The ongoing reforms to the National Disability Insurance Scheme (NDIS) are raising significant concerns, particularly regarding the funding and delivery of mental health supports for individuals who do not qualify for the scheme. The Hawkesbury Local Government Area (LGA), which had a population of approximately 67,500 in 2021, has around 5.6% of its residents identified as living with a disability, indicating that many individuals could be affected by these changes.
The current focus of reform is on “foundational supports,” which are disability-specific programs for those outside the NDIS. While the federal government has initiated the Thriving Kids initiative targeting children with developmental delays and autism, advancements for adults with psychosocial disabilities remain limited. Psychosocial disabilities, which stem from mental health conditions such as schizophrenia, major depression, and post-traumatic stress disorder, can severely hinder daily functioning.
A recent report from the Grattan Institute suggests that Australia could establish a national system of psychosocial supports within five years, without necessitating additional expenditure, provided that governments adopt a clearer vision and enhance coordination of existing resources. These psychosocial supports are non-clinical services aimed at assisting individuals with mental health challenges to live independently and engage in their communities. They encompass programs that foster social connections, develop daily living skills, and secure stable housing.
The scale of the issue is substantial. In 2023, it was estimated that nearly 223,000 Australians aged between 25 and 64 experienced significant psychosocial disabilities. Yet, only about 58,000 received support through the NDIS, which allocated over $5.8 billion for this demographic in the past year. The majority of those with significant psychosocial disabilities do not meet the NDIS eligibility criteria, leaving around 130,000 adults without formal support.
Access to non-NDIS psychosocial programs significantly varies across states, with the Grattan Institute identifying a seven-fold difference in accessibility. Queensland offers the highest coverage while Tasmania provides the least. This discrepancy creates what advocates refer to as a “postcode lottery,” where the type and intensity of services differ widely based on location.
The Grattan Institute’s report proposes a new national program of psychosocial supports, to be implemented through Primary Health Networks (PHNs) in collaboration with local providers, hospitals, and community organizations. Proposed services include support facilitation to help individuals navigate mental health and disability systems, community participation programs such as activity groups, family education and support, and assistance with housing and daily living skills. This strategy aims to provide more consistent access across the nation while alleviating pressure on the NDIS.
Despite these proposals, concerns have arisen regarding the implications of such a shift. Sarah Langston, a disability rights advocate and contributor to the Hawkesbury Gazette, criticizes this approach, asserting it misunderstands the fundamental purpose of the NDIS. “The NDIS is not just a funding program,” Langston states. “It is how Australia gives legal effect to the UN Convention on the Rights of Persons with Disabilities.”
Under the NDIS, individuals with disabilities are entitled to individualized supports tailored to their specific needs. Langston argues that the proposed transition to a separate psychosocial support system threatens to undermine these rights, creating a situation where support is contingent on local budgets and service availability rather than personal needs.
Langston also questions the effectiveness of many existing psychosocial programs, highlighting that they often lack endorsement from the people they aim to serve. “Many of these programs are not endorsed by the people they are meant to serve, and evidence about their effectiveness is often weak or selectively presented,” she explains.
Framing the exclusion from NDIS as merely a systems and funding issue, as the Grattan Institute does, overlooks the human rights implications, according to Langston. She emphasizes that individuals with psychosocial disabilities are being excluded from a system that is intended to recognize their rights.
Furthermore, Langston challenges the assertion that reform can take place without additional funding, pointing to existing pressures such as rising costs and staff shortages. “Shifting money around inside an already strained system does not fix these pressures,” she warns. “It risks making access even more uneven.”
For disability rights advocates, the distinction between discretionary programs and legislated entitlements is crucial. Many believe that guarantees of support cannot be sacrificed for programs that may lack the same level of legal protection. The rallying cry within the disability rights movement encapsulates this sentiment: “rights, not welfare.”
Langston and other advocates argue that the original promise of the NDIS, championed by former prime minister Julia Gillard, must be upheld to ensure Australia meets its obligations under the UN Convention on the Rights of Persons with Disabilities. “Real reform means honoring individualised, legally enforceable supports for all disabled people, not replacing them with cheaper parallel programs,” she asserts.
For residents of Hawkesbury seeking assistance with the NDIS, Disability Advocacy NSW offers free advocacy support, including help with access, planning, and appeals. They can be reached at (02) 4708 3047 or 1300 365 085.
This article draws on research by Sam Bennett, Disability Program Director at the Grattan Institute; Mia Jessurun, Associate; and Reilly Polaschek, Associate, originally published by The Conversation, supplemented with local commentary and service information for residents of Hawkesbury.
