DOCUMENT 7

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Introduction to complex decision making

Scheme Eligibility Branch

Facilitator notes:

• State: Good morning, everyone, and welcome to our introductory session on complex decision making.

• Click to go to next slide.

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Acknowledgement of Country

Before we begin, I would like to acknowledge the Traditional Owners and Custodians of the Country on which we meet today, and their continuing connection to land, sea, and community. I pay my respects to their Elders, past present and emerging.

I would like to extend that acknowledgement and respect to any Aboriginal and Torres Strait Islander peoples here today.

Facilitator notes:

State:

Before we begin, I would like to acknowledge the Traditional Owners and Custodians of the Country on which we meet today, and their continuing connection to land, sea, and community. I pay my respects to their Elders, past present and emerging.

I acknowledge that I am facilitating this training from the lands of the [insert name] people.

I would like to extend that acknowledgement and respect to any Aboriginal and Torres Strait Islander peoples here today.

Click to go to next slide.

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Learning outcomes

By the end of this session, you’ll:

• understand that access assessors make complex decisions
• learn key terms related to complex decision making
• expand your knowledge of different disabilities
• be introduced to complex decision-making scenarios
• know that managing expectations is important during complex decision making.

Facilitator notes:

State: Here are our learning objectives for this session. By the end of this session, you’ll:

• understand that as access assessors, complex decision-making forms part of your work.
• learn key terms related to complex decision making
• expand your knowledge of different disabilities
• be introduced to complex decision-making scenarios
• know that managing expectations is important for new starters when making complex decisions.

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Please feel free to ask questions throughout the session.

You can do this by raising your hand. Let’s get started.

Click to go to next slide.

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Activity: key terms and definitions

Your task:

1. Download the learner worksheet from the chat.
2. Read the list of key terms and definitions.
3. Match each key term to a definition.
4. Compare your answers with a colleague, then type ‘done’ in the chat.

Facilitator notes: For access assessors to pre-learn key terms related to complex decision making. This is a pre-teach activity which means learners may not have background knowledge of these terms before completing this activity. This activity provides context, and facilitates understanding as learners progress through the information and

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scenarios in the PowerPoint module.

Actions:

You’ll need to give learners the Introduction to Complex Decision Making Learner Worksheet. Send it to them via the chat and ask them to download their own copy.

State:

We’re going to start with an activity. This will introduce you to some key terms and definitions relevant to complex decision making.

Your task:

1. Download the learner worksheet from the chat.
2. Read the list of key terms and definitions.
3. Match each key term to a definition.
4. Once you have finished, reach out to a colleague and compare your answers with them. Then, type done in the meeting chat.

(Facilitators: Drop learner worksheet into the chat and check that learners can download it. Allow 10-15 minutes for learners to complete their worksheet. Be available if anyone needs help. Once they have finished, use the Answer Guide to lead a discussion of the answers).

Click to go to next slide.

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Facilitator notes:

State:

So we’ve just learnt a few key terms related to making complex decisions. When we use these terms to talk about disabilities or describe functional capacity, it’s important to remember we’re talking about a person. Learning about someone’s lived experience helps us keep the applicant at the centre of our decision-making.

Let’s meet redacted and learn a bit about his personal experience of living with a psychosocial disability.

Your task is to:

• watch the first video titled redacted - lived experience.
• answer the questions on the slide.

Which psychosocial disability does [redacted] live with?

How many years has he been living with his disability?

(Play video. Approx 5 minutes. Allow learners a moment to complete their answers then call on learners to share their answers.) If video does not play or learners need the transcript, use link on slide or paste this link into the chat - s47F - personal privacy

Answers:

1. Schizophrenia
2. 30 years

Click to go to next slide.

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Activity: Schizophrenia snapshot

Use the Schizophrenia Disability Snapshot to answer these questions:

1. Schizophrenia is characterized by three symptom groups. Briefly describe them.
2. What’s the main form of treatment for Schizophrenia?
3. Give two examples of appropriate phrases to use when describing someone with Schizophrenia.
4. How might you tailor your communication style for someone living with Schizophrenia?

