Submission\
Getting It Right: A
New Definition for
NDIS Providers
Date : 27 February
Our Commitment to First Nations Wellbeing, Culture, and Self-Determination
We stand in strong support of First Nations Australians, affirming their inherent right to self-determination, cultural preservation, and sovereignty over their land and traditions. We acknowledge that for First Nations peoples, mental health is inseparable from cultural, emotional, physical, and spiritual wellbeing — a holistic understanding maintained through thousands of years of continuous culture.
The Gayaa Dhuwi (Proud Spirit) Declaration Framework and Implementation Plan, launched in Meanjin (Brisbane) on the lands of the Turrbal and Yuggera peoples where our office stands, provides a crucial 10-year roadmap. QAMH fully endorses this community-led approach to integrating First Nations leadership, cultural knowledge systems, and healing practices into Australia’s mental health frameworks.
QAMH is committed to supporting truth-telling as a process of acknowledging the histories, lived experiences, and ongoing strengths of First Nations peoples, particularly in the context of mental health. By confronting the impacts of colonisation, intergenerational trauma, and ongoing systemic injustices, we can better address the historical and contemporary factors affecting the mental wellbeing of First Nations individuals and communities.
In this submission, we emphasise the importance of holistic and healing approaches to mental health that incorporate the cultural knowledges, connection to Country, and spiritual practices of First Nations peoples. We are dedicated to ensuring that the principles of self-determination, cultural safety, truth-telling, and holistic health are central to the mental health initiatives and recommendations we propose. Our goal is to help build a future where mental health systems respect and respond to the unique needs and strengths of First Nations Australians.
Acknowledgement of Country
QAMH acknowledges and pays deep respect to Aboriginal and Torres Strait Islander peoples as the Traditional Custodians of the lands and waters across Australia. We honour their Elders past and present, whose knowledge, leadership, and cultural practices have sustained these lands for millennia.
Who is QAMH?
The Queensland Alliance for Mental Health is the peak body for the state’s Community Mental Health and Wellbeing Sector and people with experiences of psychosocial disability in Queensland. We represent more than 120 members and stakeholders, involved in the delivery of Community Mental Health and Wellbeing Services.
Our role is to reform, promote and drive Community Mental Health and Wellbeing Service delivery for all Queenslanders, through our influence and collaboration with our members and strategic partners.
At a national level, we have a formal collaboration with Community Mental Health Australia and provide input and advice to the work of Mental Health Australia and the National Mental Health Commission where appropriate. Locally, we work alongside our members, government, the Queensland Mental Health Commission and other stakeholders to add value to the sector and act as a strong advocate on issues that impact their operations in Queensland communities.
Recognition of Lived Experience
QAMH recognises that the Community Mental Health and Wellbeing Sector exists because of people with Lived Experience of mental distress, their families, carers and support people. We acknowledge the expertise and the courage of people with Lived Experience, and we commit to work with and alongside people with Lived Experience in all we do.
Definitions
Psychosocial supports are non-clinical, trauma-informed, recovery-oriented services that support people experiencing mental health challenges to live independently and safely in the community. They enable people to stay well, avoid crisis and participate in community life. By strengthening wellbeing and social participation, they also reduce pressure on hospitals and emergency services, making them a cornerstone of a sustainable mental health system.
Community Based Mental Health Services delivered by the NGO sector occupy a unique and critical position within the broader mental health system. These services address the complex realities of distress shaped by trauma, poverty, isolation and other social determinants, providing practical support with housing, relationships, employment and social inclusion.
These services are critical for:
- People who are eligible for the NDIS and those who are not
- Individuals facing barriers to accessing mainstream mental health services
- People whose needs are significant but not primarily clinical
Introduction
QAMH welcomes the opportunity to provide input on the proposed amendment to the definition of “NDIS provider” in the National Disability Insurance Scheme Act 2013. This submission builds on our earlier contributions to the NDIS Provider and Worker Registration Taskforce and reflects our ongoing engagement with community-based mental health and psychosocial support providers delivered by the NGO sector across Queensland.
Changes to the legislative definition will determine which providers are required to register under a future risk-proportionate regulatory model. As such, the definition will shape who is recognised as delivering disability-specific supports, the level of oversight applied, and the obligations placed on providers across the Scheme.
QAMH supports a mandatory, risk-proportionate regulatory framework that strengthens participant safety. However, amendments must ensure the definition explicitly captures the breadth of community-based mental health and psychosocial supports delivered to people with psychosocial disability and does not unintentionally exclude specialist recovery-oriented providers from the Scheme. These supports are non-clinical and embedded within community settings. They are often delivered through outreach, and include peer support, culturally led programs and place-based models that do not align neatly with traditional disability service categories. The legislation must therefore clearly recognise these models as legitimate disability supports where delivered to NDIS participants.
