NDIA Accountability Project

Psychosocial plan handling issues and NDIA bureaucracy

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Problem: Psychosocial plans are being mishandled and NDIA is causing harm.

I am writing as a carer (for my adult daughter) and as a participant. We are both registered as having psychosocial disabilities. We have self-managed our plans since 2016.

I have been deeply traumatised by my interactions with the NDIS, especially over the past 18 months, as things have worsened considerably. While I have funding that I didn’t have before NDIS, I feel my physical and mental health are much worse than before I had to deal regularly with the toxic bureaucracy of NDIA. I have suffered significant health problems directly related to my experiences with them, including very high blood pressure due to prolonged stress.

It is my position that I have been subject to psychological warfare from the NDIA, who have left me distressed, disempowered and disenfranchised. Ultimately I feel completely beaten down and broken by the experiences. My current needs are higher and my capacity significantly lower than they were before I joined the scheme. After my most recent plan review, I called Lifeline, because the experience had left me feeling so overwhelmed and distressed. My resulting (two year) plan is completely insufficient, but I have nothing left in the tank to fuel me through yet another battle with NDIA. I am barely making it through my day to day life.

Advocating for our needs with NDIA has left me vulnerable to an assortment of very upsetting experiences.

  • NDIA demand “more evidence” endlessly – as soon as one report is provided by us, we are told we need to provide more evidence. This has happened countless times, and for one of our plans we have provided over 20 reports. When we ask what evidence is needed, or what was missing from the previous reports, or what questions have been left unanswered in the material we have provided, these have not been clarified or specified. Providing endless reports, particularly with inadequate information about what NDIA is seeking, has been time-intensive, highly anxiety-inducing, and at times financially costly.

  • NDIA ignore evidence that has been provided, even though this evidence has been requested by them, and is expert and comprehensive. I have even been told by a delegate that specialist reports are not evidence, and that they are not obliged to pay attention to the contents. If that is true, why are we sent to get more and more evidence? It is unfathomable how delegates with limited expertise in specialised areas get to override the expertise of multiple specialists with high levels of expertise.

  • Removal of choice and control – both of our plans are self-managed, but we are told at reviews that the proven, documented and cost-effective services that we have chosen as most helpful for us (within the rules of the NDIA), will no longer be

Psychosocial plans are being mishandled and NDIA is causing harm.

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  • funded. My daughter was recently refused funding for her psychotherapy with her proven, cost-effective, appropriately registered practitioner, and the delegate insisted that my daughter find a new psychologist and work with them instead – with an expectation that they focus solely on functional development.

  • We are not given reasons for decisions. We cannot learn from this or hope to become better participants if we do not have this information.

  • No understanding of and total disregard for our needs as we describe them, as well as a hyperfocus on reducing overall spending instead of meeting participant needs. We go to great lengths to describe our needs, both written and verbally, and to outline what we know is the best way to meet those needs, but it continually falls on deaf ears – no matter how much evidence we provide. Most often, responses are to tell us that what we’re saying isn’t true. For example, “No, you don’t need that.” This is incredibly disenfranchising, frustrating, disempowering and distressing. We know best what we need, and the principles of the NDIS are supposed to work from that basis.

  • It is expected that we will definitely be reducing our needs over time. This ignores that people with disabilities will have some needs that never reduce or go away. We are registered with NDIA because we have permanent psychosocial disabilities. This is a given, or else we wouldn’t have been accepted as participants. On several occasions, someone has decided that as we have previously had certain services, funding for the services should no longer be required, as our problems “should be fixed by now”. It is nonsense to assume that we only need services within an arbitrary limited time frame.

  • Constant focus on improving function instead of recognising that people with psychosocial disability have entirely different needs. We have even been told that individual counselling under a psychosocial plan should involve the therapist looking at functional goals, planning how to tackle these, training support workers in how to support the participant, measuring success, noting, reporting and modifying the plan if things don’t work (much like an occupational therapist). That approach might make sense for someone with a physical disability, but does not make sense for someone with a psychosocial disability. First, this description is nothing like NDIA’s own definition of Individual Counselling. Second, a person with psychosocial disability can have high functional skills and also not have capacity. Clearly when that is the case, supports and services are needed without the focus on functional development. NDIA does not yet seem to understand this.