Schizophrenia snapshot (external)

Facilitator notes:

State:

We’ve heard from redacted about his experiences living with Schizophrenia. Let’s find out more about this psychosocial disability.

Your next task is to:

• go to the Disability Navigator page on the intranet and select Psychosocial disability – schizophrenia.
• scroll down and locate Disability Snapshot location.
• use the information in this section to answer the questions on the slide.

1. Schizophrenia is characterized by three symptom groups. Briefly describe them.
2. What’s the main form of treatment for Schizophrenia?

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Schizophrenia

3. Give two examples of appropriate phrases to use when describing someone with Schizophrenia.
4. How might you tailor your communication style for with someone living with Schizophrenia?

Facilitator to post this link in the chat in case learners can’t find the page: https://intranet.ndiastaff.ndia.gov.au/service-delivery/disabilitynavigator/Pages/pds_snapshot.aspx Link is also on the slide for reference.

Click to go to next slide.

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Debrief: Schizophrenia snapshot (1 of 2)

Symptom groups:

• Positive: Intense episodes of psychosis which make it difficult to know what’s real and what isn’t.
• Negative: Reduced expression, motivation or capacity to function in daily life.
• Cognitive: Longer periods of slowed or confused thinking.

Facilitator notes:

Suggestion: Have the Schizophrenia Disability Navigator page open for reference.

State:

Schizophrenia is characterized by three symptom groups. Describe them. (Facilitator to call on learners to share their answers via hand up or chat)

CLICK to show answers on slide

Click to go to next slide.

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Debrief: Schizophrenia snapshot (2 of 2)

2. Antipsychotic medicines
3. Examples include:

• She has had an experience of schizophrenia
• He has had an experience of psychosis.

4. Examples include:

• Allow the person more time to express themselves
• Remain calm
• Show respect and compassion.

Facilitator notes:

State: Question 2 - What’s the main form of treatment for Schizophrenia? (Facilitator to call on learners to share their answers via hand up or chat)

CLICK to show answers on slide

3. Give two examples of appropriate phrases to use when describing someone with Schizophrenia. (Facilitator to call on learners to share their answers via hand up or chat)

CLICK to show answers on slide

4. How might you tailor your communication style for with someone living with Schizophrenia?

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Facilitator to call on learners to share their answers via hand up or chat

CLICK to show answers on slide (Add to discussion if necessary, then wrap up) Click to go to next slide.

Complex decision-making scenarios

Facilitator notes:

State:

We mentioned earlier that some applicants live with multiple diagnoses and intersecting functional presentations. This means that someone may live with co-existing conditions, for example a psychosocial disability and multiple physical impairments.

Let’s explore some sample scenarios, so you can get an idea of applications that may need complex decision-making skills.

Click to go to next slide.

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Jake (part 1 of 5)

1. Which disabilities does Jake live with?

2. True or False? When assessing an application, we only consider the primary disability.

Name: Jake Age: 40 Reported primary disability: schizophrenia Reported secondary disabilities: arthritis, diabetes, oedema

Facilitator notes: There are 2 scenarios here — Jake and Rosa. The goal here is to show the type of applications which may require AAs to use complex decision-making skills. The aim is NOT to talk about whether Jake and Rosa meet the eligibility requirements. There is no need to discuss whether they meet/not meet in this module. The emphasis should be around co-existing conditions, volume of information, and linking specific parts of the supporting evidence to specific impairments.

State: Our first applicant is Jake. Jake is 40 and is an Australian citizen living in Brisbane. You’re reviewing Jake’s information, and you see a few disabilities listed. What are they? Type your answers in the chat.

(Wait for answers then confirm: Primary — schizophrenia. Secondary - arthritis, diabetes, oedema).

