Breaking down Barriers: Co-designed recommendations to reduce stakeholder identified NDIS access barriers for people with psychosocial disability

Abstract

The Issue The National Disability Insurance Scheme (NDIS) commenced in 2016 and is designed to support people with all types of disability including those living with psychosocial disability. However, many thousands of Australians living with psychosocial disability have still not applied to access the Scheme and are consequently missing out on their right to receive valuable NDIS supports to advance their social and economic inclusion.

The Project Aims The project aims were to work with stakeholders to 1. Understand the barriers to applying to the NDIS for people living with psychosocial disability, and 2. Identify solutions to remove or reduce these barriers and to synthesise these into a practical set of stakeholder-informed recommendations.

Across all states and territories, 386 stakeholders collaborated on this project. Stakeholders included: 1. people living with psychosocial disability of mental distress; 2. their family and friends, and 3. workers and organisations engaged in supporting or advocating for them.

The Approach The project was conducted over three phases: 1. A scoping review of literature to identify previously reported barriers to applying to the NDIS for people with psychosocial disability – used to inform phase 2 survey. 2. A national survey to identify current, stakeholder informed and prioritised barriers. 3. Co-design of practical, lived experience informed recommendations to address NDIS access barriers with stakeholders.

The Barriers Stakeholders described ten broad and interconnected NDIS access barriers for people with psychosocial disability. These included: 1. Key information about NDIS is confusing or not accessible 2. Hard to get supports to help to apply - formal (services) and informal (family and friends) 3. Hard to obtain evidence required by the NDIA 4. Application process is too long, complicated, and inflexible 5. Application process is harmful to mental health and well-being 6. The application process does not accommodate for mental illness and psychosocial disability 7. The negative reputation of NDIA staff and culture 8. Disconnect between ‘disability’ and ‘recovery’ 9. Personal beliefs, fears and stigma, and 10. It is not worth it – NDIS won’t meet my needs anyway. Each of these is detailed within the report.

The Recommendations Seven recommendations were identified, reviewed and refined by stakeholders. These recommendations are practical, lived-experience informed actions to address NDIS access barriers faced by people living with psychosocial disability. 1. Build, maintain and disseminate accurate, up-to-date, easily accessible information - Update, enhance and build upon best currently available information. Invest in and maintain the update of a single national source of information. Enhance the dissemination of this information including easy read downloadable one-pagers that can be printed and paper-based fliers to maximise accessibility. 2. Co-develop and co-deliver systemic training and establish workforce support champions – Co-develop and deliver continually available training for health and community service providers. GPs, public, community and private mental health, disability and social services require ongoing access to training about the psychosocial stream of the NDIS. Workforce support champions will provide expert support and guidance to complement this training so that workers can provide accurate and helpful support, advice and evidence to people who are considering or are applying for the NDIS. 3. Establish navigator positions – independent and psychosocial specific - Create a clear, independent NDIS Psychosocial specific Navigator role to assist individuals, family members and service providers throughout the NDIS application process. 4. Cover out-of-pocket expenses - Create funding streams or models of reimbursement to ensure that people have equitable access to the experts required to provide evidence of psychosocial disability without incurring out-of-pocket expenses. 5. Commission and fund an independent evaluation of the application process specifically for people with psychosocial disability - Independent evaluation of the impacts of: a) recent legislative changes; b) the future implementation of the Recovery Framework; and c) adoption and future implementation of the recommendations within this report, on the experiences of the NDIS application process for people living with psychosocial disability. 6. Co-develop and co-deliver recovery and psychosocial disability training for a. NDIA staff, b) NDIA partner staff (Local Area Coordinators - LACs), and c) NDIS service provider staff (community managed/controlled organisations) - All staff within these 3 distinct workforces need to have access to recovery-oriented, trauma-informed psychosocial disability training and education that is co-developed and co-delivered with people with psychosocial disability. 7. Commission and fund an independent review of NDIA culture and workforce issues - Review the impact of implementing the NDIS Psychosocial Recovery-Oriented Framework agenda on NDIA staffing practice and cultural issues.

Conclusion Almost 400 stakeholders partnered with us to identify current barriers to applying for NDIS support. They then engaged with us to develop seven key, lived experience informed, recommendations to address those barriers. These seven practical action-oriented recommendations need urgent implementation to enable the people living with psychosocial disability who are most disadvantaged and most in need of NDIS support to be able to apply for that support. The feasibility and value of each of these recommendations is evidenced by them being raised across numerous previous national NDIS-focused reports including for example, the Tune Review and the ‘Mind the Gap’ report. Today, stakeholders are asking for more than policymakers’ awareness of the barriers that deny much needed NDIS access – although these too are re-iterated and further detailed within this report. Stakeholders call for immediate investment in these practical actions to ‘break down barriers’ to accessing NDIS support and by doing so, improve the lives of many Australians living with psychosocial disability.