The Unfunded Client Group – mental health clients in remote areas

Many clients living with a mental health diagnosis on remote communities have traditionally been supported by the community’s aged and disability program. But what will they do when they are no longer eligible for these supports? This is the situation facing some clients living on remote Aboriginal communities.

There has always been issues around providing care and support to clients with a diagnosed mental health condition or for ex-substance misusers. Many of these clients need a regular meal, reminders to take their medications and access to a centre where they can have a shower, have their clothes washed and join in activities. Services have generally accepted these people under their funded disability programs, and yes it has been argued for many years by Disability Services that these people have a medical condition or an addiction problem rather than a disability and aren’t eligible for their programs. Nevertheless, the people seeking support generally had problems with their activities of daily living (ADL’s) and their mental health conditions were seen as disabling and coordinators and service providers have responded with compassion. Now however, we are starting to see a worrying trend emerging; exclusion from support due to clients not meeting the NDIS assessment and eligibility process.

The National Disability Insurance Scheme (NDIS) is currently being trialled in a number of locations around Australia. While it is assisting clients with complex needs with a defined disability, it does appear that many of the clients who had previously received low level support through state and territory operated disability programs, may be assessed as ineligible to access NDIS funding.

In the Northern Territory, access to the disability support program, Disability In Home Support (DIHS), is via the Centralised Intake which sits with the NT Allied Health Teams. We understand that Centralised Intake is now using the NDIS assessment criteria to determine eligibility for the current DIHS program. While it is a good idea to align the intake criteria as it eliminates future problems of client eligibility, it is highlighting that we have a group of clients who will be ineligible to receive support through either the current aged care or disability programs.

The issue is that there is a vulnerable target group of people who may be left unsupported.  The question arises for aged and disability services operating on remote communities and in particular their management: “what can be done about it?”

As I see it, there are options, although there may well be others you can think of:

1. Create a self-funded client group. With the introduction of fees for aged care clients this may not be as much of a problem as it was in the past;
2. Explore other sources of funding to create support programs for these people and create linkages and networks with mental health and other support agencies;
3. Approach funding organisations, write to your local member or the Mental Health Commissioner and let them know about this issue and how it will impact your clients and community.

Perhaps you need to consider all three?  Ignore the issue and services may end up with an unsupported group who create problems in their communities due to boredom, medication non-compliance and frustration.  This is an issue that cannot be ignored and needs to be addressed, after all these people are a part of the fabric of our community.