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State:

True or False? When assessing an application, we only consider the primary disability. Type your answer in the chat.

(Wait for answers then confirm FALSE. We must assess all disabilities listed in the supporting evidence.)

Click to go to next slide.

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Jake (part 2 of 5)

1. Which evidence would you use to assess permanency?
2. Which evidence would you use to assess functional capacity?

Psychiatrist evidence: 20-year extensive treatment history. Multiple inpatient admissions, community treatment orders. Compliant with antipsychotic depot injections. Engaged with community health. No other treatment recommended.

GP evidence: Vulnerable to manipulation from others, needs supervision to maintain hygiene, can’t manage own finances, needs tenancy support, at risk of eviction. Difficulty mobilising, can walk short distances only, uses a walking stick, is frequently breathless. Chronic knee and foot pain.

Facilitator notes:

State: Jake’s treating psychiatrist and General Practitioner (GP) have supplied evidence to support their application. You can see a summary on the slide.

Take a minute to read the evidence on the slide, then answer these questions:

1. Which evidence would you use to assess permanency?
2. Which evidence would you use to assess functional capacity?

(Allow learners a minute to read the information on the slide, then call on someone to share their answer. Simply confirm the correct answer. No details needed here. Further explanation on the next slide).

Click to go to next slide.

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Jake (part 3 of 5)

1. Which evidence would you use to assess permanency?

20-year extensive treatment history. Multiple inpatient admissions, community treatment orders. Compliant with antipsychotic depot injections. Engaged with community health. No other treatment recommended.

2. Which evidence would you use to assess functional capacity?

Vulnerable to manipulation from others, needs supervision to maintain hygiene, can’t manage own finances, needs tenancy support, at risk of eviction. Difficulty mobilizing, can walk short distances only, uses a walking stick, is frequently breathless. Chronic knee and foot pain.

Facilitator notes:

State:

To assess permanency, we’d use the evidence given here by Jake’s specialist, a psychiatrist. For example, it outlines a 20-year treatment history, inpatient admissions and medications. We can see Jake is compliant with antipsychotic depot injections and there is no further treatment recommended.

CLICK to show functional evidence

To assess functional capacity, we’d use the GP evidence. Here we can see descriptions of the things Jake can and can’t do. For example, Jake can’t manage their own finances which indicates difficulties with self-management. Jake also has difficulty walking for long distances which indicates a reduced ability to mobilise.

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Click to go to next slide.

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Jake (part 4 of 5)

1. Which information likely links to Jake’s Schizophrenia?

2. Which information likely links to Jake’s arthritis, diabetes or oedema?

Psychiatrist evidence:

20-year extensive treatment history. Multiple inpatient admissions, community treatment orders. Compliant with antipsychotic depot injections. Engaged with community health. No other treatment recommended.

GP evidence:

Vulnerable to manipulation from others, needs supervision to maintain hygiene, can’t manage own finances, needs tenancy support, at risk of eviction. Difficulty mobilizing, short distances only, uses a walking stick, is frequently breathless. Chronic knee and foot pain.

Facilitator notes:

State: We know Jake has listed their disabilities as schizophrenia, arthritis, diabetes and oedema.

When assessing evidence, you need to carefully link each piece of information to a listed disability, condition, or impairment. You would use complex decision-making skills to do this.

Let’s look at Jake’s supporting evidence again and break it down. Notice in the GP evidence, there’s information that states, ‘vulnerable to manipulation from others’ shown on the slide in pink text. Do you think this links to Jake’s schizophrenia or arthritis?

(Allow learners to answer and confirm it likely relates to schizophrenia.)

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State:

Your task is to read through the evidence, then decide:

• Which information likely links to Jake’s Schizophrenia?
• Which information likely links to Jake’s arthritis, diabetes or oedema?

Click to go to next slide.

