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Psychosocial Disability Snapshot
The content of this document is OFFICIAL. This Disability Snapshot provides general information about psychosocial disability to assist you in communicating effectively and supporting participants to develop their goals. Each person is an individual with their own needs, preferences and experiences. This information has been prepared for NDIA staff and partners and is not intended for external distribution
Peak body consulted
In developing this resource we consulted with Community Mental Health Australia (CMHA) and Mental Health Coordinating Council of NSW (MHCC).
What is psychosocial disability?
Psychosocial disability refers to the social and economic consequences related to mental health conditions. It is used to describe the challenges, or limitations, a person experiences in life that are related to mental health conditions. This may include challenges or limitations in their capacity to:
- have a good social network including friends and a family of their own
- participate fully in life
- experience full physical health
- manage the practical, social and emotional aspects of their lives
- engage in education, training, cultural activities and economic participation
- achieve their goals and aspirations.
The impact of psychosocial disability can vary over time because of the difficulties people experience with mental health conditions and many other factors in the individual’s life. Not everyone living with mental health conditions will experience a significant psychosocial disability and individuals will experience psychosocial disability differently.
In Australia, people with a psychosocial disability make up a significant proportion of Australia’s most disadvantaged population. People with a mental illness (21.7%) are the second largest group receiving the Disability Support Pension.
People with psychosocial disability may also have lived and living experience related to trauma, suicidal ideation, and substance use. The complexity of this means you should adopt a whole of person approach.
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How is psychosocial disability identified?
A person may be diagnosed with a mental health condition, but psychosocial disability is not a diagnosis. Psychosocial disability is identified by the impacts of, or impairment resulting from, the person’s mental health conditions.
A health professional such as a GP, psychiatrist or allied health professional may identify psychosocial disability through assessment or testing.
Impairment resulting from psychosocial disability can be episodic or fluctuating. To understand the functional impact and psychosocial disability for an individual, it can be helpful for an allied health professional (for example occupational therapist, psychologist, speech therapist, social worker) to provide an overall assessment of the person’s functioning. It is important that the assessment considers the impacts in relation to:
- mobility
- communication
- social interaction
- learning
- self-care
- decision-making.
Psychosocial disabilities often include cognitive difficulties which may affect function in the areas of:
- memory
- communication
- organising and planning skills
- social interactions
- visual interpretation.
The symptoms of a mental health condition may be of an episodic nature and vary in intensity and need for support. How this impacts on psychosocial disability may mean that there will be times when a person may experience significant limitations; while at other times they may be able to go about their daily life without experiencing the same challenges.
Language and terminology
When talking with or about a person with a psychosocial disability, use ‘person first’ language. For example, saying ‘person living with a psychosocial disability’ rather than ‘disabled person’. People with mental health conditions usually prefer not to be defined by them.
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OFFICIAL For Internal Use Onlybased language, rather than focusing on a person’s limitations, maximises a person’s sense of s \self, and independence.
The term ‘recovery’ is used widely throughout the mental health service system and can have different meanings for different professionals/disciplines and people accessing the services. The NDIA defines recovery as achieving an optimal state of personal, social and emotional wellbeing, as defined by each individual, whilst living with or recovering from a mental health condition.
Recovery is an individual and unique process. It is defined by the person and driven by their needs and preferences. Recovery involves:
- having hope
- being motivated
- feeling optimistic about the future
- having the skills and strategies to manage the challenges the participant may experience
- ensuring that services are delivered using a trauma-informed recovery-oriented practice approach.
It is important to use language that reflects the recovery-based approach. You can find more information on recovery-orientated language in the Helpful Links section and in the Practice Guide – Psychosocial Disability.
Enabling social and economic participation
Some of the consequences of psychosocial disability may include:
- poverty
- discrimination
- unemployment
- poor educational outcomes
- poor housing.
The relationship between these consequences and the underlying mental health condition can be interconnected and two-way. For example, loss of connection with family, friends and community can worsen a participant’s mental health. It is important to focus on building and maintaining social connection and relationships.
The earlier a person connects with services and supports, the better. The episodic nature of a mental health condition may vary on a day-to-day basis or over the person’s life span, and their plan needs to be flexible enough to respond effectively.
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A self-directed, strengths-based, trauma-informed, recovery-oriented approach to a person’s mental health and well-being is highly effective. This may mean working with the person to help them identify some safe activities to start such as building their social networks or getting back into work. Capacity building supports are important to this approach as well as core and assistive technology supports. Adopting a strengths-based approach in supporting the participant to identify their goals, objectives and aspirations is vital to build rapport and develop independence. In using a strengths-based recovery approach, you will focus on the participant’s talents, positive attributes and potential and identify how that will help them to achieve their goals.
