Specialised support and informal care for First Nations people with disability

People with disability may need help with daily activities – for example, eating, showering, or moving around. They may also need help to participate in social and economic life. To do so, people with disability may use a range of specialist disability services and informal care.

Aboriginal and Torres Strait Islander (First Nations) people have a higher prevalence of disability compared with non-Indigenous Australians. They may also face a range of barriers in accessing culturally safe and inclusive services across many systems (AIHW and NIAA 2022; Disability RC 2023a).

In recent years, there have been several policy initiatives relating to disability that impact First Nations people (see below Disability policy initiatives).

How many First Nations people have disability?

There are 3 main ABS sources of data on First Nations people with disability (for information on each source, see above Disability data sources). While each data source has different purposes and methodologies for capturing disability, and their estimates of overall disability among First Nations people vary, their estimates of severe or profound disability are broadly similar.

• The 2022–23 NATSIHS estimated that:
  • 37% of First Nations people had disability (or around 368,000 out of 994,000) (ABS 2024a)
  • 7.0% (69,200) of First Nations people had severe or profound disability (ABS 2024a).
• The 2022 SDAC estimated that:
  • 25% of First Nations people had disability (184,000 out of 727,000), similar to the proportion in 2019 and 2015 (both 24%)
  • 12% (84,400) of First Nations people had severe or profound disability, compared with 8.5% in 2018 (ABS and Avery 2025).
• The 2021 Census estimated that 8.6% (66,400 out of 813,000) of First Nations people needed assistance with core activities (ABS 2022a). This was an increase from 7.2% in 2016 and 5.8% in 2011 (ABS 2011, 2016).

Despite these differences, the 3 data sources all indicate that for First Nations people:

• proportions with disability are generally similar for males and females
• those aged 55 and over are more likely to experience disability than those aged under 55 (tables 1 and 2).

n.a. not available

1. Each data source has different purposes and methodologies for capturing information about disability, and therefore their estimates of disability vary.
2. Proportion has a high margin of error and should be used with caution.

Sources: ABS 2024a, 2024b; ABS and Avery 2025.

n.a. not available

1. Each data source has different purposes and methodologies for capturing information about disability, and therefore their estimates of disability vary.
2. For the Census, ‘severe or profound disability’ refers to ‘needed assistance with core activities.’ Calculations exclude ‘not stated’ need for assistance.
3. Proportion has a high margin of error and should be used with caution.

Sources: ABS 2022b, 2024a, 2024b; ABS and Avery 2025.

Education and employment

Disability can affect participation in education and in the labour force (Disability RC 2023a, 2023b; Figure 1). The Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (The Royal Commission) highlighted that First Nations people with disability have experienced racism and unsafe cultural practices in education and employment settings and services (Disability RC 2023a, 2023b). 

According to the 3 main sources of data, compared with First Nations people without disability:

• First Nations people aged 15 and over with disability were more likely to have Year 10 or below as their highest level of education:
  • The 2022–23 NATSIHS estimated that 57% (169,000) of First Nations people aged 15 and over with disability, and 64% (30,300) of First Nations people aged 15 and over with severe or profound disability, had Year 10 or below as their highest level of education. This compares with 43% (or 158,000) of First Nations people aged 15 and over without disability (ABS 2024b).
  • The 2022 SDAC estimated that 46% (60,700) of First Nations people aged 15 and over with disability had Year 10 or below as their highest level of education, compared with 29% (90,000) of First Nations people aged 15 and over without disability (ABS and Avery 2025). 
  • The 2021 Census estimated that 54% (23,900) of First Nations people aged 15 and over who needed assistance with core activities had Year 10 or below as their highest level of education, compared with 34% (150,000) of First Nations people aged 15 and over who did not need assistance with core activities (ABS 2022b).
• First Nations people aged 15–64 with disability were less likely to be employed:
  • The 2022–23 NATSIHS estimated that 46% (118,000) of First Nations people aged 15–64 with disability, and 23% (9,500) of First Nations people aged 15–64 with severe or profound disability, were employed. This compares with 66% (228,000) of First Nations people aged 15–64 without disability (ABS 2024b).
  • The 2022 SDAC estimated that 40% (45,600) of First Nations people aged 15–64 with disability were employed, compared with 75% (220,000) of First Nations people aged 15–64 without disability (ABS and Avery 2025).
  • The 2021 Census estimated that 15% (5,200) of First Nations people aged 15–64 who needed assistance with core activities were employed, compared with 57% (246,000) of First Nations people aged 15–64 who did not need assistance with core activities (ABS 2022b).

