The Mental Health system in Australia has often been labelled as complex and difficult to navigate by consumers and health professionals alike. The NDIS and current mental health reforms have only exacerbated this complexity, leaving many asking about what NDIS will and won't fund and what will happen to the programs it won't.
To help cut through some of this confusion, below is a breakdown of existing mental health supports, with our current understanding of how they will look in an NDIS world.
1. Clinical Mental Health Services
Clinical Mental Health Services (also known as Area Mental Health Services) are provided by general health facilities which operate within geographical catchment areas. These services are designed to provide both community and inpatient care to adults and children whose mental health is severe, or having a significant impact on their lives. Generally speaking, these services will focus on short-term assessment and treatment of a mental illness.
Transition arrangements: These services will remain the responsibility of the Health Department and will not be transitioned to the NDIS.
2. Non-Clinical Mental Health Services
Non-Clinical Mental Health Services operate in geographic areas and are typically run by non-government organisations. They provide programs which are focused on a person’s recovery and their participation with the community. The programs have had different names throughout the years and in different states but generally provide one-one and/or group support.
Transition arrangements: Arrangements are in place for the majority of non-clinical community managed mental health services to transition to the NDIS. The future of the numerous smaller state based mental health programs offered throughout Australia will be explored in a further article.
3. Primary Health Networks
Primary Mental Health is commissioned via the Primary Health Networks (PHNs) which operate in set geographic areas. The range of services offered are currently under reform based on the government’s response to the Mental Health Commissions review of programs and services throughout Australia. Programs delivered by the PHNs include Partners in Recovery (PIR), low intensity mental health services (previously ATAPS), complex mental health services (previously MHNIP), suicide prevention, and youth mental health services. Each Primary Health Network has some discretion in how these services are delivered within their catchment area so it is not feasible to provide a full list of services within this snapshot of the mental health system.
Transition arrangements: The only program currently delivered by the PHNs to transition to NDIS will be Partners in Recovery (PIR). PIR funded organisations will continue to be block funded by the department through the transition. PIR funded organisations are funded to support current programme clients to make NDIS Access Requests though not all PIR participants become NDIS participants.
4. GP Mental Health Care Plan
Finally, a General Practitioner (GP) may refer a person to psychological services under the Better Access to Mental Health Care Initiative. Through this program a person can receive up to 10 individual and 10 group psychological sessions per year. It is at the discretion of the service provider as to whether these sessions are bulk-billed or will incur an out of pocket fee.
Transition arrangements: This initiative will remain the responsibility of the Health Department and will not be transitioned to the NDIS.
So, if you can managed to absorb all the different services and programs available, you will understand the complexities faced in choosing the right path for a person to receive assistance with their mental health. Once NDIS is fully rolled out the following options will be available:
- Clinical Mental Health Services (acute assessment and treatment)
- NDIS (functional impairment)
- Primary Health Network (low intensity and complex management)
- GP (Psychological services)
With each program/service using differing language and inclusion criteria it is virtually impossible to create a map to assist a person to navigate through the system. Ultimately, the onus is on each individual and/or their families to navigate the system and work out which supports they may be eligible for. Considering how hard it is for professionals to grasp the system, it is more than understandable that it may be just too hard for people experiencing poor mental health.
Providers of psychosocial support face all the challenges other providers in the NDIS face but with added confusion and complexity. They must maintain a suite of different support programs with complex compliance requirements. They need to transition into a scheme that was not designed for a group that has episodic and changing needs. Funding levels for people with psychosocial support needs in the NDIS create very significant problems for existing providers. It is an understatement to say that mental health and psychosocial support is proving to be one of the most difficult areas of NDIS transition.