Canberrans living with a mental illness could be among the hardest hit by the territory’s transition into the National Disability Insurance Scheme as support agencies warn the changes could leave scores of vulnerable people failing to meet new eligibility criteria.
As Mental Health Week encourages the community to engage with an “invisible” area of health this week, a number of organisations are concerned about changes to funding, the viability and quality of mental health services and the capability of some of the community’s most vulnerable people to adjust to sweeping reform.
Vulnerable: There are fears the transition to the NDIS may leave some people hard hit.
But the changes could be an opportunity for people with a serious mental health condition to reassess the support they need to lead a fulfilling life and a chance for the territory’s relatively tight-knit mental health sector to rethink how best to support those with a mental illness.
Mental Health Foundation president Angie Ingram feared the NDIS might not be able to meet an expected shortfall in mental health support services due to the funding change, especially if many people with a mental illness were not eligible.
A two-year trial of the NDIS is currently under way in the ACT, resulting in a shift from traditional government block funding to a competitive fee-for-service model.
To be eligible a person must have a significant and permanent disability.
“The government has promised that no person who receives a service currently will be without a service with the introduction of the NDIS [but] there is concern that there may be some people who fall through the gaps created by the transition of funds to the NDIS,” she said.
“This situation may occur before people have had their plans funded or alternative services can be provided. There are discussions with the ACT and federal governments to try and prevent this from occurring.”
The transition of the The Rainbow service to the NDIS, a foundation-run rehabilitation program for adults with a mental illness, has already begun with about 8.2 per cent of funding to be moved across this financial year.
But the majority of people with a mental health condition will transition into the scheme the following financial year.
Ms Ingram was also concerned at how a skilled workforce would be maintained under the new funding model, including professional development.
Mental Health Community Coalition acting executive officer Simon Viereck said the transition to a market model might encourage new providers to raise the quality of services on offer.
But one of the biggest challenges facing the mental health sector was ensuring a lower level of services were available to those who were not eligible for a NDIS package.
“It’s a really small group of people [with a mental health condition] who will actually be given access to an individual support package,” he said.
“What will happen to everybody else – where do they go for support?”
While the NDIS will give people with a disability potentially unprecedented choice, work needed to be done to ensure the right mix of supports was available regardless of eligibility.
“The language used in the NDIS is around permanent disability,” he said.
“That in itself is a challenge for us because the language we’ve been using in the mental health sector for a long time is around recovery.”
NDIS taskforce mental health officer Wendy Kipling has been working closely with Canberra’s mental health sector as the ACT trial progresses.
While the NDIS will not cover all people with a mental health condition, she believed the broader change would complement the sector.
Of the 24 government-funded providers of mental health services 11 will be affected by the scheme.
“It’s a real opportunity for the sector to look at the services they’re delivering and position themselves to deliver good recovery-focused services that will not only impact on the eligible but those who aren’t eligible either,” she said.
“All jurisdictions have committed to a continuity of supports during the trial period so, we will be working closely with each individual organisation that is affected and working closely with the [National Disability Insurance Agency] to ensure those people who have not been found eligible are supported during this time.”
ACT Disability, Aged and Carer Advocacy Service chief executive officer Fiona May is bracing for a spike in demand as the NDIS trial gathers pace.
“We don’t have an increase in funding for our general advocacy and yet we’re expecting an increase in demand for advocacy support around the NDIS,” she said.
“We are concerned people are going to need support and that support might not be available to them.”
Ms May said unanswered questions around eligibility had enhanced anxiety.
“There are a lot of questions about what may happen to somebody who has mental health issues and accesses community services at this point who might not be eligible for the NDIS,” she said.
“When you add that to a mental health condition it can make things very difficult for individuals.”
Ms Ingram said supporting people was crucial.
“We’re having conversations at the moment with people currently receiving services around, what will make your life better, what are you getting now, do you need to continue to get this service and what do you need to do to improve your lives.”