JSC NDIS Market Readiness
Comments in response from HelpingMinds
For inquiries please contact
Dr Donna Turner
HelpingMinds is a community mental health provider (formerly Arafmi)
HelpingMinds provides a range of supports to families and individuals experiencing issues arising from mental distress. We work directly with family members and friends in an ongoing caring role and with individuals who require support as a result of mental health issues. Our offices are based throughout the Perth region as well as Geraldton, Carnarvon, Port Hedland, Broome and Kununurra.
We acknowledge the Traditional Custodians of the lands on which we work, learn and care, and pay respect to the Aboriginal and Torres Strait Islander people and their Elders, past, present and emerging.
Over 72,000 people in Western Australia have identified as requiring assistance due to a psychological condition. The vast majority of people who need assistance receive it from their family and friends who provide support in cognitive and emotional tasks, personal and health care, mobility, household tasks, transport, and reading and writing tasks¹.
The lives of people with mental health issues and their family members and friends who support them can become closely entwined. HelpingMinds encourages a ‘family centred’ approach to service delivery. This places the individual at the centre but closely acknowledges the needs of the person’s support network who might be family members or friends who provide ongoing support and who may require support themselves to continue this role in a positive manner².
In WA, the Carers Recognition Act 2004³ requires health and disability service providers to identify family members and friends who are in an ongoing, unpaid caring role.
- Australian Bureau of Statistics. 2015. Survey of Disability, Ageing and Carers: Psychological Disability, 2012 – Australia. Tables 3 and 8.
- COPMI. 2014. Family Recovery.
- Carers Recognition Act 2004 https://www.slp.wa.gov.au/pco/prod/filestore.nsf/FileURL/mrdoc_28814.pdf/$FILE/Carers%20Recognition%20Act%202004%20-%20%5B01-e0-00%5D.pdf?OpenElement
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Comments on the Consultation Paper
HelpingMinds is able to provide feedback based on our experience in working with family members and friends who are in an ongoing caring role (Carers) for a person close to them who is living with a mental health issue and based on our experience as a provider of mental health and NDIS/WANDIS services to people who require support due to psychosocial disability. We have therefore focused on the questions that are most applicable to our range of expertise and experience. This relates mainly to the hours required to assist a potential participant to test their eligibility, and to workforce development, in particular, the need for staff to be able to work in a recovery oriented manner with the individual and with their support network which may include their family members and/or friends who provide ongoing support.
a. The transition to a market based system
As one of the agencies participating in the University of Sydney Mind the Gap⁴ research, we concur with the concerns raised regarding the challenges of provide services in regional areas, funding services over weekends, and the costs of travel. The factors impact on financial viability and potentially limit the choices available to participants.
Currently, many services are able to provide advocacy to clients to test their NDIS eligibility because these are existing PiR and PHaMS clients and transition funding is assisting organisations to meet the costs of providing support workers to follow up with psychiatrists and occupational therapists for assessments etc. Our support staff commonly spend 20 hours in advocacy on behalf of PHAMS clients to assist them in testing their eligibility. For younger clients, this is generally a higher figure and in the case of one client who was eventually found eligible, 80 hours was spent in the provision of advocacy.
These are existing PHAMS clients, already connected to the service, and who have already proved eligibility to some extent. In the case of future clients who are not currently linked to a service, it is possible that more hours would be required to assist them to test their eligibility. In future, in a purely market based system, in the absence of the current transition funding, the costs of advocating for clients who are seeking to determine their eligibility for NDIS will have to be considered in terms of whether an organisation can bear the cost.