As outlined in our previous submissions 1,2,3 community-based mental health and psychosocial providers operate within multiple regulatory frameworks and face sustained workforce constraints, particularly in regional, rural and remote communities. Expanding registration requirements must be accompanied by pricing adjustments and transitional arrangements that reflect the true cost of compliance. Recent sector benchmarking, including data from the Ability Roundtable 4, demonstrates sustained operating losses and declining reserves across many registered providers under current pricing settings. In this context, additional regulatory obligations without commensurate funding reform risk accelerating financial pressure across the market. Without alignment between regulatory expectations and pricing structures, there is a material risk of market contraction among specialist psychosocial providers, including small and culturally safe organisations, particularly in regional and thin markets.
This submission outlines key considerations regarding the scope of the definition and its implications for workforce sustainability, service continuity and participant choice. Getting the definition right will determine not only who is regulated, but which supports are recognised, sustained and appropriately safeguarded within the Scheme.
1 Queensland Alliance for Mental Health. (2024). Submission to the NDIS Provider and Worker Registration Taskforce. https://www.qamh.org.au/ndis-provider-and-worker-registration-taskforce-submission/ 2 Queensland Alliance for Mental Health. (2026). Submission to the Australian Government: Disability Safeguards consultation. https://www.qamh.org.au/disability-safeguards-submission/ 3 Queensland Alliance for Mental Health. (2024). Submission to the Independent Health and Aged Care Pricing Authority: NDIS pricing reform. https://www.qamh.org.au/ndis-pricing-reform-2024/ 4 Ability Roundtable. (2026). A model built to fail: The Disability Support Worker Cost Model. Ability Roundtable. https://www.abilityroundtable.org/post/white-paper-a-model-built-to-fail-the-disability-support-worker-cost-model
Question 1
Are there any supports or services missing from the list at Table 2 that you think should be included in an amended definition of “an NDIS provider”?
The list at Table 2 captures many disability-specific supports that would reasonably warrant inclusion in an amended definition. However, from a community-based mental health perspective, greater clarity is required to ensure psychosocial supports are consistently and explicitly recognised.
While elements of psychosocial support may be assumed to sit within broader categories such as “capacity building support” or “peer support programs and initiatives,” psychosocial recovery practice is a distinct, specialist form of disability support. It is typically non-clinical, relational and recovery-oriented, and is often delivered in community settings through outreach, structured group programs and ongoing individual recovery support. Without explicit recognition, there is a risk that specialist psychosocial supports may be interpreted inconsistently or inadequately captured in practice.
To provide clarity and reduce interpretive uncertainty, QAMH recommends that Table 2 explicitly include:
Provision of psychosocial recovery supports to people with psychosocial disability, including culturally-led and community-controlled supports.
This would ensure that recovery-oriented, community-based and culturally-secure psychosocial supports are clearly recognised, while maintaining alignment with the intent of a risk-proportionate regulatory framework.
Question 2
Are there any supports or services that you would exclude from the definition in Table 2?
QAMH supports the intent to exclude mainstream goods and services from the definition. Care should be taken to ensure drafting does not inadvertently capture generic community services that are not disability-specific, as ambiguity at the definition stage may create compliance uncertainty and unnecessary regulatory burden.
Question 3
What issues should Government consider when amending the definition of NDIS provider to maintain flexibility and responsiveness to NDIS participants’ needs?
In amending the definition, Government should prioritise flexibility, proportionality and responsiveness to the diverse ways disability supports are delivered across communities.
First, the definition must accommodate the episodic and fluctuating nature of psychosocial disability. Many participants require relational, recovery-oriented supports that respond to changes in wellbeing over time. An overly narrow or rigid framing of support types, risks
failing to reflect the practical realities of psychosocial support delivery, particularly where outreach, place-based and community-embedded models are used.
Second, the definition should be sufficiently adaptable to recognise culturally embedded and community-controlled models of support. Consistent with the Government’s commitments to Closing the Gap and self-determination, refinement of the definition should occur in genuine partnership with Aboriginal and Torres Strait Islander peoples and organisations. For many Aboriginal and Torres Strait Islander peoples, cultural practice, connection to Country, Elders, language and community are foundational to social and emotional wellbeing rather than ancillary components of care. If the definition relies solely on standardised service descriptors, there is a risk that culturally embedded approaches delivered to NDIS participants may not be adequately recognised.
Third, Government should consider the impact of definitional changes on thin markets and regional service continuity. In regional, rural and remote areas, specialist providers often deliver a combination of psychosocial, community and culturally responsive supports. A definition that does not reflect this blended service reality may unintentionally reduce flexibility and limit participant choice.
Maintaining responsiveness will require clear drafting and implementation settings that support innovation, cultural safety and continuity of specialist psychosocial services within the broader regulatory framework.
