Mental health
Psychosocial disability support services
On this page:
- Key points
- Spotlight data
- Participation and access to the NDIS
- Characteristics of NDIS participants with a psychosocial disability
- Primary health diagnosis
- Supports accessed by NDIS participants with a psychosocial disability
- NDIS funding for supports
- Outcomes
- Employment services for people with a psychiatric disability
- Where can I find more information?
Key points
As at 30 June 2023:
People with a Psychosocial disability formed the fourth largest primary disability group among NDIS participants (62,011 participants or 10%), after Autism (35%) Intellectual disability (16%) and Developmental delay (11%).
$4.25 billion of paid supports were provided to NDIS participants with a psychosocial primary disability in the year ending 30 June 2023, with an average payment per participant of $71,600.
1 in 2 NDIS participants with a psychosocial primary disability (50%) had a primary health diagnosis of Schizophrenia.
Mental illness, and in particular severe mental illness, is an important cause of disability. The Australian Burden of Disease study 2023 found that mental and substance use disorders were the leading cause of years lived with disability (YLD) (AIHW 2023a). Mental illness can vary in severity and be episodic or persistent in nature. According to the 2020–2022 National Study of Mental Health and Wellbeing, an estimated 5.8% of Australians have mental illness that can be classified as severe (see ABS 2023).
For some Australians with severe mental illness their condition constitutes a psychosocial disability – and they can experience challenges with communication and social inclusion, finding suitable housing and employment and maintaining physical health (Tune 2019). Disability support services are critical in assisting people with psychosocial disability overcome functional limitations (for example, with communication, daily living or self-care) and facilitating full and equal participation in the community.
This section presents information on specialist disability support services provided under the National Disability Insurance Scheme (NDIS) to participants with a psychosocial primary disability and participants with a psychosocial secondary disability whose primary disability is not categorised as psychosocial. The NDIS (also referred to in this report as ‘the Scheme') sets out to provide Australians who have permanent and significant disability with funding for supports and services. The National Disability Insurance Agency (NDIA)is an independent statutory agency whose role is to implement the NDIS. This section also includes information on employment services provided by Disability Employment Services (DES) for people with a psychiatric disability as their primary disability. Please note that DES program uses the term psychiatric rather than psychosocial.
Spotlight data
As at 30 June 2023:
Figure showing participant numbers, primary health diagnoses, payments and outcomes data for NDIS psychosocial disability participants as at 30 June 2023.
Notes:
- Secondary psychosocial disability counts only include participants whose primary disability is not psychosocial.
- SIL refers to the accommodation support ‘Supported independent living’.
Source: Psychosocial disability support services as at 30 June 2023.
The 2019 review of the National Disability Insurance Scheme Act 2013 (NDIS Act) commissioned by the Australian Government (commonly referred to as the Tune Review) affirmed the NDIS delivery response works well in general for adults with physical disability, but singled out people with psychosocial disabilities as a group for whom the provision of services had been challenging. Among several findings relating to the NDIS delivery response to people with psychosocial disabilities, the Tune Review found that legislated requirements in relation to permanent impairment for the purposes of eligibility had created particular challenges for people with psychosocial disabilities (Tune 2019).
In December 2021, following consultation with participants, families, carers, peak bodies, service providers, clinical mental health services, state and territory governments and NDIA staff, the NDIS Psychosocial Disability Recovery-Oriented Framework (Recovery Framework) was endorsed by Disability Ministers and released. The Recovery Framework sets out six principles and a series of high-level implementation strategies designed to improve the experience of participants with psychosocial disability in the NDIS (NDIA 2021a).
In March 2022, parliament passed the National Disability Insurance Scheme Amendment (Participant Service Guarantee and Other Measures) Bill 2022 to amend the NDIS Act. The Bill reflects certain recommendations from the Tune Review including clarifications on the eligibility of people with psychosocial disability, such that impairments that are episodic or fluctuating in nature may be taken to be permanent.
