House debates
Tuesday, 15 August 2017
Committees
National Disability Insurance Scheme; Report
5:27 pm
Kevin Andrews (Menzies, Liberal Party) Share this | Link to this | Hansard source
On behalf of the Joint Standing Committee on the National Disability Insurance Scheme, I present the committee's report entitled Provision of services under the NDIS for people with psychosocial disabilities related to a mental health condition.
Report made a parliamentary paper in accordance with standing order 39(e).
by leave—It's estimated that some 64,000 people with psychosocial disabilities related to a mental health condition will become participants in the National Disability Insurance Scheme by 2019-20. For these people the scheme presents a significant opportunity to increase supports and improve outcomes. However, psychosocial disability differs from physical and sensory disabilities in important ways and presents the scheme with very significant challenges. Alongside the NDIS, the mental health sector is also undergoing significant parallel reform with the development of the Fifth National Mental Health Plan, which COAG has now adopted.
People with mental illness will continue to require services even if they are not participants. Furthermore, the committee recognises that the scheme will provide services in conjunction with those delivered through other Commonwealth, state and territory governments. The committee acknowledges the commitment made by all governments to provide continuity of support for people with psychosocial disabilities who are not eligible for the NDIS. However, the committee has found that there is a need to clarify and make public how they intend to provide these services and address the emerging gaps created by the transition of existing services into the NDIS.
I'd like to mention a number of the matters that have come before the committee and on which recommendations have been made. The first is eligibility. The NDIS eligibility criteria for people with mental illness is a central concern for all stakeholders. The committee found that, whilst the current eligibility criteria could be improved to provide greater clarity, the apparent reliance on diagnosis rather than functional needs is likely to result in inconsistent eligibility outcomes for applicants. This is of particular concern given the absence of a validated assessment tool for planners to assess the eligibility of people with psychosocial disabilities. Reported lack of skills and expertise of planners in the mental health field adds to inconsistencies of access to the scheme and planning outcomes.
The second is the planning process. The committee received evidence that the planning process to develop and review NDIS plans has not been operating well and has often resulted in unsatisfactory experiences and outcomes for people with psychosocial disabilities, their families and in some instances particularly their carers. Issues include: the development of plans over the phone rather than face to face; not involving carers in planning discussions; waiting times and delays; the poor level of planners' knowledge and understanding of psychosocial disability; and lack of flexibility and responsiveness to people's changing needs. Indeed, given the episodic nature of conditions and symptoms experienced by people with a mental health condition, the current approach to the development and review of plans does not readily build in supports that respond to fluctuating needs of participants.
The third is assertive outreach. The committee recognises the critical role that advocacy and outreach services can play in identifying and engaging people, their families and their carers with NDIS services. In many cases the most efficient way to engage these people in the NDIS process is to work with their families and carers, who have long-term personal and special knowledge of their needs and circumstances. The operational systems in place to provide information about the NDIS and to engage with hard-to-reach cohorts through assertive outreach could be greatly improved. With the transition of Commonwealth and state and territory programs, there is a risk of emerging service gaps in these areas.
The fourth is continuity of support. Given that the majority of people who experience mental ill health will not access the NDIS, for whatever reason, the continued provision of services for people outside the scheme is particularly important. The transition into the NDIS of Commonwealth programs such as Partners in Recovery, personal helpers and mentors, day-to-day living and mental health respite, and carers' support, amongst others, is concerning the committee, as evidence received indicates that a significant number of current clients of these services will not be accessing the scheme. The committee also heard of concerns across the sector that services previously delivered by states and territories were being withdrawn before participants in these services were properly transitioned into the NDIS. The committee has also made recommendations in relation to the information linkages and capacity-building aspect of the program and also in an area which I think is a particular concern, and that is forensic disability services. There are recommendations, as I said, in relation to both of those matters.
In conclusion, the committee received a wealth of information and evidence throughout the inquiry and thanks all of those who participated both by making submissions and by coming along and discussing these important matters with the committee. As a result, the committee has made 24 recommendations which aim to strengthen the effectiveness of the scheme to ensure that people with psychosocial disabilities can be appropriately supported. I thank all the members of the committee for the cooperative way in which this inquiry has taken place and the cooperative way in which we've come to a unanimous set of recommendations in relation to making this scheme a better one than it is at the present time.
