National Disability Insurance Scheme For Mental Disorders: Issues And Proposed Solutions

Issues faced by the National Disability Insurance Scheme in the implementation of the policies for assisting the people suffering from mental disorders

Discuss about the National Disability Insurance Scheme.

The National Disability Insurance Scheme (NDIS) has been implemented by the National Disability Insurance Agency (NDIA) which is an independent body created by law. The role of NDIS is to assist and guide the people suffering from mental disorders and to help them to lead a better life. Its priority is to make sure that the disabled are able to build up their skills and capacity so that they can access to the mainstream services and supports.

According to Knaus (2018) several problems pertaining to the implementation of the National Disability Insurance Scheme has been identified for people suffering with mental disorders. It has been a failure to help the people suffering from various mental health problems and as a result risks have been creating significant gaps in the services relating to assistance. So, in this report, the problems would be identified regarding the implementation of the policies of National Disability Insurance Scheme (NDIS) for the people suffering from mental disorders. Furthermore, the resolution to these problems and the resources required for the implementation processes shall be discussed. The methods relating to application of the policies in the government programs and staffing implications, evaluation of the policy, the reporting processes and the expected deliverables   shall also be analyzed in detail.

Issues faced by the National Disability Insurance Scheme in the implementation of   the policies for assisting the people suffering from mental disorders

The NDIS is not able to assist the people dealing with mental disorders and as a result many of them would be deprived of the required support by the scheme. Around 6.4% of participants of NDIS are suffering from psychosocial disability and about 81.4% of the participant’s requests were accepted by the NDIS regarding their psychosocial disability while on the other hand 97% of those are suffering from autism, intellectual disability and cerebral palsy.

The total number of people suffering from mental disorders in Australia has been numbered to 230,000 while 64,000 of them have been covered under the scheme. These risks leave significant gaps in the support systems. The important issue in this regard is that the rollout of the scheme is designed to meet the needs of only few people and the existing services have been planned to  be closed  while the funds moving to the NDIs which denotes that  many of them would be  missing the services they need.

Background/Current Situation

The reasons for the non-assistance are  the  lack of awareness amongst the NDIS staff for treating the people with psychosocial disabilities, so considering the issues  the  caretakers of the participants are either not  applying for assistance or  withdrawing their applications  to the NDIS.

Additionally, the support for the culturally diverse groups is poor in the remote locations of Australia because there is a lack of understanding amongst the staff. The families and service providers are prevented from their contributions in the planning process of NDIS and the participants are not given a chance to evaluate their support plans appropriately before their approval. As a result, the organizations specializing in psychosocial disabilities are not coordinating with NDIS as the system of the government does not work in an efficient manner (Department Of Social Services Consultation Report, 2015).

According to The University of Sydney (2018) the   gaps identified by the stakeholders can be assessed in the two main areas. Firstly, those who  are suffering from acute  mental illness and are not eligible for the scheme or not able to apply for the same shall be required to receive the appropriate assistance  outside the NDIS.

Secondly, there is lack of administrative schemes for people suffering from psychological disabilities and who pass the eligibility criteria.

The other factors responsible for the non-assistance for people suffering from mental disorders are lack of awareness amongst the disabled people and their caretakers pertaining to the scheme. Some of them do not want to apply themselves under the disability and permanence criteria and hence they are alienated from the treatments.

Moreover, the social and geographical isolation comprising of language barriers restrict the people from involving themselves with the application process. It is with the case of Aboriginal and Torres Strait Islander people .They also lack the culturally specific support in this regard. The lack of evidences required for  applying for the scheme is also a big barrier depriving the disabled people from accessing the facility of NDIS (Townsend et al., 2018).

The fluctuating nature of the disability and lack of practitioners to gather and provide the evidence is also a reason for the failure of the  implementation of the scheme .Additionally, there is  lack of support and care for people  belonging to diverse cultural and linguistic backgrounds by the staff of NDIS and lastly, the  expertise and advocacy of the family members and caretakers is excluded  and the support extended by the planners is not included in the plans.