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Jake (part 5 of 5)

1. Which information likely links to Jake’s Schizophrenia?

   • 20-year extensive treatment history.
   • Multiple inpatient admissions, community treatment orders.
   • Compliant with antipsychotic depot injections.
   • Engaged with community health.
   • No other treatment recommended.

   Vulnerable to manipulation from others, needs supervision to maintain hygiene, can’t manage own finances, needs tenancy support, at risk of eviction.

2. Which information likely links to Jake’s arthritis, diabetes or oedema?

   • Difficulty mobilizing, can walk short distances only, uses a walking stick, is frequently breathless.
   • Chronic knee and foot pain.

Facilitator notes:

State:

On this slide you can see which information likely links to schizophrenia and which likely links to Jake’s physical impairments. Take a moment to check your own answers. Did you identify the correct information for each question? (Leave the slide up for a minute for learners to read. Address any questions if needed)

State:

Linking evidence to specific impairments can be challenging. Sometimes you won’t have enough information to make a decision about certain listed impairments. If there are red flags in the evidence which point towards an access met decision, it’s a good idea to contact the applicant for further information specific to these red flags. Also, use the supports available to you if you need help.

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Click to go to next slide.

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Facilitator notes: State: Our next applicant is Rosa. Rosa is 27 and lives with co-morbid mental health and physical conditions. Her reported disabilities are listed on the slide. Your task is to:

• Read the information about Rosa.
• Then answer the question: Why might you need complex decision-making skills to assess Rosa’s application? You have a few minutes to do this task. (Allow learners a few minutes to read the information on the slide and to think of some answers. Then ask them to share their ideas. Add to discussion if necessary.)

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Discussion ideas: (No need to read these out. Not an exhaustive list. Ideas only)

• There are many different documents to read and consider. You’d need to decide which documents are relevant or not relevant to the current application.
• It might take time to analyse the volume of information.
• It might take time and complex decision-making skills to link the information in each document to each of Rosa’s different impairments.
• You may not find everything you need to make a decision in a single document. E.g., Treating health professionals sometimes state that high prevalence conditions are permanent. Complex decision-making skills are needed to investigate if the different documents show evidence of treatments and their outcomes.
• You may need to analyse what a particular piece of evidence is telling you. For example, a pharmacist’s receipt shows that Rosa purchased some medication and that it was prescribed to her. But it doesn’t show you that she actually took the medication or what the outcomes of that treatment are.
• None of these impairments are on list A or list B so you’d need to think deeply about each of Rosa’s impairments when considering whether there is a disability and whether it is caused by a permanent impairment.
• Rosa has high-prevalence conditions (e.g., generalized anxiety disorder, depression). You may need to analyse if/how psychosocial symptoms are impacting Rosa’s physical impairments and vice versa.
• Due to Rosa’s physical impairments being on the TAPIB mandatory list, you’d need to refer the application to TAPIB if you’re considering an access met decision for her chronic pain, fibromyalgia or chronic fatigue syndrome. We will talk about the TAPIB branch and how to get their advice later in the training.

Click to go to next slide.

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Activity: Authentic documents

Download the 3 documents from the chat, read them, then answer these questions:

1. List three reasons why this application might be challenging to assess.
2. Functional Neurological Disorder (FND) is on: a) List A b) List B c) The Mandatory TAPIB advice list d) All of the above
3. Refer to the section of Dr letter, circled in red. Do these statements alone provide enough evidence to assess eligibility? Why? Why not?

Facilitator notes:

State: As we’ve just learned, when making complex decisions, you’ll need to read and analyse different types of supporting evidence from a range of sources. Let’s take a look at some authentic examples. You’re going to read three supporting evidence documents, provided by three different health professionals. Note that these documents are real but have been de-identified for privacy and training purposes.

Your task:

1. Download the three documents from the chat.
2. Read each document, taking note of the author and type of information in each.

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Instructions for Task Completion

Answer the questions on the slide based on the information you’ve read. Once you have finished, reach out to a colleague and compare your answers with them. Then, type done in the meeting chat. You have 20 minutes to complete this task.