In December 2023, the Independent NDIS Review recommended new approaches within the NDIS to psychosocial disability and mental health. The Review recommended a new and dedicated approach to people with psychosocial disability that better meets needs associated with the episodic nature of mental illness and which is focussed on personal recovery. Beyond the NDIS, the review also recommended broader reforms in the mental health system to better support people with severe mental illness.
Participation and access to the NDIS
As at 30 June 2023, people with a Psychosocial disability as their primary disability formed the fourth largest primary disability group among NDIS participants (10%), after Autism (35%) and Intellectual disability (16%) and Developmental delay (11%) (NDIA 2023b). At this time there were about 62,000 people with a psychosocial primary disability who were active participants with an approved plan under the NDIS. There were also about 36,800 participants with a psychosocial secondary disability, but a primary disability that was non-psychosocial. Among participants with a psychosocial secondary disability, the most common primary disability was Autism (42%), followed by Intellectual disability (26%), and Acquired brain injury (7.5%).
As at 30 June 2023, among those who have ever applied to the NDIS on the basis of a psychosocial primary disability, 70% have been given access to the Scheme. This compares with the eligibility rate of 85% across the broader Scheme.
Characteristics of NDIS participants with a psychosocial disability
Figure PDSS.1 Demographic characteristics for NDIS participants with a psychosocial primary disability, psychosocial secondary disability, and all NDIS participants as at 30 June 2023
Horizontal bar chart showing the rate (per 100,000 demographic-specific population) of active NDIS participants with a psychosocial primary disability, psychosocial secondary disability and all NDIS participants by demographic variables.
Notes:
- Rates are calculated per 100,000 demographic-specific population.
- Secondary psychosocial disability data only include participants whose primary disability is not psychosocial.
Source: Psychosocial disability support services as at 30 June 2023, Table PDSS.4
The highest rates of participation (per 100,000 population) among NDIS participants with a psychosocial primary disability are among those aged 45–54 years (515) and 55–64 years (517). The lowest rates are among those aged 15 years and under (4). For participants with a psychosocial secondary disability the highest rate is for those aged 15–24 years (286), and the rate among those aged less than 15 years (97) is much higher than for the corresponding age group with a primary psychosocial disability.
Among the primary disability group, males have a marginally higher participation rate than females (236 per 100,000 population compared with 224), whereas this gap is wider within the secondary disability group (males, 155; females, 117).
About 1 in 12 NDIS participants with a psychosocial primary disability (8.3%) identify as Aboriginal or Torres Strait Islander origin (First Nations). Among the primary disability group, the rate of First Nations participants is almost 3 times that of non-Indigenous Australians (565 people per 100,000 population compared with 187). A similar ratio can be found both among the secondary disability group (298 compared with 106) and across the NDIS as a whole (5,109 compared with 1,823).
About 1 in 8 NDIS participants with a psychosocial primary disability (13%) identify as being from a culturally or linguistically diverse background (CALD). The rate of NDIS participants who identify as CALD (129 per 100,000 population) is half that of those who do not (260). Note that participants who identify as First Nations are not counted as CALD to align with NDIA quarterly reporting.
Whilst almost three quarters of NDIS participants with a psychosocial primary disability (72%) usually reside in Major cities, the remoteness area with the highest rate of participation among the primary disability group is Large rural towns (population between 15,000 and 50,000 residents) with 292 participants per 100,000 population. This broadly mirrors the geographical patterns of participation across the entire Scheme. The lowest rates of participation among NDIS participants with a psychosocial primary disability are for Remote areas (160) and Small rural towns (population < 5000) (172). The NDIA uses the Modified Monash Model to classify geographic remoteness – for further information, refer to the data source.
Across states and territories, the highest rate of NDIS participation for those with a psychosocial primary disability is within Victoria (290 per 100,000 population), whereas Tasmania (199) and Western Australia (185) had the lowest rates.
Primary health diagnosis
Half of NDIS participants with a psychosocial primary disability (50%) have a primary health diagnosis of Schizophrenia. The next most frequent primary health diagnosis among those with a psychosocial primary disability is Other psychosocial disorders (14%), followed by Bipolar affective disorder (9.7%) and Major depressive illness (8.6%).
