New Report Highlights NDIS Gaps for People With Severe Mental Illness

A new report has warned that the transition to the National Disability Insurance Scheme will leave many people with psychosocial disability without appropriate mental health support.

The Mind the Gap report, compiled by the University of Sydney and Community Mental Health Australia, details the experiences of consumers, providers and advocacy groups in the mental health sector.

It highlighted problems with the current state of the NDIS for people with psychosocial disability, with issues around strict eligibility criteria, slow uptake and engagement with the scheme and inadequate involvement models for carers and families.

The report said with an estimated 690,000 Australians living with severe mental health issues, the most pressing concern was ensuring support for the many people ineligible for the NDIS, who risked losing support when funding for existing services ends.

The National Insurance Disability Agency (NDIA) has estimated the full roll out of the scheme in 2019-20 will support only 64,000 people with primary psychosocial disability.

This means up to 91 per cent of people with severe mental illness would have to rely on non-NDIS community mental health services to support them.

#MindtheGap An important report on gaps in the NDIS and #MentalHealth service systems from our friends @CMHA2016 Download it here… https://t.co/R8g1GzPAaq

— Frank Quinlan (@FrankGQuinlan) January 30, 2018

Report author Associate Professor Jennifer Smith-Merry from the University of Sydney, said the NDIS was not currently well-catered to the needs of people with psychosocial disability.

“While the NDIS is an exciting reform for people with disability, its current structure does not fit easily with the lived experience of people with psychosocial disability,” Smith-Merry said.

“What this report shows is that people with psychosocial disability have significant problems accessing and being accepted into the scheme, and that plans are not meeting their needs.

“What is significantly worrying is that at full roll out the scheme is only designed to meet the needs of 64,000 people with severe mental illness, yet existing services are being closed and funding moved into the NDIS. This means that many people are going to miss out on the services they need.”

The report is based on the experiences of 58 expert stakeholders from across the country.

Community Mental Health Australia vice president Kerry Hawkins called on governments and the NDIA to take heed of the gaps identified.

“The report reinforces the gaps the sector has been identifying including that people with psychosocial disability are not engaging, not applying or withdrawing from applying, that the criteria are creating barriers, and support to access the NDIS is lacking,” Hawkins said.

“While we acknowledge that the NDIA has initiated a new pathway for participants with face-to-face interviews and consistent support for participants to develop plans, and that a process for people with psychosocial disability is being examined, there is certainly a lot of work to be done.”

Amanda Bresnan, the executive director of Community Mental Health Australia, told Pro Bono News that it was vital support was provided for those with severe mental health issues who the NDIS left behind.

“We need to stop and take stock of those programs which will transfer to the NDIS, such as Partners in Recovery and Personal Helpers and Mentors (PHaMs), and states and territories have to play a role in this as they’re transferring money into it,” Bresnan said.

“For example, Victoria has moved all their community-based funding to the NDIS and we know now… that most of the people in those programs aren’t eligible for the NDIS. So the Productivity Commission have also said that we actually have to keep funding a low barrier to entry, flexible type of program.

“It’s time that the government and the NDIA actually listened to what the sector and also what other experts like the Productivity Commission are saying.”

The report also found that organisations with expertise in psychosocial disability were “collapsing, merging and selecting not to engage with the NDIS due to an inability to provide effective services within the NDIA costing structure”.

With organisations losing staff with expertise in psychosocial disability because of inadequate NDIA funding, Bresnan said issues around costing and market failures needed to be confronted.

“One of the things we really need to do is confront that issue of costing and the fact that a number of providers, as this report shows, say they can’t provide services particularly for people with really high complexities within the cost structure of the NDIS,” she said.

“And we have to address the issue of market failure which again, there’s been a lot of reluctance to address. Because we won’t be able to provide choice and control to people if the services aren’t there, and that goes to another level with rural and remote communities where there’s already a very low service level for people.

“They’re tough issues to confront, but we have to or there just won’t be services there for people.”

We fully support this recommendation of the #mindthegap report from @USydFHS There are many vulnerable people with #mentalillness who won't be eligible for #NDIS and are at risk if supports disappear pic.twitter.com/rogQNY8G6U

— McAuley CSW (@McAuleycsw) January 29, 2018

Kris Trott, the CEO of the Queensland Alliance for Mental Health (QAMH), said this report confirmed what they had heard from their members and the broader community mental health sector.

“We are most concerned about the [effect] that these gaps, not the least of which is access to planning and supports, will have on our members,” Trott said.

“As community mental health organisations they already deal with limited funding, increasing and complex need, vast geographical distances, and the challenges of hiring and retaining talented and experienced staff. This is another set of obstacles for our members and the people they serve.”

Australian Greens Senator Rachel Siewert said the service gaps for people with psychosocial disability highlighted in the report were “deeply concerning”.  

“I have repeatedly raised concerns that people with psychosocial disability are going to lose out on services as they are wound into the NDIS. These concerns also came up strongly in the Joint Select Committee inquiry into the issue,” Siewert said.

“Unfortunately we are seeing people with psychosocial disability signing up to the NDIS at a slower rate than intended and clearly there are barriers that simply mean people are going to lose out on essential services like PHaMs and Partners in Recovery.

“There are assumptions by that those accessing those services will transition to the NDIS and for a myriad of reasons this has not materialised. People are falling through the gaps and will continue to do so unless these issue are addressed.”

Hawkins said there were a number of solutions raised by stakeholders in the report that needed to be strongly considered going forward.

“The solutions highlighted in the report include a separate stream for psychosocial disability with recovery orientated language and practice, high-level leadership on psychosocial disability within the NDIA and alternate funding models for those not eligible for the NDIS. These would be a good start,” she said.  

“It is through positive engagement from everyone involved that we can address the gaps and ensure that people both in and outside of the NDIS receive the support they need.”