The National Disability Insurance Scheme (NDIS) is currently being rolled out across South Australia to people with disability up to 65 years of age, with all regions expected to have commenced in the Scheme by July 2018. The NDIS is one of Australias largest national reforms since the introduction of Medicare, and is expected to offer lifetime supports to people with significant and permanent disability through an NDIS plan. What qualifies a person for an NDIS plan is largely dependent on the degree and longevity of functional impairment, and while this judgement may be possible for some people with a physical disability, it is not as clear cut for people with a mental illness. The NDIS does intend to support people with mental illness, though the language is different; in NDIS language, mental illness is referred to as psychosocial disability. The National Disability Insurance Agency (NDIA) who administers the Scheme acknowledges that psychosocial disability is often episodic in nature rather than ongoing, and that recovery is possible, and as such the Scheme aims to support people with psychosocial disability in a flexible way by increasing and decreasing supports based on the individuals need.

This all sounds reasonably positive but what is of current concern is not how the person with psychosocial disability will be supported in their plan (this concern will pick up later on in the rollout), but how many people with psychosocial disability will actually be eligible and approved for an NDIS plan. Many people may have a mental illness but not experience the day to day functional impairments required for eligibility into the NDIS, or they may experience a significant functional impairment but not have the evidence required to satisfy the NDIA that they are eligible. Many people with psychosocial disability may also refuse to test their eligibility for the NDIS for various reasons, some due to the nature of their mental illness. While all of these outcomes are concerning for people with psychosocial disability as they will potentially result in a loss of supports, our concern is for where this puts family carers in terms of supports to help them maintain their caring role and their own wellbeing.

As more people with disability enter into the Scheme across Australia, the Federal Government are simultaneously transitioning funding from existing mental health services over to the NDIS, including funding to support carers of people with mental illness. However, the rollout of the NDIS in South Australia is occurring at a slower pace than the reduction in carer funding, thereby reducing support services for carers of people with mental illness before anyone is even able to apply. The implications of this misalignment in funding transitions are dire and short-sighted, leading to people with psychosocial disability and their carers falling through the gaps with no net to catch them. The economic value of unpaid carers in Australia is reported to be $60.4 billion per annum if we dont support our carers to enable to them to continue to care for their loved one, the impact on all of our systems (health, education, employment, housing etc) will be monumental.

The NDIA have come a long way in their interpretation and approach to supporting people with psychosocial disability under the NDIS since the Schemes inception, however there is still the very real potential for many people with mental illness to fall through the gaps, taking their carers with them. Carers SA as part of the national Carers Australia network will continue to lobby the Federal Government on the importance of retaining key carer support services for the sake of our carers who work so hard to support the person they care for, and because it is just the right thing to do.

Amy Orange
Acting Executive Manager Community Services
August 2017