Mental Health Access to the NDIS

In our blog today we give you a guideline on how to access the NDIS for an adult with significant psycho-social disabilities. The information we have collected is from an NDIS run workshop, delivered by their own engagement and policy team. This information is very relevant for health professionals and service providers advocating for their clients best interests.

Psychosocial disability and eligibility – Requirements from s24

(a.) The person has a disability or impairments attributable to a psychiatric condition, and

(b.) The impairments are likely to be permanent, and

(c.)  The impairment/s result in substantially reduced functional capacity; and

(d.) The impairment/s affect the persons capacity for social or economic participation; and

(e.) The person is likely to require support under the NDIS for the person’s lifetime

Factors to consider

·       Person under 25 unlikely to meet criteria for permanent disability (psycho-social)

·       When they were diagnosed and how long has impairment been evident?

·       Is it reasonable to anticipate the impairment may alleviate with age appropriate development?

·       Have all treatment options been explored? For example, what medication or therapy has been undertaken? Why has treatment not worked/suited?

How is “substantially reduced functioning” determined?

Six key life skills areas that matter… 3 BIG S’s

·       Social Interaction

·       Self-care

·       Self-management

·       Communication

·       Learning

·       Mobility

Only need to demonstrate substantial impairment in one of these areas to access NDIS.

Examples of impairment

Social Interaction

• Can’t leave house because of anxiety/paranoia

• Can’t communicate appropriately or safely in the community

• Can’t be face to face without support

Self-care

• Limited insight. For example cut toe but doesn’t seek medical help

• Constantly require prompts/reminders and cannot care for self without these

Self-management

• Unable to get to appointments by self

• Receive DSP and give money away or spend all money on drugs/alcohol

• Tenancy issues – risk of homelessness

How can an access request be made to NDIS?

Access request can be over phone, on paper, via email or in person.

A family member, friend or support worker can assist however they do need permission to access on their behalf. Consent can be as simple as verbal or written with signature.

If access request is rejected after review they can re-apply again after 3 months. Amount of applications for review is unlimited.

Who can give evidence?

Primary – GP, psychologist, mental health nurse, occupational therapist, social worker.

Secondary – Support worker and peer worker, carers, family and friends, the participant.

What is good evidence?

·       Recent

·       Completed by treating health professional who is relevant to primary disability

·       Confirms primary disability

·       Confirms the impact of the disability on different areas of life

·       Describes previous treatments and outcomes

·       Describes future treatment options and expected outcomes

Functional Assessments – Preferred Tools

·       Life Skills Profile 16 (LSP-16)

·       World Health Organisation Disability Assessment Schedule (WHODAS)

·       Health of the Nation Outcome Scale (HONOS)

“The NDIS are not interested so much in the end ‘result’ but what the information provides about the level of functioning.”

Wording

“Patient X is receiving treatment that is helping however it is unlikely that the impairment she/he experiences will remedy and treatment is largely focussed on patient X recovery journey.”