Not sure if your psychosocial disability is eligible for the NDIS? Here’s what you’ll need to access supports.

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Mental Health and Psychosocial Disability

A mental health condition is a broad term that refers to symptoms caused by a range of factors in a person’s life. It can include mood, anxiety, personality, psychotic, and compulsive disorders, and may be lifelong or temporary.

Not everyone who has a mental health condition will be deemed to have a psychosocial disability. The Psychosocial label is usually used when a person's mental health condition is severe, longstanding, and has a significant impact on a person’s day to day life requiring various types of support.

A large proportion of NDIS participants are now being funded for their psychosocial disabilities. Currently there are almost 50,000 participants with a primary psychosocial disability, meaning this is their major reason for accessing the NDIS. Many more people on the NDIS have a psychosocial disability as a secondary and supported disability.

NDIS Eligibility

In order to be eligible for the NDIS, regardless of disability type, there are certain criteria that must be met, including age and residency status. Use the NDIS “Am I Eligible” tool as a starting point.

To be eligible for NDIS support for a psychosocial disability, in addition to the usual eligibility requirements, all of the following criteria must also apply:

• There is an impairment attributable to a psychiatric condition

• The impairment is likely to be permanent

• The impairment results in substantially reduced functional capacity

• The impairment affects the person’s capacity for social or economic participation

• The person is likely to require support under the NDIS for their lifetime

Do you need a diagnosis? Not necessarily...

The NDIS recognise that diagnoses can be hard to pin down. People with mental health conditions may straddle multiple conditions that don’t fit neatly into a box nor labelled with ease. In fact, there is no list of diagnoses that will automatically be accepted by NDIS.

Rather, it’s all about the impairment that results from having a mental health condition. Of course, a diagnosis will help with an application, but if the medical team is unable to identify the precise condition, don’t be discouraged from applying.

Another common misconception is around the consistency of the impairment. Mental health conditions and psychosocial disabilities can change, be intermittent and require different levels and types of support at different times.

One month a person may require significant support and the next month they could be handling everyday activities well. This is completely normal. Evidence is required to prove that the mental health condition is likely to be permanent, but fluctuations in treatment history and supports does not disqualify eligibility.

Types of Evidence

There are a number of different types of evidence you can use when applying for the NDIS. Getting a good range of evidence types will paint a clearer picture of the impairment for the NDIS.

Evidence that usually comes from treating health professionals, such as a GP, psychiatrist or psychologist:

• NDIS Access Request Form / NDIS Evidence of Psychosocial Disability Form (click to download)

• Diagnosis history

• Existing mental health reports or assessments

• Treatment history

• Treatment plan

• Supporting letter from treating health professional

• Functional capacity assessments (LSP-16, WHODAS, HoNOS)

• Occupational therapy reports

Evidence that usually comes from the applicant or people who know the applicant well and understand their day-to-day functioning:

• NDIS Access Request Form / NDIS Evidence of Psychosocial Disability Form (click to download)

• Participant statement of supports / self-reporting on how the impairment impacts them (required as per the NDIS Act)

• Support Worker letter

• Carer statement

• Recent government applications (e.g. Disability Support Pension)

• Work history

• Financial guardian or administration orders

Focus on Impact

The focus of the NDIS is not the mental health condition itself, but rather the impact the condition has on day-to-life. There are a number of key life areas that the NDIS looks at when assessing that impact, so make sure the evidence covers these areas to yield better results.

Whether writing a self-report, asking for a support letter from a person, or requesting a report from a doctor, make sure it focuses on these life skill areas:

• Communication - being understood in spoken, written, or sign language; understanding others; and the ability to express needs.

• Social interaction - making and keeping friends, interacting with the community, behaving within limits accepted by others, and the ability to cope with feelings and emotions in a social context.

• Learning - understanding and remembering information, learning new things, and practicing and using new skills.

• Mobility - the ability to move around the home and community to undertake ordinary activities of daily living requiring the use of limbs.

• Self-care - a person’s ability to look after their own personal care, hygiene, grooming, feeding and health care needs.

• Self-management - a person’s ability to organise their own life; plan and make decisions; and take responsibility.

Be clear about what the applicant can and can’t do in all of these life skill areas. Provide examples wherever you can.

Don’t worry though, not all life skill areas must be impacted from the condition, NDIS eligibility can still be met with reduced capacity in just one life skill area.

The most common areas that people with a psychosocial disability struggle with are social interaction, self-management, and self-care.

If there is concern about sharing deeply private information, don’t worry - no personal details are required, particularly regarding trauma or abuse. Although the NDIS does need evidence of the condition, the focus is on it’s impact and the supports required, rather than the cause.

Where to next

When you have all your evidence gathered, and you’ve completed the NDIS access and evidence forms, it's a good idea to have someone close to you look over it all. This could be a family member, friend, support coordinator, support worker, or you can reach out to a Kinora Coach to look it over. Sometimes another pair of eyes can spot gaps you may have missed, and strengthen your application overall by making sure all the i's are dotted and t’s crossed.

Once you’ve got the tick of approval from someone you trust, it’s time to submit.

You can do this via:

• email to NAT@ndis.gov.au, or

• post to GPO Box 700, Canberra, ACT 2601

• or, if you’re unable to complete the access request form, you can also make a verbal request by calling 1800 800 110.

If you’re going through this process now, or you’ve been through it before, jump onto the Kinora community and share your experience. This is a difficult journey for many, so sharing support, advice, and ideas together, can make all the difference.