https://hdl.handle.net/2123/34365 2026-06-13T13:03:19Z 2026-06-13T13:03:19Z Smith-Merry, Jennifer Hollier, Joel Yen, Ivy https://hdl.handle.net/2123/35119 2026-04-22T05:35:53Z 2026-04-17T00:00:00Z

Submission: Inquiry into the Integrity of the National Disability Insurance Scheme Smith-Merry, Jennifer; Hollier, Joel; Yen, Ivy This submission draws on qualitative interviews conducted in 2025 with 86 NDIS participants, carers, and stakeholders from across Australia to understand experiences of the NDIS for people with psychosocial disability. As part of these discussions, participants discussed a range of experiences relating to the nature, impacts, and drivers of fraud, financial misuse, and sharp practices within the Scheme.

2026-04-17T00:00:00Z Mullin, Bernie Smith-Merry, Jennifer Hollier, Joel https://hdl.handle.net/2123/35094 2026-04-15T08:02:45Z 2026-04-10T00:00:00Z

Review of Commonwealth commissioned reports (2020-June 2025): themes and key findings relevant to targeted foundational supports for psychosocial disability. Mullin, Bernie; Smith-Merry, Jennifer; Hollier, Joel This paper synthesises the common themes that we considered in the design of the research-based Foundational Support model. These were extracted from relevant Commonwealth government commissioned reviews and reports, published from 2020 through to June 2025.They focus on the findings and recommendations from the perspective of government policies, rather than the academic literature and research sector or any critiques of these reports from the broader mental health advocacy and lived experience sectors.

2026-04-10T00:00:00Z Smith-Merry, Jennifer Mullin, Bernie Hollier, Joel Bobo, Firew https://hdl.handle.net/2123/34425.2 2026-05-13T02:40:12Z 2026-03-04T00:00:00Z

Targeted foundational supports for people with psychosocial disability outside of the NDIS: model proposal Smith-Merry, Jennifer; Mullin, Bernie; Hollier, Joel; Bobo, Firew To provide a draft model for delivering targeted foundational supports for people with psychosocial disability who are outside the NDIS. The aim is to offer a model derived from a research perspective as a basis for critique, refinement and to inform the wider sector’s approach to foundational supports.

2026-03-04T00:00:00Z Hollier, Joel Smith-Merry, Jennifer https://hdl.handle.net/2123/34827 2026-02-09T02:38:16Z 2026-01-01T00:00:00Z

Expectations and Reality: The Lived Experiences of Australians with Psychosocial Disability Within the NDIS Hollier, Joel; Smith-Merry, Jennifer While Australia's National Disability Insurance Scheme (NDIS) was founded on principles of choice and control, for people with significant mental health challenges (what the NDIS calls ‘psychosocial disability’) these ideals often remain elusive. Support systems continue to be fractured and in the context of ongoing policy reforms, it is vital to understand expectations people have of the scheme, alongside ongoing experiences. Drawing on semi-structured interviews with NDIS participants (n = 30) and informal/ unpaid carers (n = 18), this research explores these expectations and lived realities. Results showed that prior to engaging with the NDIS, participants had mixed expectations of the scheme, with a lack of information accessed and confusion about what the scheme could offer. For some, expectations were also formed in the context of acute mental illness. When expectations were expressed, these were often unmet, with interviewees reporting a lack of choice and control, frustrations with the system, a lack of appropriate services, and encounters with unscrupulous or underperforming providers. Findings should inform policy directions to better align Australia's mental health ecosystem with the realities faced by those it seeks to support. Strategies are required for planning and communication about what the NDIS offers participants to inform choice and control of needed supports.

2026-01-01T00:00:00Z Bobo, Firew Tekle Hollier, Joel Yen, Ivy Chang, Kuo-yi Jade Smith-Merry, Jennifer https://hdl.handle.net/2123/34823 2026-05-07T02:24:31Z 2026-01-01T00:00:00Z

