How does the NDIS work for someone with a mental health condition? Our experts step you through what the NDIS funds and how it can support people with a mental illness.

How does the NDIS support someone with mental illness?

The NDIS can seem complicated, especially for disabilities related to mental health – or if an existing disability gives rise to mental health problems. What mental health conditions qualify for the NDIS, and what mental health supports will the NDIS fund? In this guide, we’ll step you through the most up-to-date information. The NDIS provides government funding to people with a disability to help them pay for the services and supports they need because of their disability. Some people living with mental illnesses will qualify for the NDIS because their mental health condition results in a psychosocial disability. The NDIS is there to support people whose psychosocial disability is likely to be life-long and substantially impacts their ability to manage day-to-day activities, interact with others, their environment or learn new skills.

Sometimes people with a different type of disability might also face mental health challenges, so we’ll look at what the NDIS might cover in that situation too.

The NDIS funds supports – like recovery coaching – that will help to build a person’s independence, connect them to their community and improve their health and wellbeing. The NDIS does not fund diagnostic or clinical mental health supports – these supports are funded by the mental health service system.

Since July 2020, the NDIS has covered psychosocial recovery coaching to support people with a psychosocial disability to live a full and contributing life. Under the NDIS, recovery means a person is “able to achieve an optimal state of personal, social and emotional wellbeing while living with a mental health condition”. What this really means is that a recovery coach will work with you to build a life that’s focused on your own personal recovery – building resilience and hope, incorporating your strengths and recognising you are the expert in your own life, rather than the medical model of clinical recovery which focuses on eliminating or managing your symptoms.

The NDIS is designed to give the people who use it (the NDIS participants) choice and control over their supports, meaning they get to choose the services they use. If you are finding a service provider isn’t a great fit for you, you can choose to use a different one. Check out our article on finding a recovery coach.

What mental health conditions are eligible for the NDIS?

While the term ‘mental health condition’ is very broad (it can include mood, anxiety, personality, psychotic and compulsive disorders, which can be temporary or lifelong), only some people living with mental health conditions will qualify for the NDIS. This is because you need to be able to show that your mental health condition causes a psychosocial disability that is likely to be with you for life, and substantially affects your ability to manage day-to-day activities.

If you have a mental health issue you might not think of yourself as having a disability, but it’s worth looking into whether you qualify for the NDIS. If your condition is permanent and affects your ability to do everyday things then the NDIS may help you to get the support you need.

Some of the mental health conditions that may be supported by the NDIS include:

• schizoid disorders such as schizophrenia,

• anxiety disorders such as post-traumatic stress disorder, obsessive compulsive disorder and agoraphobia,

• mood disorders such as bipolar disorder and depression.

What does the NDIS pay for?

The NDIS funds supports for managing everyday tasks such as assistance with daily living and working towards goals written into the plan when you first receive it. Goals are specific to each person, and often cover things like increasing independence, connecting with the community and working towards employment.

The NDIS will only pay for things that are ‘reasonable and necessary,’ which means supports have to be specific to your needs, be good value for money, be directly related to your disability, and be effective and beneficial for you. NDIS mental health supports should be linked to the NDIS goals in your plan.

What the NDIS would fund for mental health

The NDIS funds supports that are related to a psychosocial disability caused by a mental health condition.

The NDIS would fund (depending on your individual plan):

• Non-clinical supports

• Support that assist with daily living activities

• Supports that aid social, economic or community participation

The NDIS gives some examples of the types of non-clinical mental health supports it might fund to help you with your psychosocial disability:

• coaching to help you improve your motivation, focus, knowledge and skills, resilience and decision-making so you can be more independent with day-to-day activities

• assistance to help you work with broader mental health, health system and other services by ensuring the supports you receive outside of the NDIS are responsive to your needs and helping you achieve your recovery goals

• support for you to connect positively with family, friends and others.

What the NDIS doesn’t fund for mental health

The NDIS does not fund early intervention supports or treatment of the condition itself, as these are usually funded by the health system.

For example, the NDIS generally won’t fund:

• Clinical supports including treatments in a psychiatric hospital, other acute care or rehabilitation

• Mental health first aid

• Diagnosis and early intervention

• Residential care related to in-patient treatment or clinical rehabilitation

• Where treatment is the responsibility of another service such as for drug or alcohol supports

• Medicare funded Mental Health Care Plans

• Therapy to address symptoms

What happens after you are accepted on the NDIS?

If your NDIS access request is successful, the next step is to meet with an NDIS planner or Local Area Coordinator (LAC) to discuss what your NDIS plan will cover. (If you haven’t applied for the NDIS yet, check out our article on NDIS eligibility for mental health conditions and how to apply).

Tip: You can ask for an LAC with expertise in working with people who have a psychosocial disability. This could be helpful to ensure you meet with someone who understands how psychosocial disability impacts your life, and the type of supports that will be beneficial.

With the planner or LAC, you will decide on the goals in your plan – what you want your NDIS plan to help you achieve. People’s NDIS goals are often broad and around things like improving independence and community connections, but they are your goals and individual to you. You are in the driver’s seat, so they need to be about what you want to achieve.

Once you have your goals, you and the planner or LAC will identify the supports you need in working towards those goals. Your plan will include the number of hours of support you will need, and the budget.

At your planning meeting, you will also need to decide how you want your plan funding to be managed – this relates to how you submit invoices and pay your providers. There are three options – agency-managed, plan-managed or self-managed. You can also do a combination of these. Self-managing your plan or using a plan manager means that you’ll have access to a much wider range of service providers, as you are restricted to only using NDIS-registered providers if your plan is agency-managed.

After this, you will receive your plan from the NDIS. Now you can find service providers, book appointments and start getting the support you need. If you want to use a recovery coach, check out our helpful article about getting started with recovery coaching.

If you want to find out more about Goal Coach, book a free 15-minute chat to learn how recovery coaching could help you.

FAQ

Does the NDIS cover intellectual disability?

The NDIS says that intellectual disability diagnosed and assessed as moderate, severe or profound in accordance with current DSM criteria is likely to meet the requirements.

Does the NDIS cover autism?

The NDIS says that autism diagnosed by a specialist multi-disciplinary team, paediatrician, psychiatrist or clinical psychologist experienced in the assessment of Pervasive Developmental Disorders, and assessed using the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnostic criteria as having severity of Level 2 (Requiring substantial support) or Level 3 (Requiring very substantial support) is likely to meet the requirements.

If you want to find out more about Goal Coach, book a free 15-minute chat to learn how recovery coaching could help you.