of PSYCHOLOGISTS INC
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NDIS Participant Experience in Regional, Rural and Remote Australia
To the committee,
I am writing on behalf of the Australian Association of Psychologists Inc. (AAPi), a national peak body representing psychologists across Australia. We are deeply concerned about the current state of the National Disability Insurance Scheme (NDIS). Our submission focuses on the participant experience in rural, regional, and remote Australia, building upon the points outlined in your inquiry.
Implementation and Performance Issues
The AAPi remains deeply concerned about the prevalent ‘role creep’ within the NDIS in which staff operate outside their scope of practice working with vulnerable participants, which can then lead to arbitrary funding cuts that lack evidence-based justifications. Participants, particularly in rural and regional areas, are disproportionately affected by these decisions, resulting in a substantial number being deprived of crucial psychological funding essential for their capacity-building needs. We recommend that the NDIA clearly define and establish boundaries for roles within the NDIS to ensure participants in remote areas receive specialised and appropriate support.
The substitution of psychological support with roles such as coaches and support workers, who lack the specialised training of psychologists, is a persistent issue. This not only compromises the quality of care but also fails to meet the unique needs of participants in these remote areas.
Lack of Choice and Control: Participants continue to express frustration at the lack of choice and control within NDIS services. The increasing administrative costs and intermediaries absorb a significant portion of funding, limiting the resources available for direct participant support. This is particularly concerning for those in rural and regional areas where access to services is already limited.
Navigation Challenges: The overwhelming nature of the support system poses significant challenges for participants, particularly those residing in rural and remote areas. The lack of accessible information and support services exacerbates the difficulties faced by disabled and vulnerable individuals seeking assistance.
Connectivity Issues: Limited access to reliable internet and telecommunications infrastructure in remote areas further compounds the challenges faced by participants. This hinders their ability to navigate the online-centric processes of the NDIS, creating additional barriers to accessing vital support services.
Governance Issues of PSYCHOLOGISTS INC
-tJ-.,…….,.(’-1,~ Exclusionary Practices: The non-evidence-based decision by the NDIA to only accept reports from clinical psychologists remains a significant concern. This decision exacerbates the existing challenges in rural and regional areas, where there is already a shortage of clinical and all psychologists, leading to further delays in accessing essential mental health support.
Denial of Educational and Developmental Psychologists Reports: Despite the Australian
national Autism strategy acknowledging the competence of Educational and Developmental Psychologists in assessing and diagnosing Autism Spectrum Disorder (ASD), the denial of their reports continues to harm participants, particularly those in remote areas who have already been assessed and are awaiting their plan outcome. AAPi also has concerns that psychologists without endorsement, yet who are eminently qualified are also excluded further exacerbating access issues.
Emphasis on Psychologists’ Role: The AAPi emphasises the critical role psychologists play in the disability field. Limiting funding for psychologist services, as has been occurring more frequently, is inappropriate and increases the risk to participants, limiting their progression toward higher levels of independence and improved functional capacity.
Diagnosis Rejections: The common occurrence of rejecting reports of diagnosis completed by psychologists, insisting on a clinical psychologist’s involvement, is not an informed position and must cease immediately. All psychologists, regardless of clinical or other optional endorsements, are qualified to assess and diagnose psychological conditions and disabilities not predominantly physical in nature. Rejecting psychologists’ diagnoses, permitted by the National Law governing health practitioners, causes harm to the disability community, increases barriers to necessary supports, and incurs unnecessary costs.
Trust in Psychologists: The scheme must trust the clinical decision-making and opinions of psychologists and other qualified allied health professionals. These practitioners possess extensive education and training in assessing and treating clients with disabilities, providing an in-depth understanding of participants’ functioning and support needs.
Particular Experience of Marginalised Groups
Stressful Application and Review Processes: Plan reviews and applications continue to be cited as onerous by participants, leading to immense stress and prolonged waiting times. This negatively impacts the quality of life for those seeking access to the scheme, with rural and regional participants facing additional hurdles due to limited local resources.
First Nations Communities: The lack of trauma-informed and culturally safe care as a baseline in First Nations communities further exacerbates the challenges faced by participants in these areas. Culturally appropriate support services are crucial for ensuring equitable access and positive outcomes for First Nations participants. We strongly recommend that the NDIA implement mandatory training on trauma-informed and
culturally safe care for all NDIS service providers, with a focus on of PSYCHOLOGISTS INC improving support in First Nations communities in rural and regional -tJ-.,…….,.(’-1,~ areas.
The AAPi urges the committee to consider these recommendations to address the unique challenges faced by NDIS participants in rural, regional, and remote Australia. We appreciate your commitment to improving the effectiveness of the NDIS and ensuring equitable access for all participants.
Thank you for your attention on this matter. We look forward to working closely with the NDIA in future to support the wellbeing of all Australians on the scheme.
AAPi is ready and willing to discuss these matters in more depth and to provide further information.
Warmly,
Carly Dober
Psychologist
Policy Coordination & Practice Support
Australian Association of Psychologists Incorporated
References
- Under Pressure: Australia’s Mental Health Emergency- The McKell Institute. (2023, February
14). The McKell Institute.https://mckellinstitute.org.au/research/reports/under-pressure-
australias-mental-health-emergency/