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mental-health

People with intellectual disability need quality mental health services not to be ignored

The Commonwealth Government has just release the National Mental Health Plan for comment, and people with intellectual disability are not even mentioned in the 77 page draft.  This omission defies belief in view of the terrible mental health disparities experienced by people with intellectual disability and the highlighting of the need for action on these in recent years.

We urge you to speak up for people for people with intellectual disability!

See www.health.gov.au/internet/main/publishing.nsf/Content/mental-fifth-national-mental-health-plan for how you can have your say – by going to a consultations meeting, filling in a feedback survey or making a submission.

Feel free to use our arguments on why the plan must focus on people with intellectual disability  and how it can do that.  –

Why the plan must focus on people with intellectual disability?

  • Approximately 150,000 people with intellectual disability have mental disorders but poor access to appropriate mental health care.
  • The COAG National Disability Strategy 2010-2020 specifically calls for universal mental health initiatives to address the needs of people with disability.
  • The National Roundtable on the Mental Health of People with Intellectual Disability 2013 endorsed eight key elements of an effective response:
  1. The needs of people with intellectual disability and a mental disorder are specifically accommodated in all mental health initiatives.
  • The NSW Mental Health Commission included a specific and detailed focus on intellectual disability mental health in its 10 year strategic plan for mental health in NSW.

How the plan should include people with intellectual disability  

 The plan should:

  1. Include a focus on the research in relation to poor mental health of people with intellectual disability.
  1. Include “people with intellectual disability” in the list of groups whose specific needs should be considered when implementing the plan.  Already listed are: Aboriginal and Torres Strait Islander people; lesbian, gay, bisexual, transgender and/or intersex people; and people from culturally and linguistically diverse backgrounds.
  1. Include specific measures through the plan so that the needs of these equity  groups are in fact acted upon. Without specific measures, the plan’s call for equity is likely to be little more than a motherhood statement.  This is the experience of people with intellectual disability and their families over many decades.

In particular, specific measures to ensure inclusion of equity groups are needed in the draft plans sections on:

  • Priority area 1: integrated regional planning and service delivery
  • Priority area 7: safety and quality in mental health care
  • Monitoring and reporting on reform progress

Priority area 2 : coordinated treatment and supports for people with severe and complex mental illnesses:

  • The plan should address that people with intellectual disability often have complex mental illnesses due to difficulties with communication and diagnosis and the interplay between the mental illness, the intellectual disability and the person’s social circumstances.
  • Include people with intellectual disability who also have a mental illness in the discussion about the interplay between the roles of mental health services and the NDIS. In the draft plan, the focus on the NDIS does not address the issues arising for people who have a primary intellectual disability but also a mental disorder. The focus is concentrated on people who have a primary psychosocial disability.
  1. Priority area five: physical healthof people living with mental health issues
    Include a focus on working with the NDIS on physical health issues for people with mental illnesses. Improved health and well-being is one of the key outcome measures being used by the NDIS in its outcomes framework.
  1. Priority area six: stigma and discrimination reduction
    Include a specific focus on discrimination against people with intellectual disability in the mental health workforce. For people with intellectual disability, their mental health needs notoriously go untreated on the assumption that the behaviour resulting from the mental health problem in fact flows from the intellectual disability.
  1. INCLUDE A SPECIFIC PRIORITY AREA ON THE MENTAL HEALTH OF PEOPLE WITH INTELLECTUAL DISABILITY! The NSW Strategic Plan for Mental Health 2014-2024 includes specific sections focused on people with intellectual disability and other equity groups. If NSW can do it, so can Australia!

(The material was prepared by NSWCID which takes the lead on health issues for people with intellectual disability on behalf of all Inclusion Australia’s members)

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I am here to remind you, not to teach you …

Standing beneath a huge circus tent you have to wonder how they put it up. For someone who struggles with putting up the family tent each Christmas on our annual camping holiday this tent it is unimaginable, how they not only get this it up but that it is still standing days later!

We are standing not sitting as we are not watching a circus. We are standing as the rhythms of Afro Moses demand that you are on your feet moving, something that thankfully does not require too much skill. Our family is spending the weekend at our ‘funky little festival’.