Formal disability support

Specialist disability support services

Specialist disability support services assist people with disability to participate fully in all aspects of everyday life. Specialist disability support services in Australia are now largely provided through the National Disability Insurance Scheme (NDIS).

First Nations people, however, can face a range of barriers in applying to the NDIS and in accessing support (Disability RC 2023a, 2023b). For example, a lack of culturally safe assessment tools can contribute to the underdiagnosis or misdiagnosis of disability among First Nations people by failing to adequately account for First Nation people’s culture. There may also be discrimination in different stages of the application process or in obtaining evidence to support applications.

Research presented at the Royal Commission found that, while demand is growing for First Nations disability services, in 2021 First Nations NDIS participants were 28% less likely to receive care via the NDIS than non-Indigenous Australians and suggested that some NDIS services may be ‘unsafe, traumatising and inequitable’ for First Nations people (Deloitte 2023).

The National Aboriginal Community Controlled Health Organisation (NACCHO) serves as a leading advocate in the disability sector. They support Aboriginal Community Controlled Organisations (ACCHOs) in expanding the delivery of culturally safe disability services under the NDIS (NACCHO 2025). The Aboriginal Disability Liaison Officer (ADLO) program assists First Nations people with disabilities to become active participants of the NDIS (NACCHO 2025).

There are also a range of other government and mainstream services that support First Nations people with disability. The eligibility criteria for each vary and people can receive more than one. For example, a First Nations person may be eligible to receive both NDIS support and income support payments. For more information on disability support services, see People with disability – specialised support services.

First Nations people aged under 65 are eligible to apply for the NDIS (NDIA 2023), and those aged 50 and over are eligible to apply for government-funded aged care services (see Aged care for First Nations people). First Nations people aged 50–64, therefore, may choose to apply for aged care services rather than NDIS services depending on eligibility (NDIS Review 2023).

The proportion of NDIS participants who are First Nations people has increased over time – from 7.9% (or around 51,200) in March 2023 to 8.1% (58,100) in March 2025 (NDIA 2025c). In March 2025, around 5.5% of an estimated 1.1 million First Nations people were participants of the NDIS (based on the ABS 2021 Census-based annual estimates of the First Nations population at 30 June 2025) (ABS 2023, NDIA 2025c).

The average annualised committed support provided to First Nations NDIS participants can provide an indication of the relative amount of support they receive. Not all committed support, however, may have been accessed or used by participants. The average annualised committed support is calculated using participants’ support budget converted to a yearly rate and divided by the number of participants (rounded to the nearest thousand dollars).

Among the First Nations NDIS participants on 31 March 2025:

• the average annualised committed support was $84,000
• there were 26,800 participants in Major cities, 25,900 participants in Inner and outer regional areas and 5,400 participants in Remote and very remote areas
• participants in Major cities, Inner and outer regional areas and Remote and very remote areas averaged annual support amounts of $81,000, $77,800 and $126,000, respectively
• the Northern Territory had the highest average support with $170,000 annually, while New South Wales and Victoria had the lowest average support with $69,000 (NDIA 2025b, 2025c; figures 2 and 3).

