Psychosocial disability poses complex challenges for the primary health sector. Some people with support needs for their disability are not eligible for the NDIS, while others who may be eligible are yet to have a plan in place. New Government-funded services are commencing in 2019 to try and prevent anyone living with a psychosocial disability from ‘falling through the gap’.
When fully established, the NDIS will meet the social support needs of a quarter of Australians with a severe mental health disorder. Bilateral Agreements between the Commonwealth and the States and Territories on funding for the new National Psychosocial Support (NPS) measure have now been reached. They will help ensure people living with a severe mental health disorder and a psychosocial disability are supported in their recovery, regardless of their NDIS eligibility. The NPS measure comes at a crucial time for primary health services, with psychological issues reported as the most commonly managed health issue by a GP for the past few years.
When the NDIS was introduced, it was always intended to support a small percentage of people living with severe and persistent mental illness. People living with psychosocial disability might be eligible for the NDIS, but most are not. Those not eligible need support from the mainstream mental health system. There is also some uncertainty as Commonwealth funded programs including Partners in Recovery (PIR); Personal Helpers and Mentors (PhaMS); and Day to Day Living (D2DL) programs are transitioning to the NDIS.
Initial evaluations of the NDIS indicate people living with psychosocial disability may not access the NDIS for various reasons including being ‘hard to reach’ and possibly not in contact with services that could help them access the NDIS; reluctance to test their eligibility for the NDIS; not eligible for the NDIS; or assuming they are not eligible for the NDIS.
What Are Psychosocial Disability Services?
Psychosocial disability services provide practical support for people whose mental health conditions affect daily living, social participation or their ability to access appropriate services. In Australia, psychosocial support can sit alongside clinical mental health care and disability services, including the NDIS. Effective service models consider individual recovery goals, service accessibility and coordination across health and community providers. Larter supports organisations with psychosocial disability consulting, service planning and workforce capability to strengthen responses to people with complex mental health and support needs.
Also, people living with psychosocial disability who have managed to access the NDIS often struggle with the complex process and documentation needed. GPs can play a key role in completing NDIS Access Request Forms and assisting their patient’s transition to the NDIS. However, many support services required as part of a recovery-oriented approach to mental health service delivery are not covered under NDIS.
Larter provides psychosocial disability consulting and training services to support general practice work with the NDIS, including education and training on NDIS eligibility; what is and isn’t funded by the NDIS; and how to support eligible patients access the NDIS.
Psychosocial Disability and the NDIS
The relationship between psychosocial disability and the NDIS can be complex because eligibility for the NDIS does not cover every person who needs psychosocial support. People may require other community-based or mainstream mental health services depending on their circumstances. For primary health services, understanding these pathways can help improve referrals, coordination and support. Larter provides NDIS consulting and training to help health professionals and organisations understand service requirements and respond to changing disability and mental health systems.
A $160 million funding boost for mental health support services was announced in mid-2018, in part the result of the bilateral agreements. The new NPS measure is targeted for people living with psychosocial disability but not supported by the NDIS. Under the NPS, psychosocial supports are tailored to the person’s recovery.
The Victorian State Government is also providing psychosocial support funding to assist people living with a severe mental health disorder and either not eligible for the NDIS or yet to transition to the Scheme. The package includes funding for public health services and state funded community-managed mental health providers to provide mental health services. The package also includes grant funding for disability and community health agencies to support organisational change during the NDIS transition.
New Commonwealth funded services are being delivered through the Primary Health Networks (PHN) who commission the new psychosocial services. The commissioned services complement State and Territory funded psychosocial support. Until now, psychosocial support services have been out of scope for PHNs. The commissioning of psychosocial support services expands the PHNs role in mental health service delivery.
The Role of PHNs in Psychosocial Support
Primary Health Networks (PHNs) play an important role in commissioning and coordinating health services within local communities. Psychosocial support programs can complement clinical mental health services by addressing practical, social and recovery-related needs. For organisations working across primary health care and community services, effective commissioning requires clear service models, stakeholder engagement and an understanding of local population needs. Larter provides PHN commissioning support and healthcare consulting to help organisations respond to changes in mental health and psychosocial disability services.
Larter provides commissioning support to the primary health sector. We can provide an overview of how changes will impact primary health service delivery, as well as commissioning opportunities available through PHNs. We can support health services with funding submissions to PHNs and support organisational change during this period of significant reform. We also work with LivSmart to deliver psychosocial disability consulting.
Conclusion
Psychosocial disability support requires more than access to individual services. Effective models need clear pathways between primary health care, mental health services, disability support and community organisations. As service systems continue to evolve, health organisations need practical approaches to coordination, commissioning and workforce capability. Larter supports Australian health organisations with psychosocial disability consulting, healthcare consulting, service planning and education to help strengthen locally responsive services and improve support for people experiencing complex mental health and psychosocial needs.
Frequently Asked Questions
Mental illness describes a health condition, while psychosocial disability refers to the functional impact a mental health condition can have on areas such as daily activities, relationships, employment and community participation.
Support can include assistance with daily living, social participation, recovery goals, service navigation, community connection and coordination with appropriate health and support services.
People with psychosocial disability may interact with multiple health and community services. Better coordination can reduce gaps between services and create clearer pathways for ongoing support.
Primary health services can identify support needs, provide appropriate referrals, coordinate with other providers and help people navigate available health and community services.
Common organisational challenges can include fragmented services, changing funding arrangements, workforce capability, unclear referral pathways and difficulty coordinating support across different providers.