National Mental Health Sector Reference Group Sector Communiqué – August 2017
The National Mental Health Sector Reference Group (NMHSRG) provides expert advice from a cross section of the mental health sector to the National Disability Insurance Agency (NDIA) about the integration of psychosocial disability and mental health into the Scheme.
The NMHSRG is also an important mechanism for information sharing across the mental health sector and the broader community. As such, the purpose of this Communiqué is to provide the key outcomes of the tenth meeting of the NMHSRG which took place on 4 August 2017 in Melbourne.
The meeting was well attended with members focusing on the important work underway in transitioning to a national Scheme and planning the integration of mental health and psychosocial disability into the NDIS.
The NMHSRG, chaired by NDIA Strategic Adviser Mr Eddie Bartnik, includes diverse sector representatives and is attended by expert guest presenters when necessary.
The following members, project managers and invited guests were in attendance:
- Mr Eddie Bartnik, NDIA Strategic Advisor
- Mr Evan Bichara, Consumer Representative
- Mr Michael Burge OAM, Consumer Representative
- Mr Patrick Hardwick, Carer Representative
- Ms Janet Meagher AM, NDIS Independent Advisory Council
- Dr Gerry Naughtin, NDIS Independent Advisory Council
- Ms Belinda Highmore, Mental Health Australia (for Frank Quinlan)
- Ms Lorraine Langley, Mental Health Drug and Alcohol Principal Committee (for Robyn Humphries)*
- Ms Nikki Maloney, Mental Health Drug and Alcohol Principal Committee (for Amy Wyndham)*
- Mr Ivan Frkovic, Mental Health Commission (QLD) (replacing Mr John Feneley)**
- Ms Anne-Louise Dawes, Department of Social Services (for Mr John Riley)
- Dr Anthony Millgate, Department of Health
- Mr Scott McNaughton, NDIA General Manager, Participant Pathway Design
- Mr Rod Astbury, Community Mental Health Australia (for Amanda Bresnan)
- Ms Bronwyn James, Department of Social Services (for Ms Joanne Llewellyn)
- Ms Deborah Roberts, NDIA Mental Health Section
- Ms Elspeth Jordan, NDIA Mental Health Section
- Ms Aisling Blackmore, NDIA Mental Health Section
- Ms Sarah-Jane Edwards, Mental Health Coordinating Council, NSW
- Ms Kerry Stopher, NDIA WA Stakeholder and Engagement
- Ms Sarah Johnson, NDIA Scheme Actuary
- Ms Joanne Llewellyn, Department of Social Services
- Ms Paula Zylstra, Department of Health
- Ms Robyn Humphries, Mental Health Drug and Alcohol Principal Committee
- Ms Amy Wyndham, Mental Health Drug and Alcohol Principal Committee
- Ms Amanda Bresnan, Community Mental Health Australia
- Mr Frank Quinlan, Mental Health Australia
- Mr Josh Fear, Mental Health Australia
- Ms Belinda Krause, NDIA Actuary
- Ms Marita Walker, NDIA Regional Manager, Western Australia
*representative of the Mental Health Drug and Alcohol Principal Committee (MHDAPC) of the Australian Health Ministers Advisory Council
**representative of Mental Health Commissions.
Summary of the Tenth Meeting
The Chair acknowledged traditional owners and those with lived experience – families, friends, and supporters and those in the community. The Chair welcomed members to the second meeting of the NDIA Mental Health Sector Reference Group (the NMHSRG) for 2017 and thanked the members for their ongoing commitment to attending the meeting.
The Chairperson acknowledged that the NDIS gives effect to Australia's obligations under the United Nations Convention on the Rights of People with Disabilities (2006) and noted the criticality of continuance of the National Mental Health Sector Reference Group as an ongoing partnership mechanism between the mental health sector and the National Disability Insurance Agency.