Question 4
Are there factors, other than the type of support delivered, which should be considered in a new definition of “an NDIS provider”?
Yes. While the type of support delivered is a central determinant of risk, additional contextual factors should inform the definition and its application. Relevant considerations include:
- The intensity, frequency and duration of contact between provider and participant.
- The degree of dependency or power imbalance inherent in the support relationship.
- The setting in which supports are delivered, particularly where supports occur in private or closed environments.
- The level of autonomy or discretion exercised by the provider or worker.
- The vulnerability of the participant cohort, particularly where psychosocial disability, trauma exposure or social isolation may increase safeguarding risk.
Considering these factors alongside support type would better align the definition with a genuinely risk-proportionate approach and ensure regulatory effort is directed where participant risk is highest.
Question 5
Are there supports you currently access which may be disrupted or result in secondary impacts if they are included or excluded in a new definition of “an NDIS provider”?
There is potential for disruption if specialist psychosocial supports are either insufficiently recognised within the definition or captured in a way that increases regulatory obligations without corresponding funding alignment.
Community-based psychosocial recovery supports are sometimes delivered by small and medium not-for-profit organisations, including culturally-led and community-controlled providers. If definitional changes result in increased compliance requirements without appropriate pricing adjustments and transitional arrangements, there is a risk of service contraction in already thin markets, particularly in regional, rural and remote communities. Community-based psychosocial supports have demonstrated cost-effectiveness and reductions in hospital utilisation in multiple Australian evaluations, reinforcing their role in both safeguarding and system sustainability. 5,6,7,8
Conversely, if specialist psychosocial supports are not clearly captured within the definition, participants may increasingly access generic disability supports that do not reflect the specialist and recovery-focused nature of psychosocial practice. This may have unintended consequences for service quality and continuity of care. Careful calibration of the definition, alongside implementation settings that support sustainability, will be critical to avoiding secondary impacts on participant choice and service availability.
Question 6
Are there opportunities to ensure a new definition of “an NDIS provider” supports productivity and sustainability across the care and support economy?
Yes. A clearly defined and risk-proportionate approach to identifying NDIS providers presents an opportunity to strengthen both regulatory clarity and sector sustainability. A definition that precisely targets disability-specific supports will reduce compliance uncertainty and enable regulatory effort to be focused where participant risk is highest. This supports productivity by minimising unnecessary administrative burden for low-risk or mainstream providers while maintaining appropriate oversight of higher-risk supports.
Sustainability will also depend on ensuring that regulatory settings are aligned with workforce realities and pricing structures. Community-based psychosocial supports form part of the broader care and support economy, alongside aged care and other community
5 Smith, G.S.E., Sunley, A.K., Papinczak, Z.E., Luebbe, A., Roovers, H., Postorivo, D., Whiteford, H., Gadenne, K. & Rutherford, Z. (2024). Adult Step Up Step Down Evaluation: Final Report. Queensland Health Mental Health Alcohol and Other Drugs Strategy and Planning Branch. https://doi.org/10.14264/33d0de5 6 KPMG & Mental Health Australia. (2018). Investing to save: The economic benefits for Australia of investment in mental health reform. https://mhaustralia.org/sites/default/files/docs/investing to save 7 Peach Tree Perinatal Wellness. (2024). The First 2000 Days: Supporting families mental health and wellbeing through this critical period of parenthood. Peach-Tree-Report_final_LR.pdf 8 Queensland Alliance for Mental Health. (2026). Policy briefing. The Value of the Community Mental Health Sector.
services. Clear definitions, proportionate obligations and implementation settings that reflect the true cost of high-quality support delivery will help maintain a viable and skilled workforce.
A well-calibrated definition can therefore contribute not only to improved safeguards, but also to a more stable, transparent and sustainable support ecosystem.
Conclusion
Amending the definition of “NDIS provider” is a foundational reform that will shape the future of disability support regulation. For people with psychosocial disability, and for the community-based organisations that support them, clarity and proportionality are critical. Reform should enhance safeguards while recognising the specialist, recovery-focused and culturally responsive nature of psychosocial supports. With careful calibration and alignment with pricing and workforce settings, this change can strengthen both participant protection and sector sustainability. Without that alignment, the risk is not theoretical. It will be reflected in service availability and continuity on the ground.
QAMH Contact Details
For any further information please contact:
Chloe Jesson
Deputy Chief Executive Officer
109 Logan Road, Woolloongabba QLD 4102
Email: cjesson@gamh.org.au | Web: www.gamh.org.au
Queensland Alliance
for Mental Health
ABN: 23 216 177 453
ACN: 615 817 251
109 Logan Road
Woolloongabba QLD 4102
E: admin@qamh.org.au
qamh.org.au