Unpacking Psychosocial Disability and the NDIS

Margaret Springgay

Psychosocial Disability defined:

“ a term applicable to mental health to describe

the disability experience of people with

impairments and participation restrictions

related to [mental] health conditions. These

impairments and restrictions include reduced

ability to function, think clearly, experience full

physical health and to manage social and

emotional aspects of their lives”.

NMHCCF: Unravelling Psychosocial Disability

...the best outcome for people experiencing such disability will be achieved through supports that mitigate the effects of impairment or participation restriction and enhance the social and environmental opportunities to expand their capabilities.

The burden of disease and injury in Australia 2003. AIHW

Executive functioning: is an umbrella term for the management (control) of cognitive processes to enable planning, problem solving and, and execution of plans.

Working memory: has been described as the temporary "online" storage and the subsequent retrieval of information.

Episodic memory: is a category of long-term memory that involves the recollection of specific past & future events, situations and experiences. Past memories, play an important role in your self identity. – your first date; first day at school. Includes Prospective memory.

Visuospatial/problem solving: the sense of "whereness" in the relation of oneself to one’s environment and in the relation of objects to each other

IQ: intelligence quotient, or IQ, is a score designed to assess intelligence

Verbal ability: the cognitive ability to use and understand language.

Fluency: means the flow with which word, and phrases are joined together when speaking. "Fluency disorders" include pressured speech - florid speech.

Sustained attention: ability to focus on specific stimuli." cognitively activityrequiring sustained attention e.g. reading a newspaper. One must be able to focus on the activity of reading long enough to complete the task.

Problems occur when a distraction arises and interrupts and interferes in sustained attention.

The funding programs are as diverse as the various countries where they have been introduced. eg UK [Scotland, Wales, England, Ireland], Canada, USA, Australia, Netherlands etc

Various funding models:

1. Direct to individual

2. Fiscal intermediary [USA] – may assist in eg tax filings

3. Family host agencies [Canada – Vela Microboard] www.microboard.org/index

70-80% in USA go through a host agency

Vast majority of literature – big increase in qol, +ve outcomes, satisfaction, independence

Individualised Funding: A summary review of its nature & impact, and key elements for success. Robbi Williams 2007

Personal Capital - a person’s resources in themselves and their ability to assert themselves, inner strength and resilience

Knowledge capital – a person’s skills, knowledge and ability to use their knowledge for action

Material capital – a person’s resources and material goods

Social Capital – a person’s relationships and connections

Level of Capital

Level of Personal Capital

Significant Capital

Ability to be assertive, strong identity, ability to make decisions, confident in self-determination, control over physical environment

Reasonable Capital

Can make significant decisions known. Limited understanding of their identity, reasonable sense of confidence, reasonable control over physical autonomy

Fair Capital

Require support with decision making, limited self advocacy, limited understanding of own determination / direction including wishes & needs

Low Capital

Little personal capacity in making major decisions, limited communication, limited autonomy over physical space and limited ability to create direction [i.e. set goals]

Personal Capital [continued]

Risk High

1. Reduced cognitive capacity

2. Poor communication

3. Family not involved

4. Homelessness or living with potential exposure to people who are likely to exploit

Robbi Williams 2013

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