The Chairperson welcomed new members and acknowledged invited guests;
- Mr. Michael Burge – newly appointed Consumer representative
- Mr. Patrick Hardwick – newly appointed Carer representative
- Ms Anne-Louise Dawes – Branch Manager, Program Transition, Department of Social Services
- Mr Ivan Frkovic – Mental Health Commissioner, Queensland
- Ms Sarah-Jane Edwards, Mental Health Coordinating Council, NSW
- Ms Kerry Stopher, NDIA WA Stakeholder and Engagement Director
The Chair acknowledged that three members have completed their terms on the NMHSRG, and thanked each for their contributions:
- Ms Julie Anderson was not able to renominate due to personal responsibilities. She formed part of the group which responded to the National Mental Health Commission review, and leant a quiet but powerful voice to this group. She always had something important to contribute to the discussion.
- Mr John Feneley is finishing his term as the inaugural Mental Health Commissioner in NSW. He has been a great contributor to the development of the Scheme, including commissioning an early report for the Hunter site, and developing consumer and carer videos about the NDIS experience. The NSW Mental Health Commission made an important submission to the JSC. John had a noted personal commitment to the voice of lived experience and to forensic issues.
- John Riley from Department for Social Services has moved to a new position focusing on Market Oversight. John had a commitment to collaboration and team work across the many government jurisdictions in this space, including the Department for Social Services, Department of Health, and states and territories. He brought a very helpful broad policy overview to issues discussed at this meeting.
The Chair noted that the International Initiative for Mental Health Leadership (IIMHL) and International Initiative for Disability (IIDL) Leadership Exchange 2018 will take place in Sweden from the 28 May to 1 June 2018 and encouraged members to keep this opportunity on the agenda.
The Chair was one of three NDIA representatives to attend the Joint Standing Committee (JSC) hearing in Canberra on the 16th of June 2018. The NDIA submission, transcript, and additional documents will be available through the JSC inquiry website. The Chair noted that the final recommendations from both the JSC Inquiry Report and the Productivity Commission Report on the NDIS Costs (expected October 2017) may have a further impact on the NDIA Mental Health team workplan but at the moment there are five core areas of focus:
- Improve the shared understanding of access requirements
- Clarify the pathway for existing and potentially new participants
- Building staff competency and understanding
- Explaining the types of supports typically needed and how these are best integrated
- Finalising a Functional Assessment
The Chair introduced the agenda item as a high level overview to share perspectives from each stakeholder. Of significance, the NMHSRG heard feedback including:
- There have been changes to the NDIS Independent Advisory Council (IAC) membership, and Gerry Naughtin and Janet Meagher have retained their positions.
- IAC has prepared a paper on the topic of access to the NDIS for people with psychosocial disability living in boarding houses, residential facilities, and hostels.
- The IAC has been completing additional work on the topic of self management, and has contributed to the Participant Pathway Review.
- Both IAC members gave evidence at the JSC Inquiry public hearing on the 16th of June 2017.
- The IAC document "The First Four Years: 2013-17" was tabled at the meeting and outlines a range of key mental health reports and resources over the period
- Members of the National Register of Mental Health Consumers and Carers noting;
- The need for more clear communication about eligibility criteria for people to become part of the NDIS, and that there is some confusion for people with psychosocial disability, which may lead to some people missing out
- The need for mainstream services to continue to assist those with mental health conditions.
- The challenges some participants and their families have in using MyGov, and in understanding the purpose of support coordination.
- The role of good quality peer support work in assisting people with a psychosocial disability to lead meaningful and contributing lives.
- The benefits of an inclusive approach for carers in the planning and implementation of participant plans.
- A peer work project which the Commonwealth government has provided funding for, through the National Mental Health Commission. The project is to examine the feasibility of establishing a national member based organisation for the Mental Health Consumer and Carer peer workforce in Australia.
- The findings of a report from the University of Queensland, funded by MIND Australia, The Economic Value of informal mental health caring in Australia.
- Mental Health Australia's focus for the last two months has been on the JSC Inquiry and PC Review. MHA have welcomed the opportunity to contribute to external inquiries and external scrutiny of the Scheme, as well as the chance to review submissions from other organisations and individuals, noting the commonalities across the sector:
- MHA hopes that the long standing process issues can be resolved using existing governance structures (i.e. the NMHSRG) without waiting for Government responses to the reports.
- Ms Highmore queried continuity of support arrangements and the requirement for people to test NDIS eligibility to be permitted to continue in their current Commonwealth funded programs.
