It can be quite overwhelming to pursue an NDIS package, particularly when you have limited supports (family or services) to assist you with this process. I decided to write a few blog posts on this topic with the hope that it will assist some people who are pursuing an NDIS package with the process. By virtue of working in community mental health, I have the vantage point of knowing what it is like to support individuals with psychosocial* disabilities to access NDIS.
When applying for an NDIS package, there are a few paths that you can walk down i.e. autism, mental health or autism and mental health path. To receive an NDIS package you are required to have a diagnosed disability (physical or psychosocial), and this diagnosis needs to be current and relevant (i.e. less than two years old & based on the DSM-V criteria).
The simpler path to NDIS is with a diagnosis of Autism Level 2 or 3. Having either one of these diagnoses means that you do not need to have Part C of the Evidence of Disability Form completed or provide evidence of the impact that your disability has on your life. You just need to submit a diagnostic report to NDIA which provides evidence of having this Level 2 or 3 diagnosis. Most likely, those with Autism Level 2 or 3 already have supports in place that will assist them to transition across to NDIS.
Access to NDIS becomes a bit more complex for those with a diagnosis of Autism Level 1, as you must provide evidence that illustrates your lack of functionality and what supports are needed to assist you. Similarly, those who are a self-diagnosed Autistic need to provide evidence of another disability to receive supports. Psychosocial Disabilities can include a diagnosis of Schizophrenia, Mood Disorders, Personality Disorders, Anxiety Disorders, or a combination of these issues. If your current clinical psychologist or psychiatrist does not give you an Autism diagnosis, for whatever reason, then use the psychological disorder pathway for NDIS.
Here is a recent example of mine from work: I recently supported someone who had a past diagnosis of Asperger’s Syndrome to get a more current diagnosis. It is unclear whether this past diagnosis was official since no documented evidence exists. Upon review, the psychiatrist did not include an updated diagnosis of Autism in the diagnostic report. This may be due to the psychiatrists limited understanding of neurodevelopmental disorders; their specialisation was adults and old age. Instead, the psychiatrist listed PTSD, Anxiety, Depression, Eating Disorder-NOS, and Cluster-B Personality Disorder (i.e. Borderline, Narcissistic, Histrionic and Antisocial). In my opinion, it is not worth pursuing an Autism diagnosis via a psychiatrist if you’re time-pressed or have already started the application process and received (or completed via phone) the Access Request Form. Most psychiatrists have wait-lists (sometimes really long wait-lists) and it can also be challenging to find a good one. So, the mental health route is good enough for now, especially if you have a very good documented history of seeing your psychiatrist.
I recently participated in an e-conference for professionals seeking information about working with persons with Autism and Mental Health issues. One person that I interacted with in chat seemed to think that based on one’s current functionality a person with Autism Level 1 could receive supports under the Autism-only path. To me, this doesn’t make sense as the three levels of Autism are based on functionality and how much support the individuals need. There is no official information about this with regard to NDIS. But, one would think that if the functional impact was more severe or became more severe the person would receive an Autism Level 2 diagnosis. So, in my opinion, the only other thing that would increase the severity of Autism Level 1 is co-occurring Mental Health issues.
I would advise that when you’re applying for NDIS that you do not entirely rely on the General Practitioners (GPs) Functionality Assessment which is included in the NDIS Access Request Form that is posted to your mailing address. When I have been supporting clients to see GPs and psychiatrists they often fail to understand how psychosocial disabilities apply to NDIS. The GPs/Psychiatrists that I have interacted with also continue to fail to understand the relationship between psychosocial disabilities and NDIS when you give them examples and provide them with support tools. Your GP doesn’t get to see you in your home or the community, so they can’t properly assess you. They don’t really know you well enough. Perhaps things will improve over time when GPs and Psychiatrists go through their own training processes, and begin to understand what questions to ask people in relation to NDIS and psychosocial disabilities.
A lot of GPs are time poor, so they often want to rush through paperwork. They also do a sloppy job when they take the form to complete it at a later time. So, what ends up happening is that professionals will write “no support needed” or leave things blank under areas of need. I had this happen to a client the other day, her GP wrote no in all areas of functionality even though she has high psychosocial needs. The areas of need being: Mobility and Transport, Communication, Social Interaction, Learning, Self-Management, and Self-Care. Identifying areas of need is essential to getting an NDIS package. So, this sloppiness without additional supporting evidence will probably lead to a rejection letter from NDIA*. You can have your case reviewed, but it’s best to take steps to minimise this eventuality.
So, my advice would be for those with current supports in place to accumulate evidence through support letters from support workers/case managers and reports from psychologists, psychiatrists, and occupational therapists. All of which need to be less than two years old. The more current a document the better it is. For those of you without professional supports, my suggestion would be to not only provide diagnostic reports that outline your disability but to consider pursuing an Occupational Therapy (OT) Assessment. This is advice also advice I give to those who a reticent about getting a mental health diagnosis.
If you meet the eligibility criteria, it is worth pursuing a chronic disease management plan from your GP, as this will enable you to get rebates for seeing an OT. To a total of five sessions. A good OT report will include the following things: background & known medical information, social circumstances & supports, personal presentation at the assessment, cognitive function & mental state, current supports in place, overview of home environment, activities of daily living, and issues and support needs identified, and lastly assessment summary and professional recommendations. The exploration of all of these domains by a professional will assist to support your application for an NDIS package.
In my next post, I’ll go through the application process.
Thanks for reading!
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Notes from this blog post.
Psychosocial Disability: Term used to describe the experience of people with impairments and participation restrictions related to mental health.
NDIA: The National Disability Insurance Agency, an independent statutory agency.
NDIS: The National Disability Insurance Scheme, a healthcare program initiated by the Australian Government for Australians with a disability.
Chronic Disease Management Plan: