NDIS & people affected by mental illness

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1 David Meldrum Executive Director NDIS & people affected by mental illness Mental Illness Fellowship of Australia 1

2 Getting to grips with the number of people with severe and persistent mental illness who might be eligible for NDIS National Estimate 64,000 people in contact with public mental health system People Living with Psychotic Illness 2010, A SANE Response. About 60,000 Commonwealth initial estimate quoted in Budget 2010, includes new people. (0.4% of adult population) 57,000 NDIS initial estimate of the current number of people affected by mental illness eligible for NDIS. This is approximately 10% of Australians affected by psychosis a best guess about those who need continuing care. 24,000 DoHA estimate of Partners in Recovery target group Mental Illness Fellowship of Australia 2

3 Illness Management Hospital PHaMS GP Supported Accommodation Psychiatry Carer Ed & support Psychology Community Mental Health Private Allied Health Person affected by severe and persistent mental illness carers, families, friends Therapeutic Groups Activity Programs Employment Centrelink Education Recovering Quality of Life Emergency Department Housing & Home support Mental Illness Fellowship of Australia 3

4 Some Immediate Challenges Challenge Episodic nature of severe mental illness Overlaps with existing intensive supports Risk of withdrawal by states and territories Clinical services not included Substitute judgement when illness/impairment is an issue Comment This shouldn t be confused with underlying functional disability and is comparable to people with physical disability experiencing an illness. (note the use of impairment which is not as commonly used in our sector) For NDIS and governments- require intensive mapping and collaboration between program funders and administrators. For people - a balance between aspiration and risk to existing benefits and lifestyle. Requires a full set of anti-blame game skills and negotiations Key NDIS staff need to have a good knowledge base across 80:20 spectrum, including effective engagement with clinical services Part of the issue with an episodic illness. Need systems like advance directives developed in conjunction with person during wellness Mental Illness Fellowship of Australia 4

5 Some Immediate Challenges cont Challenge Interface with mental health legal system may be affected by limitations placed upon an individual by a treatment order Perverse disincentives people recover often, and some permanently. New eligible people may emerge Comment NDIS must work with the limitations, especially short term issues and liaison requirements. Advance directives can play an important role who speaks on my behalf? NDIS entitlement is a permanent right to a flexible level of support. Debate, risk and experimentation are all going to be involved not unfamiliar territory! Estimates are that half of people with severe mental illness are not engaged with the system. If NDIS works the way we all hope it well, we have to accept that this may pose a challenge in the future. Mental Illness Fellowship of Australia 5

6 What are some of the opportunities? NDIS will recognise that disability is for a lifetime, and so it will take a lifelong approach to providing care and support. OPPORTUNITY: Guaranteed long-term supports are long overdue. Taking a lifelong approach also means focusing on intensive early intervention, particularly for people where there is good evidence that it will substantially improve functioning or delay or lessen a decline in functioning. OPPORTUNITY : Clarify what works in early intervention, and how much an approach based on functional disability can assist. An NDIS will turn the way we currently provide disability services on its head. Rather than funding based on historical budget allocations, a funding pool will be based on actuarial assessment of need. OPPORTUNITY: Anybody can make an application for support. Mental Illness Fellowship of Australia 6

7 What are some of the opportunities? Importantly, an NDIS will support choice for people with disability, their families and carers, and put people in control of the care and support they receive, based on need. OPPORTUNITY: Greater choice for consumer re service types and providers will drive innovation. We can anticipate more peer led and intensive support models for consumer priorities of employment, social engagement and physical health. The Commonwealth objective is that disabled people s rights to resources will be portable across Australia. OPPORTUNITY: At last! A part of the response to mental illness that can be truly national Mental Illness Fellowship of Australia 7

8 People with psychotic illness identified their most pressing challenges over the next year Diff getting to medical appts Inability to access spec MH services No family or carer Stigma/discrimination Lack of stable/suitable housing Uncontrolled symptoms of MI Poor physical health Lack of employment Loneliness & isolation Financial Support From People Living With a Psychotic Illness 2010 Mental Illness Fellowship of Australia 8

9 Mental Illness Fellowship of Australia