Psychosocial disability support services

Key Points

  • As at 31 December 2021, people with a psychosocial disability formed the third largest primary disability group (53,123 people) among NDIS participants (NDIA 2021a).
  • Almost 3 in 4 (71.8%) active NDIS participants with a psychosocial primary disability resided in Metropolitan areas as at 31 December 2021.
  • The rate of active participants with a psychosocial primary disability was almost 3 times higher for Aboriginal and Torres Strait Islander people than other Australians (468.1 people per 100,000 and 164.0 respectively) as at 31 December 2021.
  • 1 in 2 (50.9%) NDIS participants with a psychosocial primary disability had a diagnosis of Schizophrenia as their main diagnosis as at 31 December 2021.
  • Only 3 in 4 participants with a psychosocial primary disability (76.0%) relied on informal supports such as friends and family as at 31 December 2021, compared to almost all participants (94.7%) across other disability groups.
  • For the month ending 31 December 2021, jobseekers with a psychiatric primary disability comprised 40.1% of all jobseekers (126,100 cases) across the Disability Employment Services, second only to the proportion of jobseekers with a physical disability (43.5% or 136,776 cases).

Mental illness, and in particular severe mental illness, is an important cause of disability. The Australian Burden of Disease study 2018 found that mental and substance use disorders were the second leading cause of years lived with disability (YLD)  (AIHW 2021). Mental illness can vary in severity and be episodic or persistent in nature. The Productivity Commission estimates that around 5% of Australians or 800,000 people have a severe mental illness, of which 500,000 people have episodic mental illness and 300,000 have persistent mental illness (PC 2020).

Many Australians with severe mental illness may also have a psychosocial disability - and can experience challenges with communication and social inclusion, finding suitable housing and employment and maintaining physical health. As a consequence, they are among the most disadvantaged people in our community (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 primary disability of psychosocial disability. The NDIS sets out to provide reasonable and necessary supports to eligible Australians who enter the Scheme under the age of 65 years, with a permanent (or likely to be permanent) and significant disability (NDIA 2021c). The National Disability Insurance Agency (NDIA) is an independent statutory agency whose role is to implement the NDIS. This section also provides information on employment services provided by Disability Employment Services (DES) for people with a psychiatric disability as their primary disability. Please note that DES uses the term psychiatric and not psychosocial (for more information please refer to Key Concepts).

Spotlight data: How many NDIS participants have a psychosocial primary disability?

Alt-text: Map and horizontal bar chart showing the number, per cent and rate (per 100,000 state-specific population) of NDIS participants in each state and territory. Victoria had the highest number of participants (17,473), followed by New South Wales (15,640), Queensland (9,905), Western Australia (4,489), South Australia (3,072), the Australian Capital Territory (1,103), Tasmania (962) and the Northern Territory (468), Overall, there were 53,123 participants with a psychosocial primary disability and a further 34,200 with a psychosocial secondary disability.  

Note: Rates are calculated per 100,000 demographic-specific population.

Source: Psychosocial disability support services as at 31 December 2021 Table DIS.1, Table DIS.4

Data downloads:

Psychosocial disability support services as at 31 December 2021 tables (194KB XLS)

Psychosocial disability support services as at 31 December 2021 section (274KB PDF)

 

Data coverage for NDIS applies to the second quarter of the 2021–22 financial year.  DES monthly data applicable at 31 December 2021.

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NDIS participants with a psychosocial primary disability

As at 31 December 2021, people with a Psychosocial disability as their primary disability formed the third largest primary disability group among NDIS participants (11%), after Autism (33%) and Intellectual disability (19%) (NDIA 2021a). At this time there were 53,123 people with a primary psychosocial disability who were active participants with an approved plan under the NDIS (Figure DIS.2) (NDIA 2021a).

As at 31 December 2021, among NDIS active participants with a psychosocial primary disability:

  • Victoria had the highest rate in the NDIS with a rate of 263.0 participants per 100,000 population, followed by the Australian Capital Territory (256.2). The lowest rate was in Western Australia (167.2).
  • 1 in 5 participants (19.1%) were aged under 35 years. The bulk of participants were spread fairly evenly across the 35-44 years (22.7%), 45-54 years (27.7%) and 55-64 years (25.0%) age groups. The highest rate was among the 45-54 years age group with 452.9 participants per 100,000 population whilst the lowest rate was among the less than 15 years age group (5.4).
  • males had a higher rate of participation (209.7 participants per 100,000 population) compared with females (198.2).
  • 1 in 13 (7.8%) identified as Aboriginal and Torres Strait Islander.  The rate of active participants with a primary psychosocial disability was almost 3 times as high for Indigenous Australians (468.1 participants per 100,000 population) than non-Indigenous Australians (164.0).
  • 1 in 8 (12.6%) identified as being from a Culturally and Linguistically Diverse (CALD) background.
  • almost 3 in 4 (71.8%) usually resided in Metropolitan areas compared with 1.5% in Remote or Very Remote Communities. People who usually resided in Large rural towns had the highest rate of participation with 261.8 participants per 100,000 population, whereas people with a usual residence in Remote communities had the lowest (143.4).
  • 1 in 2 (50.9%) had a diagnosis of Schizophrenia (F20) as their primary diagnosis, making this the largest primary diagnosis group among NDIS participants with a primary psychosocial disability, followed by Other psychosocial disorders (F99) at 16.5% and Bipolar Affective Disorder (F31) at 9.7%.

