Inquiry into Disability Care and Support 
Productivity Commission 
GPO BOX 1428 
CANBERRA ACT 2601

MIFA members:

Mental Illness Fellowship of Nth Queensland Inc

Mental Illness Fellowship Victoria

Mental Illness Fellowship of South Australia Inc

Mental Illness Fellowship of Western Australia Inc

Mental Illness Fellowship of Queensland Inc

Schizophrenia Fellowship of New South Wales Inc

Mental Health Carers 
(ARAFMI) NT

Association of Relatives and Friends of the Mentally Ill (Tas)

Productivity Commission Disability Care and Support Draft Report 

The Mental Illness Fellowship of Australia (MIFA) welcomes the opportunity to provide input into the Productivity Commission’s Disability Care and Support Draft Report (the Draft Report).

 MIFA is a not-for-profit coalition of mental health organisations that support people with serious mental illnesses, their families and friends. Such illnesses include schizophrenia, major depression, bipolar disorder, obsessive-compulsive disorders and anxiety disorders. MIFA is committed to maximising opportunities for recovery through hope, choice and improved capacity for decision making for all people affected by serious mental illness.

MIFA welcomes the proposal to move from a fragmented system to a National Scheme that will ensure consumers are covered nationally and are able to access support even when crossing state and territory borders. We also support the use of effective local managers and organisations to assist people to connect with local services.

We are  concerned about the community’s lack of understanding of the need for disability supports that are faced by people with a mental illness that have come to light during the Inquiry. The Draft Report indicates that all people with a significant disability would be able to access funding and services from the NDIS. It is unclear how the ‘significance’ of disability will be determined. This is of particular concern for consumers with episodic conditions who might not always meet set criteria for a significant disability. For example, consumers who experience mental illness or arthritis may experience different levels of disability at different times during their illness, and might require support but not meet criteria when they are experiencing periods of comparative wellness. 

MIFA welcomes this opportunity to highlight these gaps in psychosocial disability support and to propose innovative ways of addressing them.  However, we are concerned at any inference that disability supports for mental health could possibly be better provided through the mental health sector.  This is akin to proposing that the disability support needs of people with intellectual disabilities could be met through the primary health care sector rather than through a disability support scheme.  

It is our position that community based disability supports for people with mental health conditions and related psychosocial disabilities are the business of the disability sector.  It is essential that this sector’s knowledge and skills base are used to meet the needs of the extremely marginalised group of mental health consumers with a psychosocial disability.

Mental health consumers and carers have long argued for the need for a focus on whole of life needs, and not just illness and treatment based supports; an expansion of services for people with mental illness to include accommodation and employment services to support effective community participation

The COAG National Mental Health Plan 2006-2011 provided funding for the Personal Helpers and Mentors Program, funded by the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) and the Support for day to day living program funded by the Department of Health and Ageing.  These initiatives boosted disability type support for people with severe mental health conditions.  However it was acknowledged in the Senate Standing Committee on Community Affairs in 2008 that such community based support services have been so underfunded that substantial further investment was urgently needed.

The Draft Report acknowledges workforce issues and indicates that sourcing and training competent assessors and staff for the NDIS and NIIS will be difficult. The labour shortage issues raised in the Draft Report are of serious concern, particularly due to the ageing disability workforce and the increasing demand on skilled workers. MIFA would like more detail on how the Commission envisages these difficulties could be addressed. We would also suggest that the development of peer workers as assessors be considered as an important workforce option.

MIFA commends the Commission for noting the high level of stress faced by informal carers and welcomes strategies aimed at relieving this stress and improving support for these workers. Family carers are seen in many cases to be beneficial to the health and wellbeing of a consumer, so MIFA welcomes the proposed initiative of providing payment to family members for their caring role. However, there are still concerns about the potential for abuse of payment of family members as part of self-directed funding. MIFA would support a trial of payments to family members to assess the risks, advantages, disadvantages and optimal design of such a system. 

It is essential that the NDIS and the NIIS, under the proposed National Disability Insurance Agency, are implemented with effective governance. The Agency must ensure efficacy and efficiency of the scheme and maintain a consumer-centred approach to its work. More detailed information on the proposed governance model needs to be provided. MIFA notes that the Commission has proposed that a commercial board of directors will play a role in governance, supported by an advisory committee (including consumers). MIFA is supportive of this framework but argues that to ensure a comprehensive understanding of the issues faced by consumers with a disability and their carers, strong consumer involvement at all levels of governance needs to be implemented.

Thank you for the opportunity to respond to this important draft document.

David Meldrum
Executive Director
Mental Illness Fellowship of Australia.