Note: when we say disability support needs, we mean supports you need for the impairments that meet the disability or early intervention requirements, or both
Case example
Emilia has a mental health condition that has led to a psychosocial disability. She feels her condition is getting worse. She asks us to fund clinical treatment from a mental health professional. This funding would supplement the supports she already gets from mainstream health services where she lives, through her mental health plan.
Would we fund this?
No, we don’t fund clinical treatment from a mental health professional as it’s not an NDIS support.
The health system is a mainstream system and is responsible for clinical mental health supports.
Why wouldn’t we fund this?
NDIS laws determine what we can and can’t fund. Things we can fund are called NDIS supports. You can use the funding in your plan to buy NDIS supports if they’re related to your disability and are in-line with your plan.
If your treatment is to stabilise or manage your mental health condition, or to set up longer-term recovery pathways, the health or mental health system is responsible.
The NDIS is not responsible for funding mental health supports that are a form of clinical treatment. This includes acute, ambulatory and continuing care in the community, and rehabilitation or recovery.
This means that if you need clinical treatment from a mental health professional, we are not the most appropriate funding agency. This is the case even if your need for extra clinical supports is due to your disability support needs.
We also don’t fund psychology as therapy or clinical treatment to address symptoms of your mental health condition.
What else do we think about?
We think about whether the health system or other providers are responsible for delivering these types of support. This includes:
- early intervention supports related to mental health that are clinical in nature. This includes clinical supports for child and adolescent developmental needs
- residential care where the main purpose is for inpatient treatment or clinical rehabilitation. This includes places which mainly have clinical staff to give primary mental health care supports
- supports relating to co-morbidity. This relates to other conditions you may have alongside your mental health condition. For example, treatment for drug or alcohol dependency is the responsibility of the health system.
We may fund non-clinical supports that relate to your psychosocial disability and address specific needs relating to your functional ability. This includes NDIS supports that help you to do day-to-day tasks and take part in community and social and economic life. To decide this, we look at the information you give us against the NDIS funding criteria.
Case example
Jim is 48 and lives with schizophrenia. He works part time as a groundskeeper and does landscaping. Jim has psychologist and psychiatrist support, which he gets from the health system. They help him manage his schizophrenia with psychological treatment and medication.
Jim’s disability makes it more difficult for him to get motivated and organised in the mornings. This means he’s sometimes late for work, so he wants some help to improve this. Jim asks for funding for psychology sessions to help him with strategies to improve his motivation and organisation, so he can maintain his work and independence.
Would we fund this?
Yes, we’d fund psychology sessions for Jim if:
- they are not for clinical treatment
- they aim to improve his functional abilities, resulting from his psychosocial disability support needs
- they will be likely to help him improve his motivation and organisation skills, so he can become more independent with his daily activities and work responsibilities.
What else do we think about?
When working out whether the funding for psychological support is an NDIS support for Jim, the planner looks at the information Jim gave us against the NDIS funding criteria. The planner also thinks about whether the support:
- relates to Jim’s psychosocial disability support needs
- will be, or is likely to be, effective and beneficial for Jim, to improve his motivation and organisational skills
- is an NDIS support
- represents value for money. This means the costs of the support are reasonable, compared with alternative supports which may achieve the same benefit.
In Jim’s case the planner decides this support:
- is an NDIS support because it’s not for clinical treatment. Jim already gets clinical support from the health system
- is related to Jim’s psychosocial disability for which he meets access for
- will help Jim to improve his self-management skills by giving him strategies to increase his motivation and organisation. As Jim experiences these impairments because of his disability, supports that he needs to address them can be funded
- is good value for money. It’s likely to increase Jim’s independence and reduce his need for support over time.
This means that Jim’s funding request meets all NDIS funding criteria and funding for his psychological support is approved.
For more information, refer to:
- Our Guideline - Reasonable and necessary supports
- Our Guideline – Disability-related health supports
Case example
Roxanne has lived with a psychiatric condition for several years. Her mental health has a big impact on her life, functional ability and independence. She has an NDIS plan to help her with her psychosocial disability supports. Roxanne wants to improve her independence and asks the NDIS for funding for therapeutic supports to build her capacity.
The supports will help her learn how to do day-to-day activities such as paying her bills and cooking her meals. By providing capacity building supports it is expected Roxanne’s need for support will reduce over time as she builds her independence.
Would we fund this?
Yes, we’d fund capacity building and social and community participation supports if they:
- are NDIS funded supports related to Roxanne’s disability support needs
- help Roxanne improve her independence and achieve her goals
- enable her to undertake day-to-day tasks.
Why would we fund this?
When working out whether a support is an NDIS support for Roxanne, we look at the information she gives us against the NDIS funding criteria. We typically fund non-clinical mental health supports that:
- relate to your disability support needs
- focus on increasing your functional capacity and independence.
Examples of the types of non-clinical mental health supports we might fund include:
- coaching so you can be more independent with day-to-day activities and take part in community, social and economic life, in line with your goals
- assistance to help you work with broader mental health, health system and other services. This is by making sure the supports you receive outside of the NDIS are responsive to your needs and help you achieve your recovery goals
- support you to connect positively with family, friends and others.
It’s expected by funding these NDIS supports to build capacity, the need for support will reduce over time as functional ability and independence increases.
Case example
Yindi is 27 and has a psychosocial disability. She lives in temporary accommodation and does not work. Yindi wants to move out to live in her own home and reconnect with her friends and hobbies. Her psychosocial recovery coach has recommended training and therapy to help improve her:
- day-to-day skills to live independently, focusing on cooking, cleaning and paying bills
- social skills to connect with people in a positive way and connect with the community.
Yindi asks us to fund the recommended training and therapy. She supports her request with a copy of the report from her psychosocial recovery coach.
Would we fund this?
Yes, we’d fund Yindi’s request for training and therapy as they:
- are NDIS funded supports relating to her disability support needs
- will help improve Yindi’s day-to-day independent living skills, social skills and independence.
Why would we fund this?
When working out whether a support is an NDIS support for Yindi, we look at the information she gives us against the NDIS funding criteria. This is to work out whether the funding for capacity building and social, community and civic participation supports are NDIS supports for Yindi.
The planner also thinks about whether the support:
- will help Yindi do day-to-day activities, and take part in social and economic life
- is value for money. This means the costs are reasonable compared to both the benefits achieved and the cost of other support options
- will be, or is likely to be, effective and beneficial for Yindi, in line with current good practice.
Based on the report from Yindi’s psychosocial recovery coach, the planner decides the supports will help her to do day-to-day tasks and take part in social and economic life.
The planner also decides the supports are:
- good value for money and likely to build Yindi’s independence, reducing her long-term reliance on other supports
- effective and beneficial for Yindi’s mental wellbeing. This is because recovery coaches follow a recovery-orientated approach, in line with current good practice
- not clinical in nature. As they focus on improving Yindi’s functional abilities and independence, this will mean she can do day-to-day activities and take part in her community
- NDIS supports.
This means Yindi’s training and capacity building is an NDIS support for her. Funding is included in Yindi’s plan to help improve her:
- day-to-day skills to live independently, focusing on cooking, cleaning and paying bills
- social skills and build her capacity to connect with people in a positive way and connect with the community.
For more information, refer to: