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Mental Health and the NDIS

Understanding NDIS mental health support: eligibility, services, and access

Written by
Dan McCutcheon

As awareness around mental health continues to grow, understanding its support within the National Disability Insurance Scheme (NDIS) becomes increasingly crucial. This article delves into the intricate relationship between mental health and the NDIS, shedding light on available supports, eligibility criteria, and the process involved in accessing these vital services.

Understanding the NDIS and Its Role in Mental Health Support

The NDIS primarily supports individuals with intellectual, neurodevelopmental and physical disabilities in Australia however around 10% of NDIS participants have a primary diagnosis of Psychosocial disability. Psychosocial disabilities significantly impact a person;s ability to complete daily activities and engage with their community. The NDIS provides support and resources to enable individuals with psychosocial disabilities to lead fulfilling and independent lives.

Eligibility and Support

To be deemed eligible for NDIS support, individuals must meet specific criteria, including a diagnosed, permanent, and significant disability. The vast majority of people experiencing mental health conditions will not be eligible for the NDIS. There are two main criteria that the NDIA will look at when determining eligibility for a person experiencing a mental health condition:

  1. permanence (all reasonable treatments have been attempted with little to no benefit)
  2. functional impact (ability to complete day to day tasks and participate in the community) 

Once deemed eligible, the NDIA will facilitate discussions on goals, support needs resulting in the formulation of a personalised NDIS plan aimed at building the capacity of the NDIS participant living with a Psychosocial disability. Potential supports include:

  • Psychosocial recovery coaching (an NDIS funded mental health worker who supports participants on their mental health journey (https://www.ndis.gov.au/media/2412/download)
  • Core supports such as funding for a support worker to help maintain their home, form community connections/friendships and engage in activities of interest.
  • Capacity building supports; e.g. mental health OT, Psychology sessions focused on capacity building, skill development and emotional regulation. 

Navigating the NDIS Application Process for Mental Health Support

The NDIS application process requires thorough assessment by healthcare and medical  professionals to establish eligibility. In relation to mental health these professionals will likely include:

  1. GP
  2. Psychologist
  3. Psychiatrist 

These professionals all need to align in their professional opinion that this person (the potential NDIS participant) has been diagnosed with a treatment resistant psychosocial disability that has a significant impact on their day to day life. They may all need to provide written evidence e.g. reports specifically addressing a) permanence and b) functional impact. 

Difference Between Mental Health and Psychosocial Disability

It's essential to differentiate between mental health conditions and psychosocial disabilities within the NDIS framework. While mental health conditions affect emotional well-being, psychosocial disabilities encompass broader social factors impacting daily functioning. 

Mental Health vs. NDIS Responsibility and the Applied Principles and Tables of Supports (APTOS Principles):

The NDIS operates under the principle of providing reasonable and necessary supports to achieve participants goals. The Applied Principles and Tables of Supports (APTOS) guide decision-making in regards to which government service system (e.g. mental health or NDIS) is responsibility for funding supports in different situations. As a general guide, the mental health/health system is responsible for ‘treatment’ such as medication and psychiatry as well as more acute needs in an emergency/crisis. The NDIS is responsible for ongoing support that addresses permanent impacts arising from a person’s psychosocial disability. 

Case Study

Consider two hypothetical individuals to demonstrate the place of both the NDIS and the mental health system in supporting people with mental health conditions. 

  1. Sarah was diagnosed with schizophrenia at age 22 and is now age 40. Sarah has tried counselling, psychological based cognitive behavioural therapy, a range of medications, and peer support with no noticeable positive impact.Sarah has been diagnosed by her Psychiatrist, GP and psychologist with treatment resistant schizophrenia and has been deemed eligble for the NDIS. Sarah benefits from psychosocial recovery coaching, employment supports, and community connection-building to manage her disability and improve her quality of life. 
  2. Joe (aged 20) on the other hand is experiencing anxiety and depression and more appropriately receives support through the mental health system for medication, subsidised psychology sessions, and regular GP check-ins. Joe is still young and actively seeking treatment for his anxiety and depression by experimenting with different types of psychiatrist prescribed medication and attending weekly psychology sessions. 

While both Sarah and Joe navigate mental health challenges, the tailored supports and the government system responsible for supporting them is different based on their personal circumstances and conditions.

Understanding the complexities of mental health support within the NDIS empowers individuals to access appropriate services and resources. Understanding the eligibility criteria, differentiating between mental health and psychosocial disability, and understanding available supports will help people experiencing ill mental-health to navigate the system effectively to enhance their well-being and quality of life.

Understanding NDIS mental health support: eligibility, services, and access
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