(Facilitators: Drop the three documents into the chat and check that learners can download them. Allow 20 minutes for learners to complete the questions. Be available if anyone needs help. Leave this slide showing. Once they have finished, bring everyone back together. Use the next slide to discuss the answers)

*Questions for reference:

1. List three reasons why this application might be challenging to assess.
2. Functional Neurological Disorder is on: a) List A b) List B c) The Mandatory TAPIB advice list d) All of the above
3. Refer to the section of Dr [redacted] letter, circled in red. Do these statements provide enough evidence to make a decision? Why? Why not?

Click to go to next slide.

Debrief: Authentic documents (1 of 2)

Challenges could include:

• large volume of information. Multiple documents from different health professionals. Takes time to read and interpret.

• co-existing conditions — need to consider each piece of information carefully and how it links to each condition.

• lots of technical health information and medical jargon to interpret. FND is on the TAPIB mandatory advice request list
• Mandatory TABIP list is available in the AA OneNote (external).
• It’s important to follow our processes and seek support where necessary.

Facilitator notes: (Call on learners to share their ideas. Use the information below and your own QDO knowledge to lead a discussion around the questions. The point here is not to try and determine if the applicant meets the criteria. It’s to emphasise the challenges that occur when making complex decisions).

Answers and discussion points:

1. List three reasons why this application might be challenging to assess.

• Challenges could include:

• large volume of information – multiple documents from different health professionals
• co-existing conditions – need to consider each piece of information carefully
• lots of technical health information and medical jargon to interpret
• This applicant’s disability isn’t straightforward. It has complexities.
• You may not find everything you need in a single document. For example, not all information needed for one section of the legislation is available in one report. You’ll need to read multiple documents to gather information about each section of the legislation.
• Takes a lot of time to read through all the information
• Some of the information in the documents may be unnecessary for

our purposes.

You need to carefully analyse which parts of the evidence to consider and which parts not to.

• Takes time to become familiar with the different medical professionals and specialists who write the reports. Need to think about which specialist holds more weight for which type of evidence or which impairment.

CLICK

(Call on learners to share their answers to question 2)

2. Functional Neurological Disorder is on the mandatory TAPIB advice list.

CLICK

State: Reading the information, you probably felt that this was a challenging case to assess because of the reasons we just talked about. When you first begin assessing cases like these, it’s important to still follow our standard processes. If you check List A and B, you can see that FND is not listed. This tells you that Section 24(1)(a) and (b) is not automatically considered likely to be met and you will need to assess the disability criteria carefully. When you are faced with a complex condition, remember to check the mandatory TAPIB advice list. This is in the OneNote. I’ll show you now.

(Navigate to the OneNote and point out where the mandatory list is)

Checking the mandatory TAPIB list often prompts you to seek QDO tech support. This is a good idea when first making complex decisions.

Click to go to next slide.

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Debrief: Authentic documents (2 of 2)

Does this section of Dr s47F - personal privacy letter provide enough evidence to assess eligibility? Why? Why not?

This correspondence confirms the following:

• The disability is attributable to sensory, physical and neurological impairments
• The domains affected include but are not limited to; cognitive, communicative, physical, functional domains
• The disability has resulted in a substantial and permanent reduction in functional capacity
• The disability is considered stable
• The disability will result in permanent impairment requiring ongoing disability support

Facilitator notes: (Answers for discussion continued…)

State: Let’s move on to question three. Please raise your hand to share your ideas about this question.