One line from Afro Moses reminds me of the week I just had, 3 days in the Hunter/New England region talking to people with disability and their families about their transition from school student to employee in the open labour market. How to use their NDIS School Leavers Employment Support funding to choose a provider which will support them into a job of their choice. No one said that they wanted to be a afro/blues singer but they all had aspirations to have a job; including a graphic artist, a mechanic and a teacher.

In talking to people with disability and their families about work in the open labour market; about the opportunity for people with significant disabilities not to be reliant on the DSP, to be able to afford the ‘extras’ that working people take for granted; about the opportunity to build skills for independent living , to be able to travel by themselves; to have the opportunity to make friends through working with a wide range of people; I am not telling them something new. When our children are born we all have expectations and hope for them. Without an awareness of what lies ahead we plan a future of happiness and being part of their community. As the years roll by hopes are dashed as our daughters and sons are constantly reminded of their deficiencies and what they will not be able to do because they have a disability. They are separated from their peers and so do not see themselves reflected in the expected activities of their community, work, sport, music, etc. All manner of people, teachers, therapists, social workers, government agencies, etc, tell them that they are different, not different special like Afro Moses who has an enormous talent for music, not like the special people who put up this enormous tent, but special because they cannot do …

The choice of our daughters and sons to be a graphic artist or a teacher reminds us of our first hopes and aspirations. Wanting to be like their brothers and sisters reminds us that we all live in our community and we should all be fully in it. Wanting to have a job that pays well and is interesting reminds us that service providers have a responsibility to make choices happen, not to remind people of the low expectations of the past.

From now on I will open my talks with the phrase, “I am here to remind you not to teach you …”

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Commonwealth takes NDIS back to the ‘bad old days’ …

Minister Porter’s unilateral action in appointing new Board members to the NDIS has cast a shadow over the successful implementation of the NDIS.

“Inclusion Australia’s strong support for the NDIS was largely based on the belief that the new scheme would end decades of ‘bickering’ between the States and Commonwealth over meeting the daily support needs of people with disability; cooperation not competition. Minister Porter’s authoritarian approach will destroy the co-operation that has been built up to date and replace it with a new Centrelink, currently in the spotlight for its adverse treatment of people with severe disabilities”, says Mr Kevin Stone, President.

The States and Territories must be equal partners in NDIS. This is the only way in which people with disability and their families will have a direct say in how the Scheme works or not for them as this is where trusted relationships currently exist.

Inclusion Australia calls on the Commonwealth Government to genuinely consult with the States and Territories. As a matter of urgency the Commonwealth must re-establish the cooperative spirit of the NDIS and build the trust of people with disability and their families. Without this the NDIS will just become another Commonwealth department with all the inherent faults of a political and centralized bureaucracy.

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If you would like more information about this topic, please contact Mark Pattison at 0407 406 647 or email at media@inclusionaustralia.org.au.

Full media statement

psychiatic institution

IA response to denial of DSP to people in psychiatric ‘confinement’

Inclusion Australia’s Submission to Senate Economics Committee – September 2016

Introduction

This submission makes three claims:

  1. That the UN Convention on the Rights of Persons with Disabilities (UNCRPD) and the Disability Discrimination Act both require the Commonwealth Government to treat people with intellectual disability equally. So, if a person charged with a serious offence is found to be not guilty or unfit to stand trial then the Commonwealth Government is required to treat them the same as other people who have been charged and been found to be not guilty.
  2. That this Bill does not meet the Government’s expectations of ‘value for money’, evidence based policy and congruency across all program areas.
  3. That the intention of the Bill is not to address the real needs of people with intellectual disability but is another instance of people with intellectual disability being caught in the middle of a ‘futile’ argument between the Commonwealth and States.

Rehabilitation builds opportunity, punishment diminishes opportunity

The Explanatory Memorandum states:

While the person is undergoing psychiatric confinement, the relevant state or territory government is responsible for taking care of their needs, including funding their treatment and rehabilitation.

The purpose of all government legislation must be to ensure that people with intellectual disability have the best chance and opportunity to be full contributing members of society. Where people are well supported with evidence based practices they are able to contribute to the financial, social and cultural life of the community in which they live. The key is investment, intervening early to ensure that people have the opportunity to build on their skills and to gain a sense of value.