5:33 pm
Jenny Macklin (Jagajaga, Australian Labor Party, Shadow Minister for Families and Payments) Share this | Link to this | Hansard source
I want to join with the member for Menzies in particularly thanking all of those who participated in this inquiry. I also want to say to the member for Menzies that we strongly agree with all of the remarks that he's just made about the committee's work and this inquiry. I think it has been a very successful inquiry, with a large number of submissions, particularly from the mental health sector, but the committee also conducted a number of public inquiries, and a large number of people came and made very clear their views about the issues that people with mental health conditions have with the National Disability Insurance Scheme.
I want to join with the member for Menzies in thanking all the members of the committee. I particularly want to thank the staff who did such a great job in preparing this report. The report makes clear that there are around 64,000 people with psychosocial disabilities related to a mental health condition who will come into the National Disability Insurance Scheme by 2019-20. We all hope that each and every one of them will see this as a significant opportunity to increase the support they get and to improve the outcomes for Australians with psychosocial disabilities. Each and every one of us in this House has a responsibility to make sure that the National Disability Insurance Scheme delivers on that promise. That, really, is the promise of the NDIS—that people with psychosocial disabilities will see their circumstances improve as a result of the NDIS. Unfortunately, there is a lot of evidence to suggest that this is not always occurring. It is for some people, but not always.
I am very pleased with the way in which the recommendations of this report have come together, as the member for Menzies outlined, unanimously agreed by everyone on the committee, setting out a clear way forward so that we might see the strengthening of support for some of Australia's most vulnerable people. There still remains uncertainty about what psychosocial services will be available as the National Disability Insurance Scheme transitions to full rollout. This is for people in the scheme, but many of the representative groups and many people with psychosocial disabilities are especially concerned about what is going to happen to those people who are not in the National Disability Insurance Scheme. We share those concerns.
As the member for Menzies outlined, there are 24 recommendations. I will touch on a couple of them. One of the most important is this question of permanency provisions. The way the National Disability Insurance Scheme, the act, is written, it does require that a person's condition be permanent. We had a lot of representations from the mental health sector that this runs counter to the principle of recovery oriented practice for people with psychosocial disabilities. So I'm very pleased that the committee is recommending that the act be reviewed to assess the permanency provisions and that we assess—we're asking the government to do this—the appropriateness and effectiveness of including the principle of recovery oriented practice for psychosocial disability. This is a very complex issue, but one that would benefit from a very carefully considered review.
There is a related issue that is very important, something that the mental health sector asked for, and that I'm pleased that the committee is recommending. We're saying the National Disability Insurance Scheme, in conjunction with the mental health sector, should develop and adopt a validated, fit-for-purpose assessment tool to assess the eligibility of people with psychosocial disability, focusing on people's functional capacity for social and economic participation. This is a very significant issue as well. It is not be a focus on diagnosis; it is a focus on what people can and can't do, and the supports they need to lead a good life. Once again, I very much hope that the National Disability Insurance Agency will pick up this recommendation and develop this tool in conjunction with the mental health sector so that services can be better delivered to people with psychosocial disability.
I want to touch on another issue, which the member for Menzies also highlighted, and that is just how important it is that those people who are currently getting terrific services through Partners in Recovery, including the Personal Helpers and Mentors, Day to Day Living and Mental Health Respite Carer Support programs—all of these excellent programs that both sides of this parliament have supported for a long time—continue to do so. It should not be the case that people who are outside the National Disability Insurance Scheme lose access to these sorts of supports that they have relied on. We do want to make sure that people who are in the scheme also have a guarantee of continuity of support and access to services.
I want to mention recommendation 7, which refers to the National Disability Insurance Agency developing and proactively marketing resources and training for primary healthcare professionals about the National Disability Insurance Scheme, particularly for people with a psychosocial disability. There just isn't enough information that those professionals have, so it would be very helpful if that was done.
Another issue that I know is very, very important, particularly for those who support and care for young people with psychosocial disabilities, is to make sure that people who are not participants of the National Disability Insurance Scheme, young people in particular, have access to early intervention services. We're all aware that a lot of people get mental health conditions in their late teens and early 20s. We certainly don't want to wait until it's seen to be permanent for those young people get adequate early intervention services. So that recommendation is extremely important.
Finally, I want to really reinforce the call of the committee for the Australian government and the state and territory governments to make sure the services that people with psychosocial disabilities need, either in the scheme or outside, are there when people need them. I think we all agree that mental health is a huge issue for this country, and that's why I'm so pleased that we've been able to work together cooperatively to produce this report, and I hope we see all the responsible governments, and the National Disability Insurance Agency, responding positively.