Capacity building supports:
- A Recovery Coach support can provide assistance in building capacity and resilience in people with psychosocial disability and support them to live a more fulfilling life. Recovery coaches work with participants, families, carers, and other services to get the best outcomes from NDIS supports.
- A support coordinator can be effective in maintaining continuity of supports and allows for supports to be increased quickly and/or accessed at short notice as needed. Support coordinators can also ensure appropriate support is available around transitions from hospital to community, and that an ongoing relationship is there to facilitate engagement in social, economic and community life.
- An occupational therapist with specialist knowledge in mental health can assess functional capacity and provide support in maintaining a job, volunteer role, study, and/or social networks.
- An exercise physiologist can provide an accessible and achievable exercise program to support a person’s mental health and build community networks.
Core supports:
- A functional home environment can improve mental health. Support workers can assist with daily living activities in the home like meal preparation and cleaning.
- Support workers can also assist with and encourage participation in an exercise plan given by an exercise physiologist and promote self-care with regards to personal care and physical health.
- Access to community groups can help facilitate social inclusion and build relationships.
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Assistive Technology (AT):
- AT can provide both functional and emotional support for example by assisting individuals to learn new information and build organisation, concentration and planning skills.
Families and carers
Family, friends, carers and kinship groups play an important role in a person’s recovery. Mental health carers can include a parent caring for a child, an adult caring for a partner, friend, parent, or sibling, or a child caring for a parent. Due to the episodic nature of mental health conditions, people living with psychosocial disability may require regular on-call care. Family members often provide care for many years, often either in their own home or the home of the person living with psychosocial disability.
Other informal supporters are often unexpectedly called upon to play a role in mental health care. They may have found themselves in this carer role because they see it as part of their relationship with the person with psychosocial disability. Nevertheless, they may not think of themselves as a ‘carer’.
It is important to consider whether the level of care provided by family members, carers or informal supports is sustainable. It may be reasonable and necessary to include core supports and respite to prevent carer burnout. To support carers and family members in this role, provide them with relevant resources and information.
Refer to the Helpful Links section for more information.
How can I tailor a meeting to suit a participant with psychosocial disability?
Many people who live with psychosocial disability may have experienced trauma in their life and can become distressed if they do not feel safe. To facilitate a sense of safety make sure you:
- Allow enough notice for the person to prepare for meetings (ideally four weeks) and be clear about what ‘prepared’ means.
- Consider the environment and ask the person what helps them feel safe in a room. Let them know the choices they have, such as having the meeting in a familiar place, having a support person with them, and whether the gender of the support person and the NDIA representative is important. A support person may need to be invited to attend as they can be particularly important to help convey a person’s needs.
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- Provide easy access to exits and offer breaks or follow-up meetings.
- Be honest and clear about what you can and can’t do. Set boundaries and expectations early and allow the person to set their own boundaries if possible.
- Maintain confidentiality and be clear about what information will be kept and what it will be used for.
- Provide information about your recommendations and why they are relevant, even if it seems obvious.
- Ensure the participant understands what choice and control means in the conversation. People may feel very disempowered by those they see as ‘authority figures’ and may feel intimidated. Encourage the person to take part in the process, allow them space and time to speak up. An example question could be: “Is this the ideal outcome today from your point of view? How do you think we could achieve this?”
- Listen non-judgmentally and collaborate with the person to clarify their need. Ask the person what they find important and don’t make assumptions. Use paraphrasing and clarifying questions to understand their wants and needs.
- Use the Reimagine Workbook (see the Helpful Links section) which has a tool to use in collaboration with the participant.
What people with psychosocial disability want you to remember
- People living with psychosocial disability have first-hand knowledge of what they experience.
- Involving a support person in a planning meeting can help the participant feel safer and more confident to ask for what they need and don’t want.
- The road to recovery varies from person to person.
- People with psychosocial disability often experience stigma and discrimination which can be highly distressing.
- Psychosocial disability is not a visible disability, but the impact on a person’s life is very real.
- Take the concerns of the person living with psychosocial disability seriously.
- Social inclusion and community connection are significant to recovery.
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Psychosocial Disability Snapshot
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Helpful links
- Reimagine
- Reimagine my life Workbook
- Mental Health Carers Australia
- Recovery Oriented Language Guide
- Unravelling Psychosocial Disability Booklet
- Practice Guide — Psychosocial Disability
- Conversation style guide
Version control
| Version | Amended by | Brief Description of Change | Status | Date |
|---|---|---|---|---|
| 1.0 | ZWECK\M | Initial Version | APPROVED | 2020-08-28 |
| Class 3 Approved |
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OFFICIAL This document is uncentreled when printed.