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10 Jul 2017

In April 2017, Professor Patrick McGorry, Executive Director of Orygen, Professor of Youth Mental Health at The University of Melbourne, and a Director of the Board of the National Youth Mental Health Foundation (headspace), called for mental health to be removed from the National Disability Insurance Scheme (NDIS). Professor McGorry told The Australian (5 April 2017): 

“[the] mental health sector should never have been shoehorned into the NDIS because it was a ‘completely different model’ [and] the disability model does not fit with mental illness, which is a mostly fluctuating kind of illness. The biggest issue here is that the state governments have already dismantled the community mental health system, the clinical system with doctors and support. All that is left now is emergency rooms and acute care, the system is collapsing at a state level.” 

According to The Australian, unpublished modelling commissioned by some state governments for the National Mental Health Service Planning Framework, reveals about 100,000 people who once received individual funding support through other federal, state and territory mental health programs (such as Day to Day Living [D2DL] and Partners in Recovery [PiR] will no longer be covered when those federal and state programs end. These programs will transition to help fund the NDIS, however the issue is that the NDIS is not seen as able to fund the number of people experiencing mental illness. 

Note: Day to Day Living in the Community (D2DL) is a structured activity program that provides funding to improve the quality of life for individuals with severe and persistent mental illness by offering structured and socially based activities. D2DL is designed to recognise that meaningful activity and social connectedness are important factors that can contribute to people's recovery. D2DL is transitioning to the NDIS, however the programme has been extended for three years to support the transition of programme funding to the NDIS. This extension is supposed to ensure service continuity for programme clients until NDIS rollout is completed in each jurisdiction. Partners in Recovery (PiR) provides support to people with severe and persistent mental illness with complex needs and their carers and families, by getting multiple sectors, services and supports they may come into contact with (and could benefit from) to work in a more collaborative, coordinated and integrated way. It too is transition to the NDIS over three years. 

Professor McGorry expanded on his concerns in a Radio National interview (11 April 2017), telling Fran Kelly that the NDIS was not able to include the majority of people with mental illness and that he had raised these concerns with Minister Hunt. He also cited support from Beyondblue, whose submission to the parliamentary inquiry into the NDIS warned that “estimates suggest that current funding models will fail to provide care to all who need it.” Beyondblue’s position is that more people with mental illness and associated psycho-social disability will be eligible for the NDIS than originally anticipated, and therefore appropriate resourcing is needed, not a tightening of eligibility requirements.

According to The Australian (11 April 2017): “Conservative estimates in the health sector put the blowout in cost to the NDIS at $500 million a year because of the decision to include mental health. Beyondblue also point to a failure to marry up the two big reforms occurring in mental health – the NDIS and the 2015 National Mental Health Commission review. These, say Beyondblue, should be working in tandem. Community Mental Health Australia (CHMA) said the NDIS is being rushed, with the focus on signing eligible people up, leaving quality of care to fall by the wayside. CHMA want to see the NDIS slowed down. “This should not be about the numbers [signed up to the NDIS] because that tells us nothing”, CHMA Executive Director Amanda Bresnan told The Australian.

What is not clear is to what extent this push to remove mental health from the NDIS is supported by the mental health sector and if mental health is taken out from the NDIS, where the funding and programs for people with mental illness will come from. As the Government is transitioning PiR, PHaMS and D2DL monies across to the NDIS, it is not clear if advocates for removing mental illness from the NDIS are expecting these program funds to be clawed back from the Department of Social Services to support people with mental health needs, or whether they are championing for new money for those no longer in the NDIS.

At the June AMAPG teleconference, members discussed what the consequences would be if mental health was removed from the NDIS, specifically who would provide the mental health care and how would this be funded. AMAPG agreed that patients should be able to access both traditional mental health services and psychosocial supports, but the latter at the expense of the former. The AMAPG noted:

  • possibility of patients being exploited;
  • the removal of the gatekeeper role of doctors to coordinate provision of heath care;
  • the emphasis on psychosocial rehabilitation at the expense of medical and dental care and the need to ensure the balance is properly maintained; and
  • qualifications of those employed to look after and support people with mental illness must be of the appropriate standard.

AMAPG members were undecided whether mental health should remain in the NDIS as there are valid concerns about the way the NDIS is assessing and providing for people with mental illness. 

Published: 10 Jul 2017