Uncertain about the eligibility of your psychosocial disability for the NDIS? Here’s the essential information you’ll require to access support services.

Portrait of an Adult woman holding papers

Mental Health and Psychosocial Disability

A mental health condition encompasses a broad range of symptoms influenced by various factors in an individual’s life, including mood, anxiety, personality, psychotic, and compulsive disorders. These conditions may vary in duration, being either temporary or lifelong.

Not everyone with a mental health condition qualifies as having a psychosocial disability. The term “psychosocial” is typically applied when the mental health condition is severe, enduring, and significantly impacts daily life, necessitating various forms of support.

A substantial number of NDIS participants now receive funding for their psychosocial disabilities, with nearly 50,000 individuals having a primary psychosocial disability as their main reason for accessing the NDIS. Additionally, many others within the NDIS have a psychosocial disability as a secondary and supported condition.

NDIS Eligibility

To qualify for the NDIS, irrespective of the type of disability, specific criteria related to age and residency status must be satisfied. The NDIS “Am I Eligible” tool serves as an initial reference point.

For eligibility regarding NDIS support for a psychosocial disability, the following criteria, in addition to the standard requirements, must be met:

1. There is an impairment attributed to a psychiatric condition.
2. The impairment is expected to be permanent.
3. The impairment significantly diminishes functional capacity.
4. The impairment hinders the individual’s ability to participate socially or economically.
5. The person is likely to require ongoing NDIS support throughout their lifetime.

Do you need a diagnosis? Not necessarily…

The NDIS acknowledges the complexity of diagnoses, especially for individuals with mental health conditions that may not neatly fit into specific categories. Unlike other conditions, there isn’t a predefined list of diagnoses automatically accepted by the NDIS.

Instead, the focus is on the impairment resulting from the mental health condition. While having a diagnosis can aid in the application process, it’s not a strict requirement. If the medical team struggles to pinpoint a precise condition, it shouldn’t deter individuals from applying.

There’s a common misconception regarding the consistency of impairment. Mental health conditions and psychosocial disabilities can be variable, exhibiting changes and requiring different levels of support at different times. It’s normal for someone to need significant support one month and manage everyday activities well the next. Although evidence of likely permanence is necessary, fluctuations in treatment history and support needs don’t disqualify eligibility.

Types of Evidence

When applying for the NDIS, it’s beneficial to gather a variety of evidence types to provide a comprehensive view of the impairment. Typically, this evidence is obtained from healthcare professionals involved in the individual’s treatment, including a GP, psychiatrist, or psychologist:

NDIS Access Request Form / NDIS Evidence of Psychosocial Disability Form (click to download)
History of diagnosis
Current mental health reports or assessments
Record of past treatments
Outline of the treatment plan
Endorsement letter from the treating healthcare professional
Assessments of functional capacity (such as LSP-16, WHODAS, HoNOS)
Reports from occupational therapy

Evidence typically provided by the applicant or individuals familiar with the applicant’s daily life and functioning:

NDIS Access Request Form / NDIS Evidence of Psychosocial Disability Form (click to download)
Participant’s statement of supports / self-assessment detailing the impact of the impairment (mandatory according to the NDIS Act)
Letter from a Support Worker
Statement from a caregiver
Documentation from recent government applications (e.g., Disability Support Pension)
Work history records
Orders related to financial guardianship or administration

Do you need a diagnosis? Not necessarily…

The NDIS acknowledges the complexity of diagnoses, especially for individuals with mental health conditions that may not neatly fit into specific categories. Unlike other conditions, there isn’t a predefined list of diagnoses automatically accepted by the NDIS.

Instead, the focus is on the impairment resulting from the mental health condition. While having a diagnosis can aid in the application process, it’s not a strict requirement. If the medical team struggles to pinpoint a precise condition, it shouldn’t deter individuals from applying.

There’s a common misconception regarding the consistency of impairment. Mental health conditions and psychosocial disabilities can be variable, exhibiting changes and requiring different levels of support at different times. It’s normal for someone to need significant support one month and manage everyday activities well the next. Although evidence of likely permanence is necessary, fluctuations in treatment history and support needs don’t disqualify eligibility.

Focus on Impact

The NDIS places its focus on the impact of a mental health condition on daily life rather than the condition itself. To enhance the effectiveness of evidence, it’s crucial to address specific life areas assessed by the NDIS.

Whether drafting a self-report, seeking a support letter, or obtaining a medical report, ensure a concentration on these life skill areas:

1. Communication: Ability to be understood and understand others in spoken, written, or sign language; expressing needs.

2. Social Interaction: Establishing and maintaining friendships, community interaction, adhering to social norms, and managing emotions in a social context.

3. Learning: Grasping and retaining information, acquiring new skills, and applying newfound knowledge.

4. Mobility: Moving around the home and community to perform daily activities requiring limb usage.

5. Self-Care: Capability to attend to personal care, hygiene, grooming, feeding, and health care needs.

6. Self-Management: Capacity to organize one’s life, make decisions, and take responsibility.

Clearly articulate the applicant’s capabilities and limitations in these life skill areas, providing examples where possible. It’s important to note that eligibility can still be met even if only one life skill area shows reduced capacity.

Commonly, individuals with psychosocial disabilities often encounter challenges in social interaction, self-management, and self-care. Concerns about sharing deeply private information are understandable, but no explicit personal details, especially regarding trauma or abuse, are required. The NDIS primarily seeks evidence of the condition’s impact and the necessary supports rather than the underlying cause.

What next ?

After assembling all your evidence and filling out the NDIS access and evidence forms, it’s advisable to have someone in your support network review the documentation. This person could be a family member, friend, support coordinator, support worker, or you can seek assistance from Home Care Experts. Another perspective may identify any overlooked gaps, ensuring a comprehensive and polished application.

Once you receive the approval from a trusted individual, it’s then time to submit your application.

You can do this via:

– email to NAT@ndis.gov.au,

– or, post to GPO Box 700, Canberra, ACT 2601

– or, if you are unable to complete the access request form, you can also make a verbal request by calling 1800 800 110.