Submission 751
Submission to the National Disability Insurance Scheme Amendment (Securing the NDIS for
Future Generations) Bill 2026
Before implementing significant reductions to social and community participation supports for autistic people, I strongly urge government to investigate the representation of autistic children and young people within emergency departments, inpatient mental health units, youth mental health services and other acute care settings. I also urge consideration of the broader consequences of unmet needs, including the tragic murders of autistic children in Perth and Sydney, which have raised serious concerns about the pressures experienced by autistic children and their families and the adequacy of available supports.
I understand the government’s concerns regarding the long-term sustainability of the National Disability Insurance Scheme (NDIS). However, I am concerned that current reform efforts place disproportionate scrutiny on participants while insufficient attention has been given to provider practices, organisational expenditure, service effectiveness and accountability for public funding.
I wish to be clear about the scope of my comments. I am not providing evidence as an economist, policy analyst or expert in government budgeting. My observations are drawn from two areas of professional experience.
The first is acute child and adolescent mental health. As a senior mental health clinician, a substantial proportion of the children and young people I encounter in acute mental health settings are autistic. Many present with self-harm, suicidality, severe emotional distress, behavioural crises, school refusal, family breakdown and significant functional deterioration.
The second is the design and delivery of community-based social participation programs for autistic and neurodivergent children, adolescents and adults. Through this work, I have observed the role that friendship, belonging, peer connection, shared interests and community participation can play in promoting wellbeing and reducing isolation.
My submission is therefore focused on the intersection between these two areas. Specifically, I am concerned about what happens when opportunities for meaningful social connection are reduced and how this may contribute to increased demand for more intensive mental health and crisis services later.
Submission 751
In my experience, these presentations rarely emerge in isolation. They are frequently preceded by prolonged periods of social exclusion, loneliness, bullying, school difficulties, community disconnection and a lack of environments where autistic young people feel understood and accepted.
Government should investigate how many autistic children and young people are represented within emergency departments, inpatient units and crisis services. It should examine the pathways that lead to these presentations and the role that social isolation, loss of community connection and unmet participation needs may play.
This is not a theoretical concern. It reflects patterns repeatedly observed within acute mental health settings.
When autistic young people reach crisis point, families often present to emergency departments because they have exhausted all other options. Many parents make it clear that they do not feel safe taking their child home without meaningful intervention. These situations frequently escalate through senior clinical, operational and executive pathways within hospitals because services must respond to immediate risk concerns.
The result can be lengthy emergency department stays, prolonged inpatient admissions, increased pressure on already stretched mental health services and significant costs to the health system. Families may also be required to reduce working hours or leave employment entirely to manage escalating care needs. This reduces workforce participation, increases financial strain and often increases reliance on government-funded support systems elsewhere.
There is also a risk that insufficient early intervention, social participation opportunities and preventative community supports may contribute to escalating levels of disability and dependence over time. In my experience, some autistic young people who repeatedly present to crisis services experience progressive deterioration in functioning, education, community participation and family stability.
When needs escalate and families can no longer safely manage at home, the response often requires increasingly intensive and expensive support arrangements. This may include high cost support packages, specialist accommodation, Supported Independent Living arrangements, dedicated residential models and ongoing 24-hour support.
Submission 751
I encourage government to consider the full trajectory of care rather than viewing supports in isolation. The question should not only be whether a particular support can be reduced today, but what costs may be incurred tomorrow if preventative opportunities for connection, participation, skill development and community belonging are removed.
I raise these concerns because I believe the discussion about NDIS sustainability is incomplete if it focuses only on the cost of disability supports without also considering the costs generated when preventative social infrastructure is absent.
Much of the public conversation regarding NDIS sustainability focuses on fraud. While fraud should be identified and addressed, I believe a significant issue is not necessarily fraud, but inefficient, disproportionate or poorly scrutinised spending that may be technically compliant with funding rules while failing to represent the best use of public resources.
There should be greater accountability for organisations receiving significant government funding, whether through participant-funded services, grants, contracts, block funding arrangements or commissioned programs. Too often, resources appear to be absorbed by administration, management structures, branding, reporting requirements and organisational growth rather than direct service delivery and measurable outcomes.
