I recently participated in the 2018 CMHA NDIS conference in Melbourne. Our EO, Simon Viereck, was also there along with a good smattering of people from across the ACT sector. It was a worthwhile experience – though very different to the first such conference last year in Sydney as the focus in the plenary sessions was more about the mental health sector than a detailed examination of the NDIS from a variety of perspectives.
My takeaway thoughts from the conference are several. The most striking one is that there still seems to be a great mismatch between how executive level leadership of the NDIS sees the progress with implementing the scheme and how it is being experienced firsthand by consumers, carers and service providers.
Admittedly NDIA leadership are more willing to acknowledge that there are problems and they are working to address them – an example being improved access pathways and special support for people with complex needs. However, I was not convinced by what I heard at the conference that acceptance of the extent of problems and the speed and effectiveness of addressing them, matched the need at the coal face.
I gave a presentation in the breakout session called “Mental Health Reform”, based on the MHCC ACT report launched in June, “When the NDIS came to the ACT – a story of hope and disruption in the mental health sector.” Unfortunately, I mistimed it rather dramatically and was not able to present a lot of what I had prepared – but it’s on our website (PowerPoint & presentation) and the CMHA 2018 NDIS conference website.
In preparing my presentation I wondered about the value of the ACT experience to others. But once at the conference I kept feeling like I was being transported back several years in the ACT experience, and quickly realised how far along the road we now are, and that we do have learnings to share with others. This was to be expected in some ways but in other ways I found it disappointing – the NDIS trial sites were meant to be for learning and improving the scheme so that national rollout would be smoother.
I was also torn between the strong commitment in the sector to see the NDIS succeed and meet its original objectives, and the reality on the ground. This statement from the ACT Human Rights Commission in its submission to the ACT Legislative Assembly 2018 inquiry into the NDIS sums up the key themes in my presentation quite well:
“At this time, the ACT HRC considers the intent of the scheme, as set out in the legislation, is yet to be fully realised in the ACT…
- The current NDIS processes are complex, bureaucratic and not user-friendly
- There is a lack of accessible complaints management and resolution, particularly in relation to NDIA decisions
- There is a lack of assistance to access and navigate the system, which places an increased burden on informal supports and other service systems, and results in some vulnerable people not accessing the scheme
- The approach to plan approval appears to be to apply standardised or benchmark levels of support rather than consideration of the individual’s reasonable and necessary supports as required by the legislation
- Delays in processes, inaccessibility of NDIA staff and limited accountability of the NDIA impact on participants’ outcomes
- The developing disability services market in the ACT is not yet able to fully meet participant’s needs and deliver quality supports across the sector.”
To this list I would add that the financial framework of the NDIS is a very real limitation to achieving the schemes objectives from several perspectives. I finished my presentation by outlining some of the initiatives that are being implemented to address current issues and service gaps, many of which have been caused by NDIS implementation in the ACT.
The presentations which impacted me most were made by Professor Dianna Rose (on user-led research), John Brogden (lived experience and Lifeline Australia), Lucy Brogden (Chair, National Mental Health Commission) and Scott Avery (Culture is Inclusion). I also found the panel sessions on the 2nd day particularly useful: “How can the different parts of the mental health system work together?” and “What have we learnt over the last 2 days and what do we do now to make these changes happen?”
The statement that has remained strongest in my mind was from a speaker who said that everyone in society should understand the basics of trauma informed care because lots of people walk around with a clever mask of ‘normal’ on their faces and you can’t tell who hides trauma behind it and who does not.
While it was interesting to hear from leaders in the NDIA and across the sector, at future conferences I would like to hear more in the plenary sessions from those outside government with experience in how the NDIS works in practice. It is also important that CMHA addresses future conferences and that the voice of smaller NDIS service providers is heard.
MHCC ACT believe that people will not be well served if the NDIS results in participants only having choice between a narrow range of large providers and highly commodified services. We believe that people with mental illness and psychosocial disability deserve to be supported by a highly skilled and qualified workforce, and that in turn this workforce be well remunerated, trained and developed.
Yes, the NDIS is working well for some people. But it is still causing too much disruption, fragility and stress in the sector and many people are feeling worse off. Even where people are benefiting one year there is no certainty that the same level of support will be available in subsequent plans. As an advanced rich country and for a scheme designed to support some of the most vulnerable people in our society, I think we should be able to do better than this!
Manager, Policy and Sector Development, MHCC ACT