Mental health in NDIS a ‘mistake’, says Patrick McGorry

The decision to include mental health support in the NDIS was a costly mistake, a mental health advocate says.

Patrick McGorry.

The last-minute decision to include mental health support in the $22 billion National Disability ­Insurance Scheme was a costly, dangerous mistake that should be unwound before lasting damage is done, says the nation’s leading mental health advocate.

Patrick McGorry, a clinician and former Australian of the year, told The Australian the mental health sector should never have been shoehorned into the NDIS because it was a “completely different model”.

He gave the same response to Malcolm Turnbull during a recent meeting when the Prime Minister asked if it was appropriate for mental health support to be wrapped up in the massive disability scheme, which was designed primarily for people with physical disabilities. The Gillard government included mental health, a move backed by NDIS architect Bruce Bonyhady.

“It should have been done properly,” Professor McGorry said. “This is a much bigger issue than the NDIS itself. The disability model does not fit with mental illness, which is a mostly fluctuating kind of illness.”

Professor McGorry met recently with Mr Turnbull and Health Minister Greg Hunt and said both were keen to make amends for mistakes of the past. But he cautioned it was “too important to be just tinkering around the edges of the NDIS”.

“Turnbull actually asked me that question, whether this arrangement was appropriate, and the answer is no,” he said. “The biggest issue here is that the state governments have already dismantled the community mental health system, the clinical system with doctors and support. All that is left now is emergency rooms and acute care, the system is collapsing at a state level.”

About $1.8bn was spent on federal, state and territory-funded community mental health programs in 2012 and the NDIS is ­expected to have a budget of about the same amount, to help a much smaller number of people.

The Northern Territory is one of the few jurisdictions which has not folded its mental health support into the insurance scheme.

Professor McGorry — now the executive director of Orygen, The National Centre of Excellence in Youth Mental Health — has given the strongest backing to a chorus of voices, including unions and service providers, who have questioned how the disability scheme will cope with mental illness given poorly defined eligibility criteria.

The Australian has revealed unpublished modelling, commissioned by some state governments for the National Mental Health Service Planning Framework, which shows about 100,000 people who once received individual funding support would no longer be covered when those federal and state programs ended.

The programs will close to part-fund the NDIS but the latter is only funded for a fraction of the number of participants.

Mental Health Australia chief executive Frank Quinlan said all levels of government needed to reset the clock on changes that are almost locked in, and ­redesign the interface between the health and disability system.

He said the scheme should include 64,000 places for people with permanent psychosocial disabilities but these should not be confused with mental health problems.

“The two have been conflated,” he said. “People think we are having an NDIS instead of a mental health system … Mental health came to the NDIS argument a bit late and we’ve been late all the way along in terms of considered policy advice and now, just when the NDIS agency is dealing with some really complex challenges, we have mental health bringing up the rear.”

The Health Services Union asked the Productivity Commission to work with a current parliamentary inquiry into the same issue to “examine whether the inclusion of mental health in the (NDIS) and associated funding arrangements are appropriate.”

Just 6.3 per cent of people with an approved plan under the scheme have a primary psychosocial disability, well below its prevalence across the country.

The peak body for disability service providers said people with these disabilities, their families and services had reported confusion about who got in.

A spokesman for Health Minister Greg Hunt said the government was working closely with the mental health sector on the “best ways to address mental health both within and outside of the NDIS”.