Supports accessed by NDIS participants with a psychosocial disability
Supports available under the NDIS fall into 15 categories, and include assistance with daily life, transport, social and community participation, funding for disability-related consumables, assistive technologies and home modifications (refer to the Supports and services funded by the NDIS) (NDIA 2021c). There are differences in utilisation of supports between psychosocial disability participants and across the NDIS (see Figure PDSS.2). Therapeutic supports to facilitate functional improvement where maximum medical improvement has been reached may also be funded under the NDIS (NDIA 2024a). Early intervention supports are also provided under the NDIS to eligible children and adults (NDIA 2024a).
Figure PDSS.2 Selected NDIS support categories by proportion of participants accessing support for psychosocial primary disability and across the NDIS, as at 30 June 2023
Horizontal bar chart showing the percentage of participants who use various support categories across the following groups: psychosocial primary disability and all NDIS participants
| Support category | Psychosocial primary disability | All NDIS participants |
|---|---|---|
| Consumables | 50% | 74% |
| Assistance with daily life (incl. SIL) | 90% | 50% |
| Assistance with social, economic, community participation | 95% | 55% |
| Transport | 76% | 37% |
| Improved life choices | 82% | 63% |
| Improved daily living skills | 98% | 98% |
| Finding and keeping a job | 3% | 4% |
| Improved health and wellbeing | 5% | 4% |
| Improved relationships | 13% | 12% |
| Increased social and community participation | 14% | 11% |
| Support coordination | 93% | 45% |
| Assistive technology | 5% | 17% |
1. SIL refers to the accommodation support ‘Supported independent living’.
Source:
Psychosocial disability support services as at 30 June 2023, Table PDSS.2
|
Data source overview
Residential supports
The NDIS funds various home and living supports including:
- assistance with daily life in the home
- home modifications
- short-term and medium-term accommodation
- assistive technologies
- independent living options (ILO)
- supported independent living (SIL)
- specialist disability accommodation (SDA)
For more information on residential supports in the NDIS, refer to the data source.
As at 30 June 2023, 1.8% of NDIS participants with a psychosocial primary disability access Specialist disability accommodation, compared with 9.9% of participants with a psychosocial secondary disability and 3.8% of participants across the Scheme. Just over 1 in 20 psychosocial primary disability participants (5.8%) access Supported independent living (SIL), similar to the proportion across the entire scheme (5.2%), whereas more than 1 in 8 (14%) of the psychosocial secondary disability group access SIL.
Supports outside the NDIS accessed by participants with a psychosocial disability
There are supports outside the NDIS important to the well-being and quality of life of NDIS participants and the NDIS facilitates connecting participants with these. These are classified by the NDIS as:
- Informal supports such as friends, family and other people that participants know in their community
- Community supports such as community groups religious groups and other activities in a participant’s area
- Mainstream supports such as the health and education systems and other government services available to all Australians (NDIA 2024b).
As at 31 June 2023, almost all (95%) participants with a psychosocial primary disability had accessed Mainstream supports such as health and other government services, the same proportion as across all NDIS participants (95%). While the proportion of participants with a psychosocial primary disability who accessed Community supports (44%) was slightly lower than for across the NDIS (49%), the proportion who are recorded as accessing Informal supports such as friends and family was lower (76% compared to 93%).
NDIS funding for supports
In 2022–23, a total of $4.25 billion in supports was paid to NDIS participants with a psychosocial primary disability, a 37% increase from 2021–22 ($3.11 billion).
The average payment per participant with a psychosocial primary disability was $71,600, about 18% higher than the average across all NDIS participants ($60,600) and a 21% increase from 2021–22 ($59,000).
In 2022–23, the average payment per participant with a psychosocial primary disability aged over 18 years and living in SIL was $356,600 whereas this figure was $55,100 for those aged over 18 years not in SIL.
Outcomes
Seventy-nine per cent of NDIS participants with a psychosocial primary disability reported at their most recent assessment that the NDIS has helped them with daily activities. This is compared with 73% of participants during baseline assessment after entry to the Scheme and 79% of participants across the NDIS as a whole.
