Carol Brown (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Families and Payments) Share this | Link to this | Hansard source

I rise to take note of the government response to the Joint Standing Committee on the National Disability Insurance Scheme report Provision of services under the NDIS for people with psychosocial disabilities related to a mental health condition. This was a very important inquiry. Before I go into the content of the report, I want to thank those people and organisations, particularly from the mental health sector, who made submissions and attended the public hearings. The report makes 24 recommendations, which were unanimously agreed to by everyone on the committee, across all parties. I will touch on some of the recommendations later.

As the report points out, it is estimated that 64,000 people with psychosocial disabilities related to a mental health condition will become NDIS participants by 2019-20. This equates to nearly 14 per cent of the total 460,000 Australians who will be participants in the NDIS. We must do everything that we can to ensure that each and every one gets increased supports and improved outcomes under the NDIS. We must also end the uncertainty that exists about just what psychosocial services will be available as the NDIS is fully rolled out. It is also vital that all governments continue to provide support for people with psychosocial disabilities who are not eligible for the NDIS. I've met with many carers who are worried about the future of services for people who experience mental ill-health, the majority of whom will not be covered by the NDIS. Some carers are worried that psychosocial disability support services may not be adequately funded through the information linkages and capacity-building framework. It is clear, however, that the NDIS eligibility criteria for people with mental illness are a major concern for all stakeholders.

As I said, the committee made 24 recommendations. What the committee particularly recommends is that the NDIS Act be reviewed to assess the permanency provisions and the appropriateness of the reference to psychiatric conditions. It goes on to recommend at recommendation 2:

… a review of the NDIS (Becoming a Participant) Rules 2016 should be considered to assess the appropriateness and effectiveness of:

The NDIS Act, as we all know, requires that a person's condition be permanent. The mental health sector says that this runs counter to the principle of a recovery orientated practice for people with psychosocial disability. The committee heard that some people did not even bother to engage with the NDIS because of the permanent disability requirement and the definition of mental illness disability. This was particularly so for young people who experience severe mental ill-health. In fact, Anglicare Tasmania was one of the organisations to raise concerns about the permanent impairment requirement for young people. Anglicare said:

Professionals are often reluctant to both diagnose and label symptoms as a specific illness and to confidently state that this is a permanent condition. Many young people living with mental health conditions are likely to be reluctant to consider that their condition is permanent, given the recovery model's emphasis on positive improvements.

It is a complex matter, and I am pleased that the permanency position has been recommended to be reviewed.

In a related recommendation, the committee recommends that:

… the NDIA, in conjunction with the mental health sector, develops and adopts a validated fit-for-purpose assessment tool to assess the eligibility of people with psychosocial disability that focuses on their functional capacity for social and economic participation.

It should be about what people can and can't do, and what we can do to support people with psychosocial disability to lead good lives.

The report also touches on forensic disability services, and it goes to the point that the NDIS has the potential to decrease the incarceration rates for people with cognitive and psychosocial impairment, particularly Aboriginal and Torres Strait Islander people who are overrepresented amongst those in prison with complex disability support needs. However, before the opportunity offered through the NDIS can be realised, access to the NDIS must be readily available and consistent within the criminal justice system. There are recommendations that have also been made in that regard.

I also would like to touch on the role of carers under the NDIS. We have data from the ABS that estimates that 194,000 primary carers care for someone with a psychosocial disability. It came out in the inquiry—and I touched on this in an earlier contribution about another NDIS committee report which was tabled earlier—that it seems that the planning process to develop and review NDIS plans has not been operating as well as it should be. This has resulted in unsatisfactory experiences and outcomes for people with psychosocial disabilities, their families and particularly their carers, who have raised concerns with me and also in the context of this inquiry. Sometimes it seems that carers have not been involved in planning discussions, and, instead of face-to-face contact with NDIS participants, it has been done over the phone. That has been an issue raised continuously.

Before I conclude, I want to raise the very important issue of advocacy and outreach services. The committee recognises the critical role that advocacy and outreach services can play in identifying people and engaging them, and their family and carers, with NDIS services. I quote from the executive summary of the report:

In many cases the most efficient way to engage with 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.

I wish to thank the committee again for the work they have done in producing this report, and I thank all those people and organisations who made submissions. It is a very good report. Those recommendations are extremely important and I hope that NDIA takes up the recommendations. If they are taken up and implemented correctly, they will go a long way towards enhancing the NDIS, but they also will make the process much easier for participants entering the NDIS. Some of the gaps that are emerging for those who are inside and outside the NDIS can be identified and dealt with. I seek leave to continue my remarks later.

Leave granted; debate adjourned.