First Nations people with disability in remote communities, along with their families and carers, can also face challenges such as:

• limited service choice and availability
• the need for travel and transportation
• availability of trained professionals who are culturally competent
• issues relating to service/support quality
• a lack of alternative accommodation options (Disability RC 2023a, 2023b; NDIA 2016; PwC 2018).

The higher average annualised committed NDIS support for First Nations people in Remote and very remote areas compared with other remoteness areas could be one indication of these challenges. This also applies to the Northern Territory, as a significant proportion of the population in the Northern Territory live in rural, remote and very remote locations (NTMHC 2017).

Income support payments

Disability Support Pension (DSP) is an income support payment for people aged 16 and up to Age Pension age with disability who have a reduced capacity to work because of their impairment. In December 2024, 67,800 First Nations people were receiving DSP, making up 8.3% of total recipients (DSS 2025).

Carer Payment provides income support for carers aged 16 and up to Age Pension age who are unable to support themselves through substantial paid employment because of the demands of providing constant care to a person with disability, a medical condition, or who is frail aged. In December 2024, 22,700 First Nations people were receiving Carer Payment, making up 7.1% of total recipients (DSS 2025).

Carer Allowance is a supplementary payment for carers who provide additional daily care and attention to someone with disability, a medical condition, or who is frail aged. In December 2024, 33,700 First Nations people were receiving Carer Allowance, making up 5.0% of total recipients (DSS 2025).

Indigenous status identification in Services Australia is voluntary and self-identified (Services Australia 2024). This may influence the quality and completeness of the data and subsequent reporting on the number and proportion of First Nations people receiving income support payments, especially among older First Nations people.

For more information on these payments, see Income and finance of First Nations people, People with disability – specialised support services, Income support payments for the working age population, Income support for older Australians and Informal carers.

Homelessness services

People with disability of any age who are homeless or at risk of homelessness can receive support from specialist homelessness services (SHS). In 2023–24, 26% (2,100) of SHS clients with severe or profound disability who provided information about their Indigenous status were First Nations people (AIHW 2024). Of around 1,130 First Nations people who were identified as needing disability services or assistance, 44% (495) were provided with this assistance and 16% (180) received a referral, while 40% (460) were not provided with or referred for disability services.

For more information on homelessness services, see Specialist homelessness services annual report 2023–24, First Nations clients - Australian Institute of Health and Welfare.

Informal care

A person’s interaction with both formal and informal welfare support and services can help support their wellbeing. Informal (unpaid) care provided by family, friends or neighbours within the context of an existing relationship often complements formal (paid) services from government and other organisations. The demands of the role, however, often go beyond what would normally be expected of the relationship.

Caring is often seen as an important cultural responsibility in First Nations communities, and a significant proportion of First Nations carers are young carers and/or providing multi-generational care. The availability of support and services for carers can be particularly limited in regional and remote areas, with First Nations carers particularly impacted by this issue which is more pronounced in remote communities (DSS 2024b).

The 2022–23 NATSIHS collected data on whether First Nations people aged 15 and over had provided unpaid care, help or assistance to someone with a long-term health condition, disability or a problem related to old age. The assistance must be ongoing, or likely to be ongoing, for at least 6 months. These data showed that:

• an estimated 17% (or 113,000 First Nations people) were providing unpaid care
• an estimated 20% (or 70,200) of First Nations females had provided unpaid care, compared with 13% (or 43,300) of First Nations males
• the proportion who had provided unpaid care was slightly higher among First Nations people living in remote than non-remote areas (an estimated 20% or 21,400, and 16% or 92,000, respectively) (ABS 2024a).

The 2022 SDAC collected data on First Nations people of all ages who had provided any informal assistance (help or supervision) to people with disability or older people (aged 65 years and over). The assistance must be ongoing, or likely to be ongoing, for at least 6 months. These data showed that:

• An estimated 14% (or 103,000 First Nations people) were providing informal assistance. Of these informal carers, 36% (or 37,100) had disability and 63% (or 64,600) did not.
• An estimated 15% (or 57,400) of First Nations females had provided informal assistance, compared with 12% (or 41,600) of First Nations males.
• An estimated 9.5% (or 9,700) of First Nations people who had provided informal assistance were aged under 15, 35% were aged 15–34, 38% were aged 35–54, and 17% aged 55 and over.

