itself, but a budgeted plan, which lists what items of service an individual will be eligible for. The individual can then get these supports provided by providers that they choose.

The NDIS has a set range of supports that it funds and items of support outside of this cannot be funded under the NDIS. They will fund only supports that are deemed to be ‘reasonable and necessary’.

There are three parts to the budget that an individual will receive within their plan:

  • Core: The items in this budget include supports, which help with daily living, community participation, and sometimes transport.
  • Capital: The funding in this part of the plan includes assistive technologies that are needed for daily living and community participation, such as specialised computers, wheelchairs, walkers, car modifications and home modifications.
  • Capacity Building: The supports offered under this are designed to build an individual’s capacity and provide resources related to: education (lifelong), choice and control, community participation, support coordination, health and wellbeing, daily activities, finding a job and staying employed, and relationships.

The NDIS does not fund medical treatment including dental treatments or medical treatment by psychologists and psychiatrists.

HOW DO PEOPLE GO ABOUT BECOMING INVOLVED IN THE NDIS?

If you are already receiving services, you should talk to those people supporting you as they may be able to help you with the process.

The first step should be to become familiar with the scheme, so that you know what you or the person you support are eligible for. The next step is to make an access request. Once an individual’s request to access the scheme is made, it should be assessed within 21 days (see below for more about this). If this request is successful, the individual and, if appropriate, their carers will meet with a planner who will develop an individual plan. This plan should then be checked by the applicant and their carers so that it does in fact meet their needs.

Contact details for the NDIS and the Local Area Coordinators for Inner Sydney region are listed below.

WHAT DO PEOPLE NEED TO BE WARY OF WHEN THEY APPLY TO THE SCHEME?

Our recent report Mind the Gap looked at the experiences of service providers related to the implementation of the scheme. That report identified some areas where the scheme needs to be improved, so that it better includes people with mental illness. If you, or someone you care for, are applying for the scheme, you should be aware of some of these issues, so that you can make sure that they do not complicate the application process.

  • Support for the applicant is essential: Because the NDIS will only fund services that are reasonable and necessary, it is essential that someone applying for and being provided a plan under the scheme is able to speak about their illness in a way that makes it clear to the planners and assessors that the supports requested are necessary. As some applicants can inadvertently talk down their illness and not fully explain its impact on their lives, it is helpful to have a carer or friend along who really knows the person and can help to explain their life and the impact of the illness on them. If the NDIS worker is not listening to carers or family members, then applicants have the right to have this addressed.
  • Aboriginal and Torres Strait Islander people: It has been reported that Aboriginal and Torres Strait Islander people are less likely to join the scheme. If you are from an Aboriginal and/or Torres Strait Islander background, you can work with your existing support providers to access the scheme. If that is not available to you, please speak to the NDIS or the Local Area Coordinators, as there is a special strategy in place by the NDIS to enable your participation.
  • Understanding of mental illness: Some assessors and planners lack an understanding of mental illness and can sometimes make assumptions about an individual’s abilities. If you, or the person you support, believes that the assessor, planner or other NDIS worker is making assumptions that are not correct, you have the right to question this and have your application handled by someone else.
  • Documentation for assessment: When deciding eligibility, assessors rely on information provided by GPs, specialists and other services. Individuals may need support to gather this information together and it may take some time to track down relevant information.
  • Needs of carers: Carer-related supports are important and can be written into plans, but are currently being ignored in the development of many plans. This can be addressed by including carers in NDIS meetings. If they are not, applicants should ensure that their needs are included.
  • Support coordination is a really important part of plans: Because of the complexity and range of needs associated with psychosocial disability, people some- times need help to connect with services. Applicants and those supporting them should make sure that support coordination is built into plans.
  • The assessment, planning and review processes are often delayed: While the NDIS states that requests to access the scheme must be assessed within 21 days, services have told us that in reality it can take much longer because there can be holdups at many steps of the application process. For that reason, make sure that an applicant’s current supports remain in place until their plan has been activated.
  • Language barriers: If you are attempting to negotiate with the NDIS, and you or the person you are supporting do not use English as a first language, you should make sure that appropriate translators are available to you.

WANT TO KNOW MORE ABOUT THE SCHEME?

Speak to your current service providers about how you can access the scheme.

Visit the NDIS website: https://www.ndis.gov.au

The Local Area Coordinator organisation for Inner Sydney is St Vincent De Paul’s. They can provide individual support for people accessing the scheme and their carers and family members. To contact the St Vincent de Paul Society NSW Local Area Coordination team please call 1800 794 934 or email LAC@vinnies.org.au More information is available at: https://www.vinnies.org.au/page/Find_Help/NSW/Disability_Employment/Local_Area_Coordination_for_the_NDIS_Rollout/

 

Jen Smith-Merry is an Associate Professor in the Faculty of Health Sciences at the University of Sydney. She conducts research on mental health services and policy systems. She has a particular interest in the experiences of people with mental illness and regularly collaborates in research with people with a lived experience of ill-health. She was on the project team that produced the ‘Mind the Gap’ report, that highlights problems with the current state of the NDIS for people with psychosocial disability such as eligibility criteria that exclude many, slow uptake and engagement due to a disconnect between the notion of ‘disability’ and ‘mental health’, and inadequate involvement models for carers and families. The link to ‘Mind the Gap’ report and references can be found with the online version of this article

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