This issue is one of the reasons HelpingMinds actively sought a Perth based workshop to hear from participants about strategies to improve NDIS pathways for clients with psychosocial disability. However, there is also much to be learned from people who have tested their eligibility and not been accepted, and from those who have chosen not to test their eligibility. We strongly suggest that consultation with people in this position
- University of Sydney. 2018. Mind the Gap: The NDIS and psychosocial disability. http://sydney.edu.au/health-sciences/documents/mind-the-gap.pdf
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is necessary to ensure that all existing barriers to NDIS participation are identified and addressed.
b. participant readiness to navigate new markets
Please note comments above regarding our concerns that people with psychosocial disability who are already linked with service providers have expressed concern about the design of pathways into the NDIS. Barriers to the NDIS will hopefully be addressed as a result of the current round of workshops to identify and address these issues.
We also note the potential importance of an individual’s network (their family and/or friends who offer ongoing support) in accessing services for an individual and undertaking advocacy on their behalf should the person be unable to do so. For this reason, it is important that service providers, in promoting services and developing pathways, have measures in place to ensure that these family members and friends are able to provide assistance to the individual where appropriate.
Training in supported decision making would be of use here, for service providers and for family members and friends in an ongoing caring/supporting role, as this would allow an individual’s friends and family to assist them if necessary, in accessing information about providers and services, yet without denying the individual their autonomy and control.
c. the development of the disability workforce to support the emerging market
We believe there is potential for NDIS service providers to learn more from existing and potential NDIS clients about what they value from service providers at all levels of contact, ie direct support worker to back office operations.
People with psychosocial disability are a diverse population of people who value varied qualities in the people they employ to provide services. For example, at a recent workshop with NDIS/WANDIS participants, and potential participants, Aboriginal people highlighted the value they place on working with a service provider with an understanding of intergenerational trauma⁵.
It is therefore important that service providers employ a diverse workforce to meet the needs of clients. Some potential employees with suitable life experience as desired by clients (eg peer workers, lived experience workers) may not have formal qualifications. Relatively small providers and regional providers can be unfairly disadvantaged due to the need to absorb the costs of ensuring lived experience or peer staff also receive formal training when required.
A further cost issue relevant to the development of the workforce is the provision of quality supervision and support to front line staff, particularly for those front line staff who are re-entering the workforce after a break. Supervision and support becomes even more expensive in regional areas where both the NDIS support worker and the
- Disability Services Commission. 2017. NDIS in WA Conversation. Book of Proceedings.
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supervising staff member may need to travel significant distances to meet face to face. While ICT can be utilised wherever possible to provide this support (eg Skype etc), it is not always culturally appropriate or adequate to the needs of the staff member.
Within mental health services in WA, front line staff are expected to provide recovery-oriented services which requires them to be trauma informed, culturally safe, client directed and able to involve the person’s support network, including family and friends in a caring role. Additionally, in WA, they are expected to abide by the Carers Recognition Act 2004. It would be advantageous to have consistency across mental health services and NDIS services so that the skills gained in other sectors translate more easily into the NDIS workforce, allowing staff to move between sectors and bringing more skills from the mental health sector into the NDIS space.
The growth of the NDIS workforce is a potential opportunity for expanding employment opportunities for Aboriginal people. Developing appropriate recruitment and retention strategies is vital. These could be included in the Reconciliation Action Plans of NDIS service providers.
Similarly, Aboriginal workers have great potential to assist non-Aboriginal workers to be accepted by Aboriginal clients. ‘Buddy’ arrangements, where the Aboriginal worker accompanies the non-Aboriginal worker to introduce them to Aboriginal clients have been effective. However, where the Aboriginal staff member is taking on a training and orientation role on behalf of the non-Aboriginal workforce, recognition of this expertise and seniority should be given with an additional payment and acknowledgement of the additional responsibility in career structures (eg Senior Support Worker). It is possible though, that this additional cost will potentially disadvantage smaller providers, regional providers, and those who work with a higher percentage of Aboriginal clients.
Conclusion
HelpingMinds supports the submission to this inquiry prepared by Community Mental Health Australia (Submission 14) and looks forward to the learnings that emerge from this inquiry. HelpingMinds thanks the individuals and family members and friends who continually share their experiences with us to inform our systemic advocacy.
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