The 2021 Census included a question about whether First Nations people aged 15 and over had provided unpaid assistance to someone with disability, a long-term health condition or a problem related to old age in the 2 weeks before Census night. In 2021, of those for whom responses to this question were provided:

• an estimated 15% (or 76,600 First Nations people) had provided unpaid assistance to someone with disability, a long-term health condition or a problem related to old age in the 2 weeks before Census night, staying constant from the proportion in 2016 (15%)
• an estimated 18% (or 48,100) of First Nations females had provided unpaid assistance, compared with 12% (28,500) of First Nations males
• the proportion of First Nations people who had provided unpaid assistance was similar among those living in remote and non-remote areas (an estimated 16% or 11,600, and 15% or 46,700, respectively) (ABS 2022b).

For more information on informal carers, see Informal carers.

Comparisons with non-Indigenous Australians

Based on the 2022–23 NATSIHS, after adjusting for differences in the age structure between the 2 populations, First Nations people were 1.5 times as likely as non‑Indigenous Australians to have disability (42% and 29%, respectively) and 2.0 times as likely to have a severe or profound disability (7.6% and 3.9%, respectively) (AIHW forthcoming 2025).

Based on the 2021 Census, the proportion of those with severe or profound disability was higher in First Nations people compared with non-Indigenous Australians. Based on age-standardised rates, the proportion of First Nations people with severe or profound disability was 2.1 times as high as for non-Indigenous Australians (Table 3) (AIHW and NIAA 2022).

1. Age-standardised using the Australian 2001 standard population (5-year age groups to 75+).
2. For the Census, ‘severe or profound disability’ refers to ‘needed assistance with core activities’. Calculations exclude ‘not stated’ responses for Indigenous status and need for assistance.

Source: AIHW and NIAA 2022.

For both First Nations and non-Indigenous Australians aged 15–64, compared with those without severe or profound disability:

• the proportion who had Year 10 or below as their highest level of education was higher among those with severe or profound disability (48% for First Nations people with severe or profound disability and 37% for non-Indigenous Australians with severe or profound disability, compared with 33% and 14% without severe or profound disability).
• the employment rate was lower among those with severe or profound disability (15% for First Nations people with severe or profound disability and 21% for non-Indigenous Australians with severe or profound disability, compared with 57% and 77% without severe or profound disability).
• the proportion of those providing unpaid care was slightly higher among those with severe or profound disability (18% for First Nations people with severe or profound disability and 15% for non-Indigenous Australians, compared with 15% and 12% without severe or profound disability (Table 4) (ABS 2022b).

Notes

1. ‘severe or profound disability’ status is determined using the ABS Census of and Population and Housing variable ‘Core activity need for Assistance’.
2. Calculations exclude ‘not stated’ responses for Indigenous status, severe or profound disability, highest level of education, labour force status and whether they were providing unpaid assistance.
3. Proportions are crude and may differ from age-standardised rates.

Source: ABS 2022b.

Informal care

Based on the 2021 Census, after adjusting for differences in the age structure between the 2 populations, the proportion of First Nations people providing unpaid care to a person with disability, long-term health condition or problems related to old age was 1.3 times the proportion for non-Indigenous Australians (AIHW and NIAA 2022).

Where do I go for more information?

For more information on disability for First Nations people, see:

• ABS Survey of Disability, Ageing and Carers: Aboriginal and Torres Strait Islander people with disability
• People with disability in Australia
• Reporting on Australia’s Disability Strategy.

For more information on First Nations participants of the NDIS, see the NDIA’s:

• Quarterly Reports
• Data and insights
• Aboriginal and Torres Strait Islander participants 30 June 2019.