  • We have experienced staff making up rules to suit themselves and ignoring existing rules when it suits them. We were told by a delegate that 1. psychotherapy is not an evidence based form of counselling, 2. that NDIA does not fund it, and 3. NDIA only

Psychosocial plans are being mishandled and NDIA is causing harm.

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funds psychologists for counselling as it is the only valid form of therapy. These three statements are all untrue.

  • Between one review and the next, the rules are constantly changing. Participants are being set up to fail. We are trying to work within the rules, but it’s almost impossible with all the conflicting messaging out there. For example, we were told in one review that NDIA funds “individual counselling” but not specifically psychology, and then in the next review we were told (by a delegate), that NDIA will only fund psychology. The pricing sheet has no mention of psychologists at all, but does mention individual counselling, and the web site has further information suggesting this claim about funding psychologists is not valid. Constantly shifting the goal posts is setting us up to make mistakes. Not only that, if delegates are getting it wrong, what hope have we got?

  • Adversarial nature of discussions – most of our conversations with NDIA staff have been very distressing. We would like to be working with a team of people who want to be working with us, not against us. We only ever ask for things that we believe are reasonable and necessary, and we are grateful to finally have supports. However NDIA staff seem to assume in most cases that we are trying to rort the system. We have frequently been treated as though we are dishonest welfare recipients and it is impressed upon us that we should be grateful for whatever we get and stop complaining when we don’t get what we actually need. NDIA staff are often secretive and evasive, highly confrontational and unnecessarily intrusive. We have at various times been gaslighted, bullied, lied to and yelled at.

  • Often, NDIA staff are not trauma trained, and as a result they are causing harm. Some staff members claim that they are fully knowledgeable about what it is like to live with mental illness, based only on having attended a mental health first aid course. These staff are often paternalistic, overconfident and don’t listen to our own descriptions of what we experience. They are also happy to disregard the content of reports written by clinical psychologists. It is not uncommon for these staff to paternalistically tell us what we do or do not need, thus also removing choice and control.

  • Our experience of NDIA has involved us having to divulge absolutely anything and everything we are probed about, and apparently having to accept this complete loss of privacy because we have our hands out to the public purse. In total contrast, NDIA shows almost zero transparency. This shows a massive power imbalance. In discussions, we have asked for definitions (such as how NDIA define reasonable and necessary in their review process), guidance of where to find information in the law or within policies, clarification of how and why decisions were made to fund things or not, clarification about what therapies have been funded or not funded in a particular “bucket”, copies of correspondence about us (such as copies of our

  • complaints), and various other simple requests for information. At every turn we are

told that these answers cannot or will not be provided. It would appear that it is nimpossible to get copies of almost anything about us, without filing a Freedom of Information request.

 NDIA is actively ignoring complaints. On multiple occasions, our written complaints have been completely ignored. Complaints about ignored complaints have also been ignored (and so on). About fifteen months ago we took this problem to the Commonwealth Ombudsman – afterwards the NDIA admitted to their poor complaint handling practices, but continued to ignore the subject of the original complaint, which was never addressed. Fifteen months later, and we are having exactly the same experience again with NDIA, as we attempt to address yet another concern.

 NDIA is operating like an insurance company, assuming all participants should not be paid unless we fight for it, and even then, we should be willing to give up our right to privacy, put up with abuse, see every cent as negotiable, and be grateful for whatever we get. The clientele of the NDIS is a vulnerable population, many of whom do not have the capacity to self-advocate or work within the machinations of an adversarial insurance industry mindset. The most recent delegate we dealt with told us that she had a long history of working in the insurance industry, that she was good at keeping costs down, and she had been hired for that expertise. It is deeply concerning that this is the mentality with which we have to contend.