3. Does the section of Dr s47F - personal privacy letter, circled in red on this slide provide enough evidence to assess eligibility? Why? Why not? Possible discussion prompts:

• No, this section is not enough to assess eligibility. There is not enough detail in this paragraph.
• The doctor has stated that the applicant meets all of our criteria. They are aware of the criteria and how

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Our Guidelines

• The doctor has stated the criteria is met but this paragraph alone does not show that the criteria has been met.
• It is not the health professional’s job to state if the applicant meets our specific criteria. It is our job to assess evidence against the criteria. It is their job to provide the evidence and detailed information that we need to analyse and assess the criteria.
• It’s important not to take a statement at face value. You need to look at the detailed evidence and apply the criteria to that evidence. We must test the actual evidence against the criteria.
• Just because a health professional states an impairment is permanent, that doesn’t mean it is for the purposes of the NDIS. We would need to see detailed evidence showing which available treatments have been tried and what their specific outcomes have been. For example, if a health professional has stated that the applicant has been treated by a psychologist, we would need to see evidence from that psychologist of the treatments tried, the timeframe of treatment, and what the specific outcomes of the engagement with that treatment are.

(Facilitator to add to the discussion if necessary)

Click to go to next slide.

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Skills for complex decision-making

When making complex decisions you’ll need the ability to:

• make logical connections and exercise judgement while interpreting multiple sources of evidence
• come to accurate conclusions after testing legislation, rules and guidance against complex evidence
• perform objective and systematic research on certain conditions, their treatments, and functional presentations
• justify your decisions using the available supporting evidence
• follow mandatory processes and seek technical support where needed.

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Facilitator notes:

State:

We’ve talked a lot about using complex decision-making skills in this module. But what exactly are these skills?

Some essential skills include making connections between the information you find in multiple sources of evidence. As we’ve seen, an application may include several different reports from various health professionals. Being able to pick that evidence apart, analyse it, and make connections between pieces of information and sections of our legislation is essential in complex decision-making.

You’ll also need the ability to look at all the pieces and come to accurate conclusions after testing each of those pieces against our legislation and other practice guidance.

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For unfamiliar conditions or impairments

For unfamiliar conditions or impairments, you’ll need to perform objective research to gain a wider understanding of that condition, its recommended evidence-based treatments and common functional presentations. There is a list of reputable websites in the AA OneNote to help with this. Your knowledge of certain conditions will increase with time and experience.

You’ll also need to justify how you came to your decision. You’ll do this by showing which sections of supporting evidence you considered, and how you connected these selections to certain sections of the legislation. Being confident to justify your decision is part of owning your decision as a delegate.

Finally, when you make complex decisions, an important skill is to methodically follow standard processes. It’s important to use the tools available to you. This includes checking lists, referring for mandatory advice, and seeking QDO technical support if needed.

Can you think of any other skills you might need? Type your answer in the chat or raise your hand.

(Addressee learner suggestions. If there are none, add your own or move on.)

Click to go to next slide.

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Managing expectations

• Complex decision making can be challenging
• Managing your expectations is important: remember the conscious competence model
• Competence and confidence increase with time and experience
• Be kind to yourself & reach out for support

Facilitator notes:

State: As new starters, you may find complex decision-making challenging at first. That’s ok. Managing expectations is important when learning something new.

On day one of training, we talked about the conscious competence model.

We learnt that:

• repeated practice is needed to become competent with a skill, and this can take time.
• practice is essential to retain unconscious competence with a skill.
• Context is also important. For example, complex decision-making is different to assessing developmental delay, so you may go back to a lower level of competence until you’ve had the opportunity to develop new understandings.

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It’s OK to feel frustrated at times.

This is a normal stage of any learning cycle. We don’t expect you to know everything after the formal training is over! Remember that formal training is just an introduction to your role. Your confidence in making complex decisions will increase with time and on-the-job experience. In the meantime, be kind to yourself and reach out for support if you need it.

Click to go to next slide.

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Questions

Facilitator notes:

State: That brings us to the end of this module on complex decision-making.

(Address any learner questions here, then it’s break time before the next module)

Click to go to next slide.

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Version control

Hidden Slide – Version Control

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DOCUMENT 7a

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The contents of this document are – OFFICIAL.

Learner worksheet: Introduction to complex decision making.

