NDIS Mental Heath Funding FAQ

NDIS Mythbusters on mental health/psychosocial disability funding

The NDIS has provided clarification on these frequently asked questions about NDIS mental health funding:

1. I have used my 10 sessions of psychology under my Medicare funded mental health care plan, I can access the NDIS to top up my mental health care plan.
False. The NDIS does not fund therapy to address symptoms, we fund ongoing functional support for day-to-day living.

Treatment supports are not most appropriately funded by the NDIS.

NDIS does not require that you access a mental health care plan and is not able to top up funding if you have such a plan.

If the only support you require is treatment, it is likely you will not be eligible for the NDIS (because you do not require NDIS support with everyday activities).

2. My family member has recently begun to experience severe mental health issues. It is best for me to access the NDIS individualised support (an NDIS plan) early to prevent these issues from becoming lifelong.
False. As agreed between Commonwealth, State and Territory governments, early intervention services for people experiencing mental health issues are generally provided by mainstream services outside the NDIS.

3. If I am not eligible for individualised NDIS support (an NDIS plan) the NDIS will not assist me any further.
False. If you do not meet the access requirements for the NDIS, we will link you to an LAC who can help connect you to local community and mainstream supports. 
Contact the NDIS by phone: 1800 800 110 Email: enquiries@ndis.gov.au or NDIS Website

4. If a person experiences “good days” the NDIA determine they do not have substantially reduced capacity.
False. The NDIA looks at the person’s ability to function in the periods between acute episodes, not at any given point in time.

It is irrelevant whether a person applies to the NDIS when they are acutely unwell or feeling particularly well.

5. A person who has not worked for 20 years because of their mental health condition must have substantially reduced capacity.
False. The NDIA looks at day-to-day functioning and considers what people can do as well as what they cannot do within the six life skill areas.

Not being able to work because of a mental health condition does not, in isolation, demonstrate substantially reduced capacity in one of the life skill areas.

6. My ability to do day-to-day activities is substantially reduced in comparison to what it was before my mental health concerns began, so I should meet the NDIS access requirements.
False. Substantially reduced functional capacity does not involve a comparison with levels of functional capacity previously enjoyed.

It is a comparison with a person in the community who has not experienced similar impairment.

7. Only a psychiatrist can provide the best evidence of a person’s functional capacity.
False. Psychiatrists can provide evidence of functional capacity however, appropriately qualified mental health professionals such as mental health nurses can also provide evidence.

Depending on the nature of the doctor/patient relationship a psychiatrist may be well positioned to provide evidence of functional capacity.

The NDIA will consider the qualification of the person giving evidence and the relationship they have with you.

8. The NDIA will make clinical judgments about appropriate treatment/interventions for an individual

False. The treating clinician will decide on appropriate treatment and/or interventions for an individual.

The NDIA requires evidence that provides a history of treatment and the rationale relating to any decisions made by the clinician not to pursue a known treatment/intervention option.

9. The NDIA requires personal and intrusive information relating to trauma and abuse to demonstrate permanence of impairment.
False. The NDIA does not require specific information identifying a trigger for a mental health condition and is respectful of a person’s right to privacy.

There is no need to share private information relating to trauma and/or abuse with NDIA staff.

10. The NDIA will not accept a person has a likely permanent impairment unless they have had years of treatment/intervention.

False. The treating clinician confirms how much treatment/intervention is required for an individual before an impairment can be considered permanent.

The NDIA requests that clinicians provide clinical rationale to support that an impairment is likely to remain across a person’s lifetime (especially where there are any unusual circumstances).

11. If a person’s impairment caused by their mental health condition is accepted as likely to be permanent then they will meet the NDIS disability requirements for individualised support.
False. Likely permanence of impairment alone is not enough to meet the NDIS disability requirements.

Other factors are also considered which include that the impairment resulted in a substantial reduction in everyday functioning. For more details refer to Snapshot 4.

12. If a person has been diagnosed with Schizophrenia, which they have lived with for a number of years, they will automatically meet the NDIS access criteria?
False. No specific mental health diagnosis will automatically meet or not meet the NDIS access criteria.

Access decisions are made on individual circumstances and not specifically centred on the diagnosis, rather the impact that this mental health condition has on a person’s daily life.

13. If a person has co-existing drug/alcohol dependency they will not be eligible for the NDIS?
False. If you are seeking to access the NDIS with a psychosocial disability, the NDIA needs to know that the impairment is because of a mental health condition.

If that is the case, a person can meet the NDIS access requirements, regardless of any co-existing dependency issue(s).

A potential participant may be accessing, or planning to access treatment, for co-existing substance dependency at the time of access and throughout any ongoing relationship with the NDIS.

14. The NDIA does not recognise psychosis as a mental health condition.
False. Psychotic disorders include a range of diagnostic categories, some of which may be brief in nature. People who experience psychosis may be eligible for individualised NDIS support if they meet the access requirements.

15. I have an episodic condition therefore I cannot access the NDIS
False. Many NDIS participants experience episodic conditions resulting in disability. An episodic condition is not a barrier to accessing the NDIS.

16. I need to provide information about my ‘worst days’
False. The NDIA needs to know how the impairment/s from your mental health issues impact your day-to-day functioning.

If your mental health issues are episodic, the NDIA will need to know about how you function between episodes (not on particularly good or bad days).

17. To meet the NDIS access requirements I need to prove I’ve exhausted all treatment options
False. There is no requirement that all known treatments have to be completed.

The NDIA needs to know what treatments/interventions have been explored – ones that you have tried and ones that you and your clinician have decided not to try – and why the impairment will remain even when treatment continues.

18. The NDIS will replace Community Mental Health Services
False. The NDIS will not replace community-based support or medical/clinical care for people living with mental health conditions

The NDIS can provide support to increase independence, be part of your community, and participate in work.