Details of Policy Proposal and Desired Outcomes

Also, the inappropriate assessments like the analysis of the patient’s illness on the phone without knowing the severity of his disability and extensive time delays on each step of the assessment can cause significant gaps in the implementation of the NDIS programs related to the assistance for the people suffering with mental disorders (Hamilton et al., 2016).

Regarding the application of the NDIS policy, it shall evaluate a strategy for monitoring and reporting on the statistics related to application, acceptance, constituents of plan, related timeframes, activation of plans and the review rates for individuals suffering from mental disorders. It would assist in development of effective long and short term strategies so that issues relating to application and implementation can be addressed.

Special implementation schemes related to the  inhabitants of Aboriginal and Torres Strait Islander  suffering from mental disabilities  should be formulated along with the provision   of structured and community relevant indicators which can be  assessed. Funding should also be provided in this regard. The Federal Department of Social Services should coordinate with the NDIS so that the existing services can be better equipped to deal with the changes occurring in it. Additionally, the processes of NDIS should involve the care takers  and the family members at the  assessment and planning stages and their needs should also be included in the plans (Carey et al., 2017).

The positive outcome due to the implementation of the NDIS for people suffering with mental disorders would be that it would help them and their family members in setting and achieving their goals relating to their contributions to the social and economic life up to the extent of their capabilities.

They would also be able to connect themselves with the community and thus would have optimum wellbeing. They and their family members would have a confidence that the care and welfare facilities provided by the scheme as well as the informal networks are reasonable and this assistance would be sustained for their entire life. Furthermore, there would be high level of support from the society for the scheme and thus it would receive appropriate funding so that it can provide adequate assistance to the individuals suffering from mental disabilities. It would also encourage and offer high quality and innovative supports from qualified workforce to the scheme from the disability and mainstream sectors (Wiesel et al., 2017).

Some of the barriers which restrict the scheme to achieve these outcomes are lack of awareness about the scheme. The people suffering from mental disorders and their family members are not able to understand the benefits of the scheme. It is because most of them are homeless and belong to not easily accessible communities. Another reason is that application procedure is too complex and they do not have enough assistance to do so. Also, the cost of obtaining reports for evidences is quite high and most of them cannot afford it. Some of the psychological barriers such as anxiety and fear related to the disability stop the people from subscribing to the scheme (Phuong, 2017).

Positive outcomes due to the implementation of the NDIS for people suffering with mental disorders

The resources required for the implementation processes would be  to establish an entry point for resolving the enquires of the patients and assisting them  to  apply   for seeking help regarding the mental disorders . The financial processes should be updated with new software so that all the redundant practices can be removed from the systems.
New systems should be designed for managing the information management and record systems regarding the enquiries of the patients and to manage the data regarding the workflows . The service delivery tracking systems should be established to trace the service delivered. Any necessary equipment for staff should be recognized and purchased for the staff and appropriate policy changes should be introduced in the system.

The credit card and bank transfer arrangements should be implemented to assist the cash flows. In order to provide accommodation facilities to the patients, a vacancy management system should be implemented (Wiesel & Habibis, 2015).  The HR systems should be modified to facilitate the matching of patients with the staff. All the staff should be trained to make them aware of the NDIS systems and practices ( Department of Social Services ,2015).

The implementation process will be conducted for 9 weeks in the months of June to August, 2018.

The scheme is executed under the National Disability Insurance Scheme Act 2013 and is administered by the Commonwealth, State and Territory Governments jointly. The National Disability Insurance Agency was formulated and it is accountable for implementing and administering the scheme.

The NDIS has replaced 17 Commonwealth funded disability programs which would be administered by the Department of Health.  For the people who are considered ineligible for NDIS, the Commonwealth would continue to provide assistance to them through its current programs.  The necessary transition plans comprised of the establishment of the NDIS transition managing team and a Chief Operating Officer was appointed. The stronger information sharing arrangements were established amongst NDIA, DSS and Department of Human Services (DHS).According to State Trustees Australia Foundation(2014) the Common wealth and State Governments have introduced the NDIS for supporting   the implementation of strategies  throughout the life of mentally disabled people.

