National Disability Insurance Scheme participants

Introduction

‘I think [choice is] one of the most important things you can have because I think a lot of mental ill-health and a lot of ill-health, and just lack of emotional wellbeing, comes from people feeling they haven’t got a choice.’

National Disability Insurance Scheme (NDIS) participant

From a semi-structured interview in research into people with psychosocial disability and the NDIS (Wilson et al. 2018)

While the NDIS is designed to give people access to ‘reasonable and necessary’ supports for daily life, it does not fund services offered through the health system such as community mental health or psychiatry. This means participants must navigate the complexity of interacting systems provided through the NDIS, national, mainstream and community health services. This complexity may prove particularly difficult to navigate when someone is not operating with optimal mental health.

‘I got turned down by about 13 services … all of the mental health ones and also disability ones turned me down… And this man said, "Oh yeah … she was too complex so we didn’t take her."'

NDIS participant

From a semi-structured interview in research into people with psychosocial disability and the NDIS (Wilson et al. 2018)

The findings below show how systemic barriers and gaps in coordination between disability supports and the health system shape NDIS participants’ mental health outcomes. When services operate in silos or are not designed to work together, people can be left without timely, preventative, or community‑based support. As a result, many NDIS participants end up seeking hospital‑based mental health services, not because these are the most appropriate options, but because other supports are unavailable, inaccessible, or not designed for people with complex needs.

This report includes data starting from 2018–19. Trends are therefore likely to be impacted by the rollout of the NDIS, which may have initially brought those with the most severe mental health conditions into the scheme.

Key findings

In 2022–23: 

  • NDIS participants had a rate of ED presentations for mental health care 10.8 times as high as people with no government disability supports after adjusting for age
  • the proportion of NDIS participants arriving at the ED by police or correctional services vehicle was almost twice as high as people with no government disability supports
  • the proportion of NDIS participants who had at least one hospitalisation for mental health care was 6.9 times as high as people with no government supports
  • the rate of hospitalisations for mental health care for NDIS participants was 13.8 times as high as people with no government disability supports after adjusting for age
  • around 3 in 5 (63%) mental health hospitalisations for NDIS participants took place in specialist psychiatric units, compared with 2 in 5 (44%) for people with no government disability supports.

Did you know?

The NDIS does not fund clinical treatment services or therapy to address mental health symptoms. It funds ongoing functional capacity building supports and supports for daily living when needed (NDIS 2024).

Emergency department care

In 2022–23, around 3 in 100 (3.2% or 16,000) NDIS participants had at least one mental health-related ED presentation, compared with less than 1% of people with no government disability supports.

‘People seek mental health-related services in EDs for a variety of reasons, often as an initial point of contact or for after-hours care, for crisis support or being unable to access support through other means.’

Peta Marks, mental health nurse

Recorded in Mental Health in Emergency Care (Marks 2022)

 

Did you know?

In a 2019 survey on the health and wellbeing of LGBTIQ+ people in Australia, more than 4 in 5 (84%) LGBTIQ+ people with severe disability or long-term health condition had been diagnosed or treated for a mental health condition in the past 12 months (Hill et al. 2020). 

Hospitalisations

In 2022–23 around 14,010 NDIS participants were admitted to public hospitals for mental health care, accounting for 31,630 hospitalisations. People could be admitted more than once. The number of NDIS participants admitted for mental health care more than doubled between 2018–19 and 2022–23 (from 5,720 to 14,010) corresponding with a general increase in NDIS participants. 

Figure 5: Number of NDIS participants who were hospitalised for mental health care, 2018–19 to 2022–23

Line chart showing number of people who were hospitalised for mental health care.


Source: AIHW NHDH 2018–23, analysis of NHDH | Data source overview

Figure 6: Number of hospitalisations for mental health care for NDIS participants, 2018–19 to 2022–23

Line chart showing number of hospitalisations for mental health care


Source: AIHW NHDH 2018–23, analysis of NHDH | Data source overview