- Community Mental Health Australia noted that good progress has been made towards the first National NDIS Mental Health conference to be held in Sydney in November, and that the organising committee are currently seeking event sponsors. In addition:
- Noted changes to the website and increased resourcing for CMHA.
- Mr Frkovic updated the NMHSRG on behalf of the Mental Health Commissions. He suggested that there is an issue around the variability in NDIS plans and there is a need to seek consistency across all jurisdictions. There is also reported instability across the non-government sector across jurisdictions, as the Commonwealth and States adjust funding for programs.
- The Mental Health Drug and Alcohol Principal Committee noted their work has continued to focus on the Fifth National Mental Health Plan (5NMHP). The Plan is on the agenda for the COAG meeting on the 4th of August, for endorsement and public release.
- The NDIA Community of Practice has not been active over the last 12 months, due to the priorities at the beginning of transition and the need to ensure the Agency brought participants in to the Scheme as per the transition schedule in the bilaterals. Further updates will be provided at a future meeting.
- The Department of Health has two programs in transition: Day to Day Living (D2DL) and Partners in Recovery (PiR). Contracts for both programs have been extended to 30 June 2019 to ensure service continuity during the transition period. Providers for both programs are supporting clients to apply for the NDIS. Organisations are also funded to provide continuity of support for clients deemed ineligible for the NDIS until the end of the transition period, after which the programs will cease. DSS is the lead for developing longer term continuity of support arrangements for those who are found ineligible for the Scheme.
- The Commonwealth National Psychosocial Supports Program was also considered at COAG Health Council on the 4th of August 2017, with Health Ministers agreeing to a process for considering implementation of the measure.
- The Federal Health Minister has written to state and territory colleagues seeking information on current state and territory expenditure on mental health services to inform negotiations.
- The Department of Social Services shared that the Commonwealth has funded continuity of support through top ups to existing programs from to July 2019, which guarantees that existing clients will receive the same supports they have been receiving up until 2019, through PHaMs and Mental Health Respite: Carer Support (MHR:CS). Funding is gradually decreasing in line with the people moving across to the NDIS, but transition rates continue to be monitored by DSS.
- Noted that PHaMs and MHR:CS are able to take on new clients if there is capacity, and there is no requirement in guidelines that these providers turn people away.
- The Commonwealth through DSS is supporting provider transition through the one-off Sector Development funding of $15,000 for NDIS readiness, for example some providers are using the funds for organisational planning, marketing, or restructuring.
- DSS is awaiting a decision on the location of the Quality and Safeguarding Commission. (Since the 4th August an announcement has been made that the Quality and Safeguards Commission will be in Western Sydney) $209 million will be provided over four years to establish the Commission for the Commonwealth.
- A number of projects have already been completed in the workforce space, including: the Disability Innovation Network, Carecareers and ProjectABLE, and the Innovative Workforce Fund, which plus $1 million towards researching and developing workforce models that can be applied to the disability sector. DSS also recently announced the opening of the Boosting the Local Care Workforce initiative, intended to build disability sector capacity and service provider readiness in the lead up to the full NDIS.
Update on the Mental Health Workplan and Scheme
The Chair gave an update on the Mental Health Workplan for 2016/17, including:
- The current Workplan and key directions to embed psychosocial disability capability in NDIA staff and Partners will be reviewed once the key findings and responses to the JSC and PC Reviews are known.
- The NDIA has listened to the sector's concerns and has set up an Independent Pricing Review, as well as a specific workshop on Pricing for Psychosocial Disability Supports.
- Meeting attendees received the Communique from the Workshop on Pricing for Psychosocial Disability Supports. This Communique captures discussion around concern around pricing points for psychosocial disability supports, and input into various reviews. The Workshop was established in collaboration with Community Mental Health Australia (CMHA), Mental Health Australia (MHA), and Vicki Rundle, Deputy CEO Market and Supports (NDIA).
- Ms Elspeth Jordan spoke to the paper titled Operational Access Review for Psychosocial Disability, with particular focus on the access criteria "likely to be permanent" and the topic of recovery.