The  programs initiated by NDIS and the  State governments address the proposed issues by changing the methods of providing disabled services in Australia and it has promoted a positive image of the service sector amongst the disabled. The reforms introduced by NDIS form the basis of transitions ranging from a block funded service system to an individually based mechanism which is insurance based (Carey & Dickinson, 2017).

The Agency Theory would be implemented to resolve the issues of staffing implications. It describes the relationship amongst the principles and agents in a business. It is concerned with solving the problems which arise in agency relationships because of unaligned objectives.

As per The Conversation (2016) the staffing implications can be resolved by strengthening the reporting framework and ensuring that there is transparency in the reporting systems. In this context workforce planning and development have to be transformed and well managed for the successful implementation of the policy framework.

Since the Government has decided to allocate the budget to the patients instead of allocating them to the disability providers so that they can choose the staff according to their needs for the required assistance. So there will be a shift of quality of control from government imposed audit to the client market decisions (Laragy et al., 2015). It will have special implications on the relationships of the staff and the authorities. The staff shall be given appropriate responsibilities according to their designations and their roles should be clearly stated in the policy framework.

In this context, the digital platforms and involvement of the participants will challenge the traditional workforce management strategies. The outdated arrangement of engagement and remuneration of the staff would be challenged and skill set required by the staff will be reviewed to ensure competitive advantage (Criterion Conferences 2016).

There should be transparency in the reporting and monitoring process and there should be continuous, systematic and transparent data collection methods to report the improvement activities. The NDIS needs to monitor the timeframes of completion of services. The performance of staff of NDIS should be monitored against the set standards (Llewellyn, 2017).

Lastly, there should be critical evaluation of the policy which will be aimed at assessment of the difficulties in the implementation and recommending practical solutions to the problems faced by the staff. It will ensure that the scheme is aligned with the National Mental Health Standards.

The identified stakeholder in this regard are federal and state governments, businesses , people with disabilities and their families, service providers , NGOs and the community groups. The social factors influencing the implementation of policy and its stakeholders are   information pertaining to the population, demographic and cultural trends have an impact on the mission and vision of the NDIS and the needs of the patients. The economic factors amount to the fluctuations in the economic and environmental policies has an impact on the aims and goals of the policy   and the purchasing power of the patients. The environmental factors include the overall social, physical and attitudinal environment in which the patients reside and conduct their lives(The University of Sydney ,2013).

Conclusion

It is recommended that the head of the department or the Ministry should approve the stakeholder engagement activities such as CEO forum, co-design engagement and specific events for the benefit of the stakeholders. The feedback should be collected from the stakeholders pertaining to NDIS and their experiences regarding the internal transitions. Appropriate policies relating to workforce management and stakeholder engagement should be approved by the relevant authorities for their implementation (Queensland Government, n.d.).

It is further recommended that the areas for improvement should be identified and appropriate strategies should be implemented regarding the training of the workforce regarding the planning processes and updating  of the technology used to treat the disabled people. The present individual centered approaches should be reviewed and evaluated in the policy framework.

References

Carey, G. & Dickinson, H. (2017). A longitudinal study of the implementation experiences of the Australian National Disability Insurance Scheme: investigating transformative policy change. BMC Health Services Research, 17(570), 1-6.

Carey, G., Malbon, E. , Reeders, D. , Kavanagh, A.  & Llewellyn, G. (2017).  Redressing or entrenching social and health inequities through policy implementation? Examining personalized budgets through the Australian National Disability Insurance Scheme. International Journal for Equity in Health,16(192),1-12.