People with intellectual disability have a cognitive impairment and require concrete, practical experience to be able to learn and use the skills that they acquire. Denying people with intellectual disability income support (including the Disability Support Pension {DSP}) will have at least two effects;

  1. it will cast people with disability into poverty. Without resources they will become a ‘burden’ to either the state government through being incarcerated for longer than necessary, or where they are eligible for the NDIS greatly increase the costs to the Commonwealth government through support to relearn skills and the need for housing.
  2. It will inhibit learning and result in the loss of skills.

It has to be acknowledged that most people with intellectual disability who are charged with a serious offence will be people ‘living on the margins of society’. As such they will have limited financial resources and support networks to assist them when they are released from the institution.

We know that without resources people with disability are often ‘stuck’ in institutions because they have no accommodation to move onto. This means greater expenditure for state governments and loss of skills and hope for people with intellectual disability as they remain incarcerated indefinitely.

Put simply, having money going into a bank account on a regular basis enables the staff supporting people with intellectual disability, in a very real way, to budget and to plan for life out of the institution; e.g., if I build up funds for a rental bond then I can talk, in a real way, about where is the best place for me to live and who with; regular money in the bank enables me, in a real way, to talk about budgeting for rent, food, etc. This does not only build skills but also expectation and hope. If my bank account is zero then all talk of housing, rent, budgeting, etc, is done in a vacuum and rightly will get the response, ‘why bother, it is never going to happen’. Funds in the bank also gives the support staff the knowledge that their work will have a positive outcome, it will create a degree of certainty and thus higher expectations.

Of particular concern is the ‘cost burden’ on the NDIS if people with intellectual disability are not supported with evidence based practices while they are institutionalised. It is our contention that all people with intellectual disability are eligible for the NDIS though the level of funded support that they will need will vary greatly depending on the support that they have had to acquire and maintain skills. The continuing investment in maintaining skills and building on these is vital for people to become increasingly independent of both support and welfare. As we have stated, people with intellectual disability learn in the real world, practical hands on day to day actual experience.

This Bill will have a detrimental effect on both the maintenance of everyday skills and the learning of new skills. The effect will be that the NDIS will have a greater cost in re-skilling people, building up their expectations and proving additional support due the lack of financial literacy during their incarceration. The cost will be greater than the pension paid during the person’s incarceration!

A fact that has a direct bearing on pension costs is that a person with both skills and high expectations has a better chance of getting paid employment in the open labour market. We know from evidence based practice that a person with intellectual disability, with the right support, has a decreased reliance on the DSP when they enter the open labour market. This fact is recognised by the Commonwealth government through a number of employment measures that promote entry into the open labour market for people with intellectual disability. This Bill is at odds with other Government policy and clearly does not equal ‘value for money’.

Governments talk about the positive effects of people being engaged in their community. The economic and social benefits of employment and the social and psychological benefits of voluntary work and being involved in cultural activities. This rhetoric must be consistent across all programs and where issues of Commonwealth/state responsibilities cross over these must be resolved without penalising people with intellectual disability.

It would appear that the Government, in trying to address a ‘wrong’ that it see the Federal Court having inflicted on it, is not considering the consequences for people with intellectual disability nor for Commonwealth finances.

Download the full Submission

When you get the right employment support good things happen!

21 DES services for people with intellectual disability show the way forward

People with significant intellectual disability can work in the open labour market when they get the right support.

The DES Outcome Rates by Disability Type report shows that some DES providers are achieving high rates of open employment outcomes for people with intellectual disability.

Twenty-one (21) providers are achieving 26-week employment outcome rates greater than fifty percent (>50%) for people with intellectual disability, with the highest performing provider achieving eighty-four percent (84%).

The highest performing provider had the following distinguishing features;

  1. Structured job search to customise a job specifically for a person with intellectual disability and building a compelling business case to the employer.
  2. Undertaking job analysis to establish the employer’s needs for job performance.
  3. Systematic job training by qualified staff at the work site to achieve the required job performance.
  4. Ongoing support with the employer and employee to maintain the quality of the job.

DES providers that adopt evidence based employment support for people with intellectual disability are demonstrating high rates of employment outcomes from 5 to 8 out of 10 persons with intellectual disability getting jobs that last at least six months.