- Ms Jordan noted that the NDIA Access team must adhere to the legislation as written. Where there is flexibility for the Agency is in the consumer experience: how NDIA staff use language, and how NDIA staff can communicate clearly with the community. The legislative requirement sits with permanence (or likely to be). The work being undertaken in the Access space is focused on language being welcoming, and supportive to the most vulnerable.
- Ms Jordan noted that the Agency has formed the Mental Health Access Team (MHAT), a specialist team within the Access team.
- Mr Scott McNaughton delivered an update on the Participant Pathway Review, noting that some of the aspects were ideas in development subject to Board approval.
- Mr McNaughton noted that the new NDIS Board has significant interest in reviewing the pathways of Participants and Providers into the Scheme. For a lot of people, the NDIS has made a significant difference. The CEO has acknowledged we need to continue to improve the experience of our participants. The review focuses on the core principles of the NDIS.
Scheme Actuary's Report
- Ms Sarah Johnson, Scheme Actuary presented highlights of the quarterly report: People with Psychosocial Disability and the NDIS – as at March 2017.
- Across all States/Territories 11,257 (11.4%) of all scheme participants have a psychosocial disability, and 6,371 participants (6.4%) have psychosocial disability recorded as their primary disability. 63% of all participants with a primary or secondary psychosocial disability have more than one disability listed.
- For the purposes of this communique, a Key Points summary of data - Key Data on Psychosocial Disability and the NDIS – as at 31 March 2017 is included at Attachment A
- Ms Roberts and Ms Johnson gave an update in relation to Reference Packages.
- Ms Roberts noted that since the last meeting, the Agency has finalised a tender with Flinders University to collect data on 300 participants in PiR and D2DL. So far they have close to 200 records from PiR, and will complete back capture on 100 participants in the Australian Capital Territory. This project is capturing feedback from providers about the experience of using severity indicators, including WHODAS, LSP16, and HONOS.
- A further workshop is planned for September 2017 and will include a broader group of stakeholders.
Key Scheme Updates
NDIS Psychosocial Resources
Ms Sarah-Jane Edwards from the Mental Health Coordinating Council (NSW) gave a presentation to the NMHSRG on the work funded by NDIA to create an online resource on psychosocial disability and the NDIS. The focus of the project was on assisting participants, providers, and carers to understand the NDIS and various important pathway processes including access.
- The project has been completed and there is a live website: http://reimagine.today/ and a workbook available for free.
- The main question which the resource sought to address was "how do we support people living with mental health conditions to fit together with the NDIS, and inspire hope, choice and control, as well as empowering the voice of people."
- The project included a significant number of co-design partners, ensuring that lived experience was included.
- The Workbook resource also sought to support people and their supporters who don't like or use computers to access information, and to record and document their journey. The workbook has received outstanding feedback.
- The NMHSRG endorsed the website resource and it was noted as a valuable resource also for Local Area Coordination Partners in the Community.
WA Psychiatric Hostels Project
Ms Kerry Stopher provided a presentation on the WA Psychosocial Hostels Project.
- This project focused on providing supported access to the NDIS for people living in psychiatric hostels. Ms Stopher noted that all stakeholders had been interviewed in order to develop the final report.
- The project included a Steering Group of stakeholders for the project, engaged a specific project officer/planner, provided one-on-one pre-planning sessions, and created a streamlined planning pathway for these participants to build their trust and confidence.
- Plan implementation strategies included peer support meetings with a facilitator to understand what was working and what wasn't working for a variety of hostel residents.
- 10 project recommendation have been made to NDIA as a result of this project.
- Ms Stopher will present the Psychiatric Hostels project at the NDIA and Mental Health conference in November 2017.
The Chair noted the following topics were likely to be covered at the next NMHSRG meeting:
- Workforce and peer support
- Self Management/Capacity Building /Safeguards
- Hostels and hard to reach populations
The last meeting for 2017 is expected to be late November/December 2017.
For further information regarding the National Mental Health Sector Reference Group and key projects please contact:NDIS Mental Health Team
Attachment B Two Page summary of the Sector Communique
Attachment C Psychosocial Hostels Project Report