Figure DIS.2: NDIS active participants with a psychosocial primary disability, by demographic characteristics, as at 31 December 2021

Alt-text: Horizontal bar chart showing the rate (per 100,000 demographic-specific population), per cent or number of active NDIS participants with a psychosocial primary disability by demographic variables of state or territory, age group, sex, Indigenous status, Cultural and Linguistic Diversity status, and remoteness area of usual residence. Victoria had the highest rate of participation with 263.0 participants per 100,000 population, while Western Australian had the lowest with 167.2 participants. The age group with the highest rate of participation was 45-54 years with 452.9 participants per 100,000 age-specific population while those aged less than 15 years had the lowest with 5.4 participants. Males had a higher rate of participation than females with 209.7 participants per 100,000 population compared with 198.2. Indigenous Australians had a higher participation rate than non-Indigenous Australians with 468.1 participants per 100,000 population compared with 164.0. Australians who identified as having Cultural and Linguistic Diversity (CALD) status had a lower participation rate than those who did not identify as having CALD status with 125.8 participants per 100,000 compared to 225.4. People with a usual residence in Large rural towns had the highest rate of participation with 261.8 participants per 100,000 population, whereas people with a usual residence in Remote areas had the lowest with 143.4.

Note: Rates are calculated per 100,000 demographic-specific population.

Source data: Psychosocial disability support services tables (281KB XLSX).

Supports accessed by participants with a psychosocial primary disability

Supports available under the NDIS fall into 15 categories, and include things like 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 2021b). Therapeutic supports to facilitate functional improvement where maximum medical improvement has been reached may also be funded under the NDIS (NDIA 2022a). Early intervention supports are also provided under the NDIS to eligible children and adults (NDIA 2021c).

Among NDIS participants with a psychosocial primarydisability, the most accessed services fell under the categories of Improved Daily Living Skills (utilised by 96.1% of participants), Assistance with Social and Community Participation (94.1%) and Coordination of Supports (90.5%). When compared to other participants across the NDIS (whose primary disabilities were not psychosocial) a much higher proportion of participants with a psychosocial primary disability accessed the support categories Assistance with Daily Life (88.4% compared with 49.5%), Assistance with Social and Community Participation (94.1% compared with 55.4%), Transport (75.5% compared with 36.3%) and Coordination of Supports (90.5% compared with 38.0%), although a much lower proportion accessed Consumables (50.3% compared with 75.5%) (Figure DIS.3).

Figure DIS.3: NDIS active participants, psychosocial primary disability and other primary disability, by support category, as at 31st December 2021

Alt Text: Horizontal bar chart showing the percentage of NDIS participants with a psychosocial primary disability or all other participants across the NDIS that accessed NDIS supports by support category. The most accessed categories of support among participants with a psychosocial primary disability were Improved Daily Living Skills (utilised by 96.1% of participants), Increased Social and Community Participation (94.1%) and Coordination of Supports (90.5%). When compared to other participants across the NDIS, a much higher proportion of participants with a psychosocial primary disability accessed the support categories Assistance with Daily Life (88.4% compared with 49.5%), Increased Social and Community Participation (94.1% compared with 55.4%), Transport (75.5% compared with 36.3%) and Coordination of Supports (90.5% compared with 38.0%), although a much lower proportion accessed Consumables (50.3% compared with 75.5%).

Note: Among NDIS participants with a non-psychosocial primary disability (i.e. in the category ‘other’) are participants who may have a psychosocial secondary disability.

Source data: XLS DownloadPsychosocial disability support services tables (281KB XLSX).

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)

Supported independent living (SIL) is generally for 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 2022b). See NDIS Home and Living Supports for further information on accommodation support.  

As at 31 December 2021, among participants with a psychosocial primary disability, about 1 in 80 (1.3% or 685 people) were accessing SDA, and almost 1 in 20 (4.6% or 2,437 people) were accessing SIL packages.

Supports outside the NDIS accessed by participants with a psychosocial primary disability

There are supports outside the NDIS important to the well-being and quality of life of NDIS participants, and which the NDIS tries to connect participants with. 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 2021d).

As at 31 December 2021, almost all (95.1%) participants with a psychosocial primarydisability had accessed mainstream supports such as health and other government services, a similar finding to that for other participants across the Scheme (95.3%). The proportion of participants with a psychosocial primary disability who accessed community supports (41.9%) was slightly lower than other participants across the NDIS (46.5%). The proportion of participants with a psychosocial primary disability who are recorded as accessing informal supports such as friends and family was much lower than other participants across the Scheme (76.0% compared to 94.7%).

Employment services for people with a psychiatric disability

Employment services was the most accessed category of service by users with a psychiatric disability under the National Disability Agreement (NDA). Disability Employment Services (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 2021e).

DES is made up of two parts. Disability Management Services (DMS) helps jobseekers with disability, injury or health conditions find a job and can also provide occasional support in the workplace. Employment Support Services (ESS) provides assistance to jobseekers with permanent disability to find a job, and regular ongoing support in the workplace to keep a job (for more information see Disability Employment Services).

According to the DES caseload data at 31 December 2021, jobseekers with a psychiatric primary disability comprised 40.1% of jobseekers (126,100 cases) across the DES, second only to the proportion of jobseekers with a physical disability (43.5% or 136,776 cases).

Within the ESS arm of DES, jobseekers with a primary psychiatric disability comprised the largest proportion of cases among all primary disability groups, forming 42.0% of the caseload (70,040 cases) on 31 December 2021.