Further Unravelling Psychosocial Disability: MH and the NDISThe Lived Experience of the NDIS at the

NSW Hunter Trial Site

National Respite Association Conference - 23 October 2014Tina Smith – Senior Policy Advisor/Sector Development, MHCC

(NDIS Mental Health Analyst in partnership with the NSW Mental Health Commission)

National NDIS Rollout

430K Australians will receive Tier 3 funded support at full roll-out and 57K will have psychosocial disability (PSD)

– Year 1 – 2013/14• NSW, Victoria, Tasmania, SA trial sites

– Year 2 – 2014/15• WA, NT, ACT trial sites

– Year 3 – 2015/16– Years 4 & 5 – 2016/18

• Queensland roll-out• Full national rollout

MHCC NDIS Partnership with the NSW MH CommissionYear 1 partnership objectives are to better understand …1. How will PSD be understood and included under the NDIS?2. The wider NDIS and health services interface (eg, physical health, substance

use)

3. People with co-existing difficulties (eg, intellectual, physical, sensory and other disability)

4. The suitability of the assessment tool/s5. Contribute to the national discourse regarding the situating of psychosocial

disability within the NDIS

… what is the NDIS and how it will affect people living with mental health concerns?

NSW Hunter NDIS Trial Site

• Trial commenced 1July 2013 and there have been high levels of mental MH/PSD activity

• 10K people in Newcastle, Lake Macquarie and Maitland LGAs (1,300 with high levels of psychosocial disability?)– Yr 1 2013/14: 3K people Newcastle LGA– Yr 2 2014/15: 5K people Lake Macquarie LGA– Yr 3 2015/16: 2K people Maitland LGA

• Potentially 1,300 people with PSD in trial site and 19K in NSW at full roll-out

• 439 people with PSD nationally at June 2015 (159 in NSW; 12% of 1,300)

Further unravelling psychosocial disability!Five objectives supported by 13 additional interdependent activities ….Learning• Learning from consumers, carers and service providers in the launch site• Liaison with the NDIA, HNELHD/MH , NSW FaCS/ADHC, NDS, etc.• Reconciling ‘permanent disability’ with the philosophy and practice of psychosocial disability and

& recovery support service delivery

Watching• Tracking ‘transitions’, ‘phasings’ & ‘new’ participants accessing the NDIS (PHaMS)• Interface between NDIA and the new Partners in Recovery program• Understanding ‘in-scope’ and ‘out-of-scope’ community sector programs• What the NDIS means for people that are not Tier 3 eligible (Tier 2?)

Influencing… establishment of the

Hunter NDIS and MH ‘Community of Practice’

Financial Contributions to NDIS (ie, ‘in-scope’ services)

• National– Personal Helpers and Mentors (PHAMS; 100% ‘in-scope’

for NDIS)– Partners in Recovery (PIR: 70% ‘in-scope’ for NDIS)– Mental Health Respite: Carer Support (50% ‘in-scope’

for NDIS)– Day to Day Living Program (D2DL; 35% ‘in-scope for

NDIS).

• NSW– FaCS/ADHC funded programs (including transfers to

community sector)– SVDP ‘Ability Links’ (Tier 2 services)– NSW Health funded programs?

Hunter NDIS & MH ‘COP’ Forum

• Hosted by MHCC & the NSW Mental Health Commission

• Meetings held:15 October 201323 January 201420 March 201417 June 201430 September 2014

• Sharing and reflecting on experiences of the NDIS including relationship development with NDIA

• Updates from HNEMHS, NDIA & MHA

Who belongs to the COP?

267 people at the end of September 2014:

• 121 community sector workers from the Hunter

• 59 community sector workers from outside the Hunter

• 64 other people from the Hunter (mostly HNEMHS staff)

• 20 other people from outside the Hunter

• 3 consumers

Josh Fear/MHCA, Suzanne Punshon/NDIA, Tina Smith/MHCC and Sage Telford/NSW Mental Health Commission at the Hunter NDIS and Mental Health ‘Community of Practice’ Forum.

Consumer & carer representation and participation in the NDIS/NDIA

• 15/10 – community sector specific meeting

• Concerns identified at 23/1 COP Forum– Organised a meeting with consumers and carers at

RichmondPRA

• Addressed at 20/3 COP Forum– Q&A Panel with a consumer, carer & service provider

representative

• Addressed at 17/6 COP Forum– Presentations by NSW CAG & ARAFMI

• 30/9 COP Forum– This forum highlighted consumer and carer

experiences/stories of NDIS and a presentation by the NSW Ombudsman

MH Family and Carer Issues

• NDIS ‘Supports for Informing Informal Supports’ Operational Guideline (January 2014)

• Arafmi Australia position statement (July 2014)

– Promote shared/supported decision making

• Carers NSW issues paper (September 2014)

– 10 recommendations including parallel carer needs assessment

• Commonwealth funded Family MH Support Services & NSW Ministry of Health funded MH Family and Carer Support Program– not ‘in-scope’ for NDIS

MH Respite Issues

• Respite not provided by NDIS – NDIA position is that the participant’s funded Tier

3 services and supports naturally result in respite

• National MH Respite: Carer Support Program 50% ‘in-scope’ for NDIS– What does this mean in practice for people both

eligible and ineligible for Tier 3 funded supports?

• CMHA MH respite project (Vicserv)– MH carers require more flexible respite and

support than other disability groups

MH Family and Carer Experiences in NSW NDIS Trial Site

People with MH problems are reluctant to engage with the NDIS • Without services a long time• Difficult to trust and engage• Lack confidence• Histories of trauma• Fear of contact with people• Don’t often feel safe

Other COAG Directions

• NDIS is just one aspect of National Disability Strategy (‘to increase choice, control and self-directed decision making’)

• The NDIS focus of the NDIS is on the participant

• Other aspects of the National Disability Strategy/Agreement and also COAGs MH sector reform agenda will help to progress family and carer support service capacity building, including respite approaches

Thank you for your participation!

To contact Tina Smith: tina@mhcc.org.au

Or for additional information about Hunter trial site activity as this relates to mental health:

http://www.mhcc.org.au/policy-advocacy-reform/influence-and-reform/ndis-and-mental-healthpsychosocial-disability.aspx

… or …. : MHCC NDIS