Criterion Conferences (2016) .NDIS will mean more competition for staff than for business. Retrieved June 5^th   , 2018 https://www.criterionconferences.com/blog/social-services/ndis-will-mean-competition-staff-business/

Department of Social Services (2015). NDIS Partners in the Community Program Statement of Requirements. Retrieved June 4^th   , 2018 https://www.dss.gov.au/sites/default/files/ndia_-_sor_for_ndis_partners_in_the_community_program.pdf

Department Of Social Services Consultation Report(2015). National Disability Insurance Scheme Quality and Safeguarding Framework. Retrieved June 5^th   , 2018 https://engage.dss.gov.au/wp-content/uploads/2015/11/consultation_report_ndis_quality_safeguarding_framework.pdf

Hamilton, M., Giuntoli, G.,  Johnson,K. &  Fisher, K.R.(2016). Transitioning Australian Respite. Sydney: Social Policy Research Centre, UNSW Australia.

Knaus,  C.(2018) . NDIS failing people with severe mental health issues, new report warns. The Guardian . Retrieved June 4^th   , 2018 https://www.theguardian.com/australia-news/2018/jan/29/ndis-failing-people-with-severe-mental-health-issues-new-report-warns

Laragy, C., Sanders, F. & Brophy, L.(2015). Implications for family carers when people with psychosocial disability have individualised funding packages – literature review. Retrieved June 5^th   , 2018 https://www.mindaustralia.org.au/sites/default/files/publications/Implications_for_family_carers_literature_review.pdf

Llewellyn, G.(2017). National Disability Insurance Scheme (NDIS) Costs Productivity Commission. Australia:  Centre for Disability Research and Policy.

NDIS(n.d.). Our history. Retrieved June 1^st  , 2018 https://www.ndis.gov.au/about-us/our-history

Phuong , D.L.(2017). How well does the Australian National Disability Insurance Scheme respond to the issues challenging Indigenous people with disability? Aotearoa New Zealand Social Work, 29(4), 49–60.

Queensland Government (n.d.) Transitioning to the NDIS learning from a launch site and practical ideas to assist in transition. Retrieved June 5^th   , 2018 https://communitydoor.org.au/

State Trustees Australia Foundation(2014). Understanding the Impact of Recent Government Reforms in the Disability, Ageing and Mental Health Sectors. Retrieved June 4^th   , 2018 https://www.statetrustees.com.au/wp-content/uploads/2014/10/123-Research-Sector-Trends.pdf

The Conversation (2016). Understanding the NDIS: the challenges disability service providers face in a market-based system. Retrieved June 4^th   , 2018 https://theconversation.com/understanding-the-ndis-the-challenges-disability-service-providers-face-in-a-market-based-system-57737

The Conversation (2017). NDIS hiccups are expected, as with any large-scale social reform. Retrieved June 5^th   , 2018 https://theconversation.com/ndis-hiccups-are-expected-as-with-any-large-scale-social-reform-75693

The University of Sydney (2013) .Submission on the National Disability Insurance Scheme Bill 2012. Retrieved June 5^th   , 2018 www.aph.gov.au/DocumentStore.ashx?id=26bf0e20-3a1b-45bc-b3cd-20c3f5ced0de

The University of Sydney (2018). Mind the Gap: The National Disability Insurance Scheme and psychosocial disability. Retrieved June 4^th   , 2018 https://sydney.edu.au/health-sciences/documents/mind-the-gap.pdf

Townsend, C., White, P.,Cullen, J. , Wright, C.J.& Zeeman, H.(2018).   Making every Australian count: challenges for the National Disability Insurance Scheme (NDIS) and the equal inclusion of homeless Aboriginal and Torres Strait Islander Peoples with neurocognitive disability. Australian Health Review, 2018( 42),  227–229.

Wiesel, I. & Habibis, D. (2015). NDIS, housing assistance and choice and control for people with disability. Retrieved June 5^th   , 2018 https://www.ahuri.edu.au/__data/assets/pdf_file/0019/5761/AHURI_Final_Report_No258_NDIS,-housing-assistance-and-choice-and-control-for-people-with-disability.pdf

Wiesel, I., Whitzman, C., Bigby, C. & Gleeson, B. (2017 ). How will the NDIS change Australian cities? MSSI Issues Paper No. 9. The University of Melbourne: Melbourne Sustainable Society Institute.