Objective

• To become familiar with key terms related to complex decision making.

Learner Instructions

1. Complete this task on your own, or with a colleague.
2. Read the list of key terms and definitions.
3. Match each key term to a definition.
4. When you have finished, compare your answers with a colleague then type ‘done’ in the main meeting chat.

Key terms

Match each key term from 1-13 with a definition from A-M. The first one is done for you.

1. Co-existing conditions
   • F. The state of having multiple health conditions or disabilities at the same time, especially when they interact with each other in some way, for example, someone who lives with mental health issues and physical conditions.
2. TAPIB
3. Psychosocial disability
4. Mental health condition

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Chronic health condition

• Depot
• High prevalence disorders
• Fibromyalgia
• Chronic Fatigue Syndrome
• Fluctuating or Episodic conditions
• Arthritis
• Oedema
• Community treatment order

Definitions

A. A term used to describe a disability that arises from a mental health condition. While not everyone with a mental health condition will experience this, those that do can experience severe psychological effects and social disadvantage. This disability can be long standing, and it can have a significant impact on someone’s life and potential recovery. B. Conditions or impairments which vary in intensity.

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• Conditions that are viewed as reasonably common conditions for which treatment options are available. They include depression, anxiety, and bipolar. Treatment options can include but are not limited to medications, cognitive behavioural therapy, and other therapeutic treatment under the care of a psychiatrist or psychologist.
• A common condition in which people experience symptoms that include widespread pain and tenderness in the body, often accompanied by fatigue and problems with memory and concentration.
• Considered by the NDIS to be a broad term that describes many different disorders, illnesses, and syndromes that may be caused by life events or genetic factors. They can be temporary or lifelong, and include mood, anxiety, personality, psychotic and compulsive disorders.
• The state of having multiple health conditions or disabilities at the same time, especially when they interact with each other in the same way, for example, someone who lives with mental health issues and physical or intellectual conditions. Sometimes referred to as comorbid conditions.
• A type of musculoskeletal condition that affects the muscles, bones and joints. Management techniques can include medical treatment and medication, physiotherapy, exercise and self-management techniques.
• An injection of antipsychotic medications. These injections are given in a ‘carrier liquid’ that releases the medication slowly, so it lasts longer. This can occur over several weeks. These injections may be helpful where the person has difficulty remembering to take medication regularly. They may also be a condition of a court community treatment order.
• The NDIA Technical Advice and Practice Improvement Branch. Provides additional specialist subject matter expertise, interpretation, and advice in terms of decisions which may include psychosocial disability and chronic health conditions. Certain conditions require mandatory advice from a TAPIB advisor before making an access met decision. A list of conditions that are mandatory for TAPIB referral can be found in the Access Assessor OneNote.
• A type of fluid retention that causes swelling and aching in parts of the body. The feet, ankles and hands are commonly affected. Can be a symptom of arthritis.

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K. A long-lasting condition with persistent effects. A condition that may get gradually worse and often needs long-term management. Can lower a person’s quality of life and affect independence. Examples include arthritis, cancer, back pain and diabetes.

L. A legal order where a patient may be ordered to accept treatment, care and management, to be provided in the community by a nominated mental health facility. Allows people who might otherwise be detained in a mental health facility, to live in the community and get the treatment, care and support they need in a less restrictive setting.

M. Otherwise known as Myalgic encephalomyelitis (ME) this is a complex disorder characterised by extreme fatigue that affects many parts of the body including the brain, muscles, digestive, immune, and cardiac systems.

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DOCUMENT 7b

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Answer Guide: Introduction to complex decision making.

Objective

• For access assessors to pre-learn key terms related to complex decision making. This is a pre-teach activity which means learners may not have background knowledge of these terms before completing this activity. This activity provides context and facilitates understanding as learners progress through the information and scenarios in the PowerPoint module.