Thirteen per cent of NDIS participants aged 15–24 years with a psychosocial primary disability reported having a paid job at their most recent assessment, compared with 8.5% of participants during baseline assessment after entry to the Scheme and 21% across the NDIS (Table PDSS.1).
Psychosocial primary | Psychosocial primary | All NDIS | |
|---|---|---|---|
Indicator description | Baseline or first assessment % | Most recent reassessment % | |
% who choose who supports them | 58.8 | 61.5 | 52.7 |
% who choose what they do each day | 70.9 | 72.4 | 60.6 |
% who have friends other than family or paid staff | 51.1 | 51.1 | 69.2 |
% who have been actively involved in a community, cultural or religious group in the last 12 months | 25.1 | 28.2 | 40.4 |
% who are happy with their home | 61.6 | 65.3 | 74.7 |
% who feel safe or very safe in their home | 61.5 | 62.3 | 73.3 |
% who rate their health as good, very good or excellent | 29.0 | 26.9 | 49.3 |
% who did not have any difficulties accessing health services | 52.1 | 54.8 | 68.9 |
% unable to do a course or training they wanted to do in the last 12 months | 48.2 | 45.4 | 32.9 |
% who have a paid job | 9.2 | 9.4 | 22.4 |
15–24 years | 8.5 | 12.9 | 20.5 |
25–34 years | 10.8 | 12.3 | 30.6 |
35–44 years | 10.8 | 11.1 | 28.5 |
45–54 years | 10.1 | 9.9 | 24.5 |
55–64 years | 6.8 | 5.9 | 15.9 |
65+ years | 4.4 | 2.9 | 9.3 |
% who volunteer | 7.3 | 7.1 | 11.4 |
Has the NDIS helped you have more choices and more control over your life? | 70.8 | 76.1 | 76.0 |
Has the NDIS helped you with daily living activities? | 73.3 | 79.1 | 78.9 |
Has the NDIS helped you to meet more people? | 51.7 | 56.1 | 58.3 |
Has your involvement with the NDIS helped you to choose a home that's right for you? | 29.7 | 32.0 | 31.1 |
Has your involvement with the NDIS improved your health and wellbeing? | 53.1 | 57.7 | 57.4 |
Has your involvement with the NDIS helped you find a job that's right for you? | 16.5 | 16.4 | 19.1 |
Has the NDIS helped you be more involved? | 60.3 | 65.2 | 65.7 |
Source: Psychosocial disability support services as 30 June 2023, Table PDSS.8
Employment services for people with a psychiatric disability
Employment and financial security are important for improving outcomes for people with disability. In 2018, the Survey of Disability, Aging and Carers found an unemployment gap of 19 percentage points for people with a psychosocial disability and those without disability, the highest gap among all disability groups surveyed (AIHW 2022).
Disability Employment Services (DES) help people with disability both find work and keep a job. DES are not part of the NDIS and are operated by the Australian Government Department of Social Services (DSS). Supports greater than what may be reasonably provided by an employer or the provisions of the DES are able to be funded by the NDIS (NDIA 2021b). As at 31 December 2023, almost 3 in 5 working NDIS participants (57%) reported getting the support they needed to do their job (AIHW 2024).
According to the DES caseload data at 30 June 2023, jobseekers with a psychiatric primary disability comprised 41% of jobseekers (109,900 cases) across the DES, second only to the proportion of jobseekers with a physical disability (43% or 114,400 cases) (DSS 2023). For further information on DES program data, refer to the data source section.
In 2022–23, psychiatric disability was the primary disability category with the largest proportion of valid 52-week full outcome claims for employment submitted to DES (41%), followed by physical disability (38%) and Autism (6%) (AIHW 2023b). For more information about this measure, refer to Australia’s disability strategy 2021–23, Disability employment services.
As at 30 June 2023, about 1 in 10 (9.4%) of NDIS participants with a psychosocial primary disability have paid employment.
For more information on employment-related outcomes for people with psychosocial disability, see Australia’s Disability Strategy 2021–31, Employment and Financial Security.
Where can I find more information?