Disparities in access to health and support services for people with disability in Australia: a scoping review of the structural social determinants Bobo, Firew Tekle; Hollier, Joel; Yen, Ivy; Chang, Kuo-yi Jade; Smith-Merry, Jennifer Background Systemic inequities in health and social services exacerbate barriers for disadvantaged groups within the disability community, leading to poorer health outcomes and diminished quality of life. We aimed to evaluate how structural determinants function to shape disparities in access to health and support services for people with disability. Methods We followed Arksey and O’Malley’s methodological framework. A comprehensive search strategy was implemented across five major databases—Medline, Embase, CINAHL, PsycINFO, and Scopus—focusing on four key concepts: social determinants, disability, services (both support and health services), and Australia. Articles published after 2013 were included in the review. Results After screening 2,506 records, 54 studies were included in the review. These studies identified key drivers of inequities in access to health and social support services. Structural determinants, such as policy gaps, geographic disparities, service integration challenges, cultural misalignment, and socioeconomic marginalisation, significantly hinder equitable access. Additionally, social determinants—including household income, educational attainment, employment status, and gender — shaped individuals’ ability to engage with systems and services. Low-income individuals, those with limited education, and other disadvantaged communities, such as Indigenous and culturally diverse groups, face compounded barriers when seeking support. Conclusions People with disability face significant structural barriers to access health and support services, especially those from disadvantaged backgrounds. The implementation of interventions and efforts to improve the health and well-being of this population should be primarily viewed through the lens of those facing intersectional disadvantage. Future research should focus on generating disaggregated evidence to support policy efforts aimed at better targeting disadvantaged groups. Keywords Disability, Social determinants of health, Inequity, Socioeconomic factors, NDIS, Health services, Australia

2026-01-01T00:00:00Z Chang, Kuo-yi Jade Yen, Ivy Bobo, Firew Hollier, Joel Smith-Merry, Jennifer https://hdl.handle.net/2123/34676 2026-01-12T03:29:01Z 2026-01-01T00:00:00Z

Implementing community-based psychosocial interventions for adults with severe mental illness in high-income countries: a rapid scoping review Chang, Kuo-yi Jade; Yen, Ivy; Bobo, Firew; Hollier, Joel; Smith-Merry, Jennifer Psychosocial interventions support functional recovery and social integration for people with severe mental illness (SMI); however, their implementation remains fragmented and inconsistent. This rapid scoping review maps the landscape of psychosocial interventions for adults with SMI in high-income countries, identifying their key components, implementation challenges, and strategies to optimise delivery. Following the Cochrane rapid review guidelines, we searched MEDLINE and CINAHL (January 2009 - May 2024) and conducted manual reference screening. Eligible studies focused on non-pharmacological, community-based interventions. Thematic analysis was used to identify implementation barriers and enablers. Of 8,624 screened records, 464 studies met inclusion criteria, covering 15 intervention types. Cognitive-focused interventions (n = 100) supported employment (n = 86), and behavioural therapies (n = 66) were most studied. Outcomes focused on symptom (n = 179), daily living skills (n = 160), and cognitive states (n = 157). Implementation was often constrained by systemic, organisational, and individual-level barriers. Systemic challenges included fragmented services, stigma, cultural and linguistic barriers, and economic constraints, highlighting the need for integrated care models, policy reforms, and culturally responsive approaches. Organisational challenges such as staff resistance, insufficient training, and resource limitations underscored the importance of leadership, stakeholder engagement, and investment. At the individual level, low motivation, logistical difficulties, trauma histories, and goal misalignment reduced engagement and retention, highlighting the need for flexible, person-centred, trauma-informed approaches, strong social networks, and a balance between structure and adaptability. Selecting, adapting, and funding psychosocial interventions remain complex. This review provides a foundation for future systematic reviews of homogeneous intervention subsets to better inform policy and practice.

2026-01-01T00:00:00Z Smith-Merry, Jennifer Chang, Kuo-yi Jade https://hdl.handle.net/2123/34623 2025-12-17T07:07:22Z 2025-01-01T00:00:00Z

Equity first: mapping who gets what is essential to re‐designing the NDIS Smith-Merry, Jennifer; Chang, Kuo-yi Jade Recent media commentary on the operation of the National Disability Insurance Scheme (NDIS) has focused on costs, fraud, and preventing dubious provider practices. This discussion obscures the broader importance of the NDIS for overcoming the entrenched disadvantages that prevent people with disability fully participating in Australian society.

