Executive summary
For people with psychosocial disability, the impact of the new NDIS access framework will depend heavily on how it is designed and applied in practice.
Psychosocial disability can fluctuate and may not be visible during a brief assessment. A person may appear stable because effective supports are already in place, or may only be able to complete an activity with significant assistance. Assessment must therefore consider functioning over time and distinguish what a person can reliably sustain from what is only possible because support is available.
Consumers’ own accounts of their daily lives must be treated as substantive evidence. Assessment tools should be tested specifically for psychosocial disability, including whether they wrongly exclude people with fluctuating or multiple disabilities. Access should not depend on a person’s ability to pay for reports or navigate complex administrative processes, and existing participants should retain support while reassessment and review are underway.
The reforms must also protect against people being excluded on the assumption that treatment or another service will meet their needs. Clinical improvement does not necessarily remove functional disability, and treatment requirements must preserve informed consent. Other systems should only be relied on where support is genuinely accessible and sufficient to meet the person’s needs. Clear responsibility for psychosocial supports outside the NDIS, including through the next National Mental Health and Suicide Prevention Agreement, will be critical. The following recommendations set out the safeguards VMIAC considers necessary to support fair access for people with psychosocial disability and reduce the risk of harm as the new framework is implemented.
Recommendations
- Consumer involvement and safety
Consumers and consumer-led organisations should be meaningfully involved in developing and reviewing the access framework, with participation appropriately resourced. Supported decision-making and accessible assessment should be built into the process, alongside safeguards against avoidable harm and disruption to support. - Assessment of psychosocial disability over time
Assessment must account for fluctuating needs and less visible forms of assistance. It should consider the effort involved in everyday activities and the impact they can have on a person afterwards. Assessment must distinguish what someone achieves with support from what they can reliably sustain without it. - Recognition of consumer evidence
Consumers’ accounts must be treated as substantive evidence. Evidence should be weighted according to its relevance and the contributor’s knowledge of the person’s everyday life, rather than automatically privileging professional credentials. - Funded assistance and procedural fairness
Government must fund the assessments and evidence required to establish eligibility, with independent advocacy and peer assistance available where needed. The NDIA should reuse relevant existing information and provide accessible guidance. People must also have meaningful opportunities to correct errors and challenge decisions. - Transparent testing of assessment tools
Proposed assessment tools and associated scoring or thresholds must be tested with diverse consumers before implementation. Testing should examine whether they accurately identify psychosocial disability and whether particular groups are wrongly excluded. Consumers should be able to understand and scrutinise how the tools affect access decisions. - Accessible treatment and protection of informed consent
Permanence decisions must distinguish clinical improvement from functional support needs. Rules should prevent exclusion where treatment is not realistically accessible or appropriate, including where it has previously been ineffective or its likely benefit remains uncertain. Access requirements must protect informed choice and consent. - Clear responsibility across support systems
Governments must demonstrate that alternative supports are genuinely available and able to meet the person’s needs before existing support is withdrawn. Funded coordination and interim assistance are needed to prevent people falling through gaps between systems. The next National Mental Health and Suicide Prevention Agreement should clarify responsibility for psychosocial supports outside the NDIS and how they will be funded and held accountable. - Continuity of support and effective oversight
Existing support should continue during reassessment and timely review. Access decisions must not rely solely on automated scoring. Monitoring should begin with implementation and examine whether people are losing necessary support or being shifted to other systems. Findings should be publicly reported, with clear processes for addressing unsafe or systematically unfair outcomes.