You may be interested in:
The NDIS began operating at trial sites in July 2013, and from July 2016 it began transitioning to the full scheme. On 1 July 2020, Christmas Island and Cocos Island joined the NDIS, thus almost completing the staged role out of the Scheme.
Except for Disability Employment Services (DES), the NDIS has largely replaced disability support services provided under the National Disability Agreement (NDA). Data were last collected under the NDA in the Disability Services National Minimum Data Set (NMDS) in 2018–19. The transition of disability support service users from the NDA to the NDIS effected a gradual reduction in data collection under the NDA between 2013 and final collection in 2019.
The NDIA collects data pertaining to the NDIS and publishes online quarterly reports
Primary health diagnoses terminology
The NDIA uses different medical diagnoses terms from the AIHW which uses ICD-10-AM terminology. The following table shows differences between ICD-10 and the NDIA terms used in this report:
ICD-10 Code | ICD-10 name | NDIA |
|---|---|---|
F99 | Mental disorder, not otherwise specified | Other psychosocial disorders |
F32 | Depressive episode | Major depressive illness |
Remoteness areas of usual residence
NDIA uses Modified Monash Model (MMM) categories to assign remoteness areas of usual residence. The MMM classifies metropolitan, regional, rural and remote areas according to geographical remoteness, as defined by the Australian Bureau of Statistics (ABS), and town size. The MMM remoteness categories are defined as follows including the Australian Geography Standard – Remoteness Area (2016):
MM 1: Metropolitan areas - Major cities accounting for 70% of Australia’s population. All areas categorised ASGS-RA1.
MM 2: Regional centres - Inner (ASGS-RA 2) and Outer Regional (ASGS-RA 3) areas that are in, or within a 20km drive of a town with over 50,000 residents. For example: Ballarat, Mackay, Toowoomba, Kiama, Albury, Bunbury.
MM 3: Large rural towns - Inner (ASGS-RA 2) and Outer Regional (ASGS-RA 3) areas that are not MM 2 and are in, or within a 15km drive of a town between 15,000 to 50,000 residents. For example: Dubbo, Lismore, Yeppoon, Busselton.
MM 4: Medium rural towns - Inner (ASGS-RA 2) and Outer Regional (ASGS-RA 3) areas that are not MM 2 or MM 3, and are in, or within a 10km drive of a town with between 5,000 to 15,000 residents. For example: Port Augusta, Charters Towers, Moree.
MM 5: Small rural towns - All remaining Inner (ASGS-RA 2) and Outer Regional (ASGS-RA 3) areas. For example: Mount Buller, Moruya, Renmark, Condamine.
MM 6: Remote communities - Remote mainland areas (ASGS-RA 4) AND remote islands less than 5kms offshore. For example: Cape Tribulation, Lightning Ridge, Alice Springs, Mallacoota, Port Hedland. Additionally, islands that have an MM 5 classification with a population of less than 1,000 without bridges to the mainland will now be classified as MM 6 for example: Bruny Island.
MM 7: Very remote communities - Very remote areas (ASGS-RA 5). For example: Longreach, Coober Pedy, Thursday Island and all other remote island areas more than 5kms offshore.
For more information on geographic remoteness categories using the MMM refer to the Modified Monash Model factsheet.
NDIS residential supports
Supported independent living (SIL) is generally utilised by people with higher support needs who require some level of assistance at home all the time. SIL consists of funding for paid personal supports and is most commonly used in shared living arrangements to help participants live as independently as possible while building skills. Specialist disability accommodation (SDA) is specialised housing designed for people with extreme functional impairment or very high support needs, and usually involves living with a small number of other people (NDIA 2022). See NDIS Home and Living Supports for further information on NDIS accommodation support.
Disability Employment Services (DES)
Caseload data include participants who have been referred to a DES provider but have not yet commenced in the programme. It also includes commended or suspended participants. For key DES program data, refer to the DSS Disability Employment Services monthly profiles.
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Unless otherwise specified, data coverage for the NDIS applies to the final quarter of the 2022–23 financial year. This page was last updated in July 2024.