2025-01-01T00:00:00Z Chinnappa, Meera Smith-Merry, Jennifer Chang, Kuo-yi Jade https://hdl.handle.net/2123/34622 2025-12-12T03:57:16Z 2025-01-01T00:00:00Z

The Cost of the National Disability Insurance Scheme: Australia’s Print‐Media Discourse Chinnappa, Meera; Smith-Merry, Jennifer; Chang, Kuo-yi Jade This paper examines the way that Australian newspapers have framed the cost of the National Disability Insurance Scheme (NDIS). Introduced in 2013, the NDIS represented a major change in Australia's disability support policy, moving for the first time to a nationwide universal insurance model. NDIS costs have continued to exceed estimates, raising concerns about the sustainability of the scheme, as reflected in recent calls for reform. Media analysis provides an understanding of the public narrative surrounding key social issues. Using thematic analysis of n = 90 newspaper articles, five key themes were identified: cost as a problem, projections of cost, politicisation of cost, drivers of cost and the interests of stakeholders. The most dominant theme was cost as a problem , which contributed to a strongly negative portrayal of the cost of the NDIS that emerged across articles. This negativity was connected to discourse relating to the deservingness of participants receiving funding and the contribution of ‘undeserved’ support to the growing cost of the scheme. We explore the way such narratives obscure the original principles of the scheme—universal insurance and investment—and suggest that the framing identified instead reflects existing negative discourses surrounding targeted‐welfare systems and their recipients.

2025-01-01T00:00:00Z Smith-Merry, Jennifer Mullin, Bernie https://hdl.handle.net/2123/34619 2025-12-17T01:08:23Z 2025-01-01T00:00:00Z

Targeted foundational supports model FAQ Smith-Merry, Jennifer; Mullin, Bernie This FAQ collates questions received through our Webinar, 'Building a system of foundational supports for psychosocial disability across Australia' https://hdl.handle.net/2123/34509 (12/11/25), along with questions raised in the leadup to the webinar which focused on the model we have developed for the provision of Targeted Foundational Supports for psychosocial disability. Questions have been paraphrased and grouped for clarity of questions and responses. We anticipate this document will continue to develop as questions emerge.

2025-01-01T00:00:00Z Smith-Merry, Jennifer Mullin, Bernie https://hdl.handle.net/2123/34509 2025-12-17T01:06:32Z 2025-01-01T00:00:00Z

Building a system of foundational supports for psychosocial disability across Australia Smith-Merry, Jennifer; Mullin, Bernie The goal of the webinar "Exploring a foundational supports model for people with psychosocial disability: Presentation and Discussion" is to provide an evidence-based model that can spark discussion, and be utilised by the sector for co-designing a robust ecosystem of supports. Questions raised during this webinar informed the development of the 'Targeted foundational supports model FAQ' https://hdl.handle.net/2123/34619

2025-01-01T00:00:00Z Smith-Merry, Jennifer Mullin, Bernie Hollier, Joel Bobo, Firew Chang, Jade https://hdl.handle.net/2123/34466 2026-04-29T00:31:51Z 2025-11-04T00:00:00Z

Targeted foundational supports for people with psychosocial disability outside of the NDIS: model background and rationale Smith-Merry, Jennifer; Mullin, Bernie; Hollier, Joel; Bobo, Firew; Chang, Jade This paper provides further background and rationale for a proposed model for delivering targeted foundational supports for people with psychosocial disability who are outside the National Disability Insurance Scheme (NDIS). This paper supplements the summary paper by outlining key elements of available research and data that informed the development of this model.

2025-11-04T00:00:00Z Smith-Merry, Jennifer Hollier, Joel https://hdl.handle.net/2123/34430 2026-04-29T00:31:51Z 2025-01-01T00:00:00Z

Psychosocial Navigator role - key attributes Smith-Merry, Jennifer; Hollier, Joel The 2023 NDIS Review recommended the introduction of a specialist ‘Navigator’ role with expertise in psychosocial disability to assist people with disability in a complex support system. Navigators are important for multiple different systems supporting people with psychosocial disability including the NDIS and targeted Foundational Supports for psychosocial disability.

2025-01-01T00:00:00Z Smith-Merry, Jennifer Mullin, Bernie Hollier, Joel https://hdl.handle.net/2123/34424 2026-04-29T00:31:52Z 2025-01-01T00:00:00Z

Targeted foundational supports for psychosocial disability. Evidence from qualitative interviews with sector stakeholders Smith-Merry, Jennifer; Mullin, Bernie; Hollier, Joel We conducted interviews with 37 people who have high-level knowledge of the operation of the NDIS and supports for people with serious mental illness outside of the NDIS. We specifically asked all interview participants about foundational supports, including general perceptions of the concept and what they would ideally include. These data are not comprehensive in that they only include the perspectives of the interviewees that self-selected to participate in the study however they do provide a snapshot of the main concerns and interests of people who understand the current situation with regard to NDIS supports and related gaps.

2025-01-01T00:00:00Z