The Commonwealth should be congratulated for;

  • focusing on rewarding providers who achieve good results,
  • introducing consequences for providers who achieve poor results, and,
  • publishing provider results by disability type, and creating an informed market.

The Executive Director of Inclusion Australia (formerly the National Council on Intellectual Disability), Mr Mark Pattison said,

“High performing DES providers deserve our recognition for their excellence in assisting people with intellectual disability get and keep jobs in the open labour market. It is encouraging to see a growing number of providers achieving 26-week employment outcome rates beyond 50%.”

These results indicate that future reform of Disability Employment Services must ensure that good practice remains viable and expanded to reach a greater number of people with intellectual disability across all regions who need the right support to get a job in the open labour market.

For inquires, contact Mark Pattison; mark.pattison@inclusionaustralia.org.au; 0407 406 647

Full statement including table

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Mobility Allowance ending causes concern …

Inclusion Australia has written to Minister Porter after we have received increasing concerns from family members of people with intellectual disability about the 2016 Federal Budget changes to the Mobility Allowance.

With the administration of this payment moving from the Department of Human Services (Centrelink) to the National Disability Insurance Scheme (National Disability Insurance Authority), families are seeking certainty that current payment levels will be guaranteed and that their sons and daughter will not be worse off under the new arrangements.
The Mobility Allowance is an employment incentive to support people with disability unable to use public transport without substantial assistance because of disability, illness, or injury and who travel to and from home for paid work, voluntary work, study or training, or to look for work.
This allowance is essentially designed to support the employment of people with disabilities.
The current open employment participation rates of people with intellectual disability who receive national disability services has been in steady decline over the long term. Inclusion Australia believes it is critical that new policy should ensure that current positive employment outcomes and practices are not harmed.
We have asked Minister Porter to provide certainty that the 2016 Federal Budget measure will not reduce the current payment received by people with intellectual disability participating or seeking to participate in the workforce.
If you have concerns about the Mobility Allowance or any of the 2016 Budget measures please make a comment below.

A national inclusive employment plan for people with intellectual disability

MEDIA STATEMENT

Inclusion Australia welcomes the Willing To Work National Inquiry into Employment Discrimination Against Older Australians and Australians with Disability report from Age and Disability Discrimination Commissioner, Susan Ryan.

We agree that we must do something to address the poor rates of employment participation of people with intellectual disability in Australia.

We call on the Commonwealth to develop a national strategy based on what works in collaboration with Inclusion Australia to lift the participation rate of people with intellectual disability.

Just 8% of adults with intellectual disability in receipt of national disability services work in the open labour market, despite decades of research and demonstration finding this group can successfully work in the open labour market when provided with the right support.

People with intellectual disability are currently subject to a system that underestimates their capacity to work, and fails to provide skilled providers across all regions.

The Commonwealth’s evaluation of Disability Employment Services found that:

Research and practice in the field has shown that with the right level and type of support, people with significant intellectual disability can achieve more substantial employment. After 30 years of open employment provision in Australia, it is clear what works and what doesn’t in achieving outcomes for people with intellectual disability. 

Our plan — provided to the Commonwealth in 2015 — is focused on building competent open employment support. This support is critical to raising expectations, engaging employers, achieving outcomes, and providing savings to the Commonwealth.

The Centre for International Economics has estimated that national evidence based open employment support for people with significant intellectual disability would save the Commonwealth up to $53 million per year.

Our plan calls for a new open employment program which exclusively targets jobseekers with disability that are NDIS eligible.  A new support system must presume a capacity to work in the open labour market and provide evidence based support to give the best opportunity to lift the current poor participation rates.

The Federal Budget 2016 did not offer any indexation to the immediate concerns about Disability Employment Services (DES) funding. There has been no Indexation of DES funding since 2010 and this is putting the the viability of evidence based open employment support for people with intellectual at risk. There was also no discussion or decision from the Budget about the Commonwealth’s plans to develop a new national disability employment system.

Inclusion Australia, in partnership with Down Syndrome Australia, will be writing to all political parties as part of the We Can Work With the Right Support Campaign, to begin a national discussion to find a way forward to develop a long term national plan to lift the employment participation rates of people with intellectual disability.

Media Statement

16.05.09 – HRC and Budget Response