Facilitator Instructions

• Learners will need the ‘Introduction to complex decision making’ learner worksheet.
• Allow about 10-15 minutes for learners to complete the activity.
• Learners can complete the questions alone, or with a colleague.

Learner Instructions

1. Complete this task on your own, or with a colleague.
2. Read the list of key terms and definitions.
3. Match each key term to a definition.
4. When you have finished, compare your answers with a colleague then type ‘done’ in the main meeting chat.

Key terms

Match each key term from 1-13 with a definition from A-M. The first one is done for you.

1. Co-existing conditions
   • F. The state of having multiple health conditions or disabilities at the same time, especially when they interact with each other in some way, for example, someone who lives with mental health issues and physical conditions.

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TAPIB

• I

Psychosocial disability

• A

Mental health condition

• E

Chronic health condition

• K

Depot

• H

High prevalence disorders

• C

Fibromyalgia

• D

Chronic Fatigue Syndrome

• M

Fluctuating or Episodic conditions

• B

Arthritis

• G

Oedema

• J

Community treatment order

• L

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Definitions

• Psychosocial disability: A term used to describe a disability that arises from a mental health condition. While not everyone with a mental health condition will experience this, those that do can experience severe psychological effects and social disadvantage. This disability can be long standing, and it can have a significant impact on someone’s life and potential recovery.

• Fluctuating or episodic conditions: Conditions or impairments which vary in intensity.

• High prevalence mental health disorders: Conditions that are viewed as reasonably common conditions for which treatment options are available. They include depression, anxiety, and bipolar. Treatment options can include but are not limited to medications, cognitive behavioural therapy, and other therapeutic treatment under the care of a psychiatrist or psychologist.

• Fibromyalgia: A common condition in which people experience symptoms that include widespread pain and tenderness in the body, often accompanied by fatigue and problems with memory and concentration.

• Mental health condition: Considered by the NDIS to be a broad term that describes many different disorders, illnesses, and syndromes that may be caused by life events or genetic factors. They can be temporary or lifelong, and include mood, anxiety, personality, psychotic and compulsive disorders.

• Co-existing conditions: The state of having multiple health conditions or disabilities at the same time, especially when they interact with each other in the same way, for example, someone who lives with mental health issues and physical or intellectual conditions. Sometimes referred to as comorbid conditions.

• Arthritis: A type of musculoskeletal condition that affects the muscles, bones and joints. Management techniques can include medical treatment and medication, physiotherapy, exercise and self-management techniques.

• Depot: An injection of antipsychotic medications. These injections are given in a ‘carrier liquid’ that releases the medication slowly, so it lasts longer. This can occur over several weeks. These injections may be helpful where the person has difficulty

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Remembering to take medication regularly. They may also be a condition of a court community treatment order.

TAPIB

The NDIA Technical Advice and Practice Improvement Branch. Provides additional specialist subject matter expertise, interpretation, and advice in terms of decisions which may include psychosocial disability and chronic health conditions. Certain conditions require mandatory advice from a TAPIB advisor before making an access met decision. A list of conditions that are mandatory for TAPIB referral can be found in the Access Assessor OneNote.

J. Oedema

A type of fluid retention that causes swelling and aching in parts of the body. The feet, ankles and hands are commonly affected. Can be a symptom of arthritis.

K. Chronic Health Condition

A long-lasting condition with persistent effects. A condition that may get gradually worse and often needs long-term management. Can lower a person’s quality of life and affect independence. Examples include arthritis, cancer, back pain and diabetes.

L. Community Treatment Order

A legal order where a patient may be ordered to accept treatment, care and management, to be provided in the community by a nominated mental health facility. Allows people who might otherwise be detained in a mental health facility, to live in the community and get the treatment, care and support they need in a less restrictive setting.

M. Chronic Fatigue Syndrome

Otherwise known as Myalgic encephalomyelitis (ME), this is a complex disorder characterised by extreme fatigue that affects many parts of the body including the brain, muscles, digestive, immune, and cardiac systems.

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