As both a clinician and founder of a community-based neurodivergent organisation, I have observed situations where substantial funding is allocated within service systems while the amount of direct support received by participants appears comparatively limited. This does not necessarily indicate wrongdoing. However, it raises legitimate questions regarding pricing structures, provider practices, workforce allocation, administrative expenditure and whether funding is consistently translating into meaningful outcomes for participants.
For example, there are situations where participants may receive relatively brief or intermittent supports while significant funding is allocated to maintain service models around them. There are also examples of transport and routine support activities being charged at rates comparable to highly specialised services. These practices may be technically compliant, but they raise reasonable questions about efficiency, value for money and whether public funding is consistently being directed to where it has the greatest impact.
Government should strengthen governance and accountability mechanisms across the disability sector. This should include transparent reporting on administrative expenditure, workforce investment, participant outcomes, community impact and independent evaluations
Submission 751
of service effectiveness. Funding decisions should increasingly be linked to demonstrated outcomes rather than organisational size, profile or historical funding relationships.
I am concerned by examples across the disability sector that suggest reductions in frontline capacity despite substantial public investment. The closure of AEIOU and the proposed reduction of specialist early childhood disability positions at the Brotherhood of St Laurence raise important questions regarding workforce planning, service continuity and the allocation of public resources.
While each organisation faces unique circumstances, these developments should prompt governments to examine whether funding is translating into sustainable frontline support and long-term sector capacity. It is difficult to understand how the disability sector can simultaneously be described as receiving significant levels of investment while specialist services close and experienced disability professionals leave the workforce.
There should also be greater scrutiny of large disability and autism organisations. Public funding should not simply be allocated and renewed without ongoing assessment of effectiveness. Organisations receiving substantial public investment should be able to demonstrate measurable improvements in participation, wellbeing, community connection, education, employment and quality of life outcomes for disabled people.
Future tenders, grants and commissioning processes should place greater emphasis on grassroots and community-based organisations with demonstrated local impact. Government should not only fund these initiatives but actively monitor implementation and outcomes over time.
A particular concern is the reduction of social and community participation opportunities for autistic people. Social communication differences are part of the diagnostic criteria for autism. Opportunities to develop friendships, practise social interaction, participate in community life, build confidence and establish a sense of belonging are not optional extras. They directly relate to areas of functional impact associated with autism.
Our organisation has developed a social infrastructure model through clinical observation, community-based program delivery and ongoing engagement with autistic children, young people, adults and families.
Submission 751
The model proposes that belonging, friendship, peer acceptance, shared interests, community participation and social identity function as protective factors that sit upstream of crisis services. When autistic people are understood, accepted and connected, they are more likely to experience positive mental health outcomes. When they are isolated, misunderstood and excluded, risk increases.
Importantly, this model is not primarily about support. It is about understanding. Many autistic people do not require constant intervention. They require environments, communities and relationships that understand them.
Our experience delivering community-based programs has demonstrated that meaningful social participation can be delivered at comparatively low cost. Group-based programs focusing on friendship, belonging, shared interests and community connection can provide substantial benefits while requiring significantly less investment than many individualised service models.
I also encourage governments to consider investment in transitional learning and participation hubs for children and young people who are unable to access mainstream education consistently.
There is a significant group of autistic young people who experience school refusal, school can’t attendance, exclusion, severe anxiety, bullying, mental health difficulties or educational disengagement. For many families, the only available alternatives become home education, prolonged periods at home or repeated presentations to mental health services.
For many autistic young people, the choice should not be limited to mainstream school attendance, home education or crisis intervention. There should be meaningful intermediate options that promote participation, belonging and development while maintaining connection to community.
The long-term sustainability of the NDIS will not be achieved solely by reducing participant expenditure. Sustainability will be achieved by investing in effective services, maintaining skilled frontline workforces, strengthening accountability mechanisms, evaluating outcomes rigorously and recognising the preventative value of belonging, connection and understanding.
Submission 751
A sustainable disability system should not simply fund intervention after crisis has occurred. It should also invest in the social conditions that reduce the likelihood of crisis occurring in the first place.