Mental Health, Homelessness, Housing and the NDIS

Tina Smith

Senior Policy Advisor – Sector Development

Homelessness NSW 2016: Some Home Truths Conference

29 April 2016

Acknowledgements

MHCC acknowledges the traditional custodians of the land and values the lived experience of people recovering from mental distress both past and present.

MHCC acknowledges people’s experiences of:

• A mental health condition

• Recovery

• ‘Participation’ in the National Disability Insurance Scheme (NDIS).

Mental Health Coordinating Council

• Peak body for non-government community managed

organisations (NGOs/CMO’s) working in mental health in

NSW

• Established in 1983, Incorporated in 1986

Our Vision

People with lived experience are the drivers of positive change in

all mental health services and mental health reforms

Our Purpose

To build the capacity and ability of community organisations to

support people on their recovery journeys

MH and Housing/Homelessness

• Mental health & homeless prevalence is high and especially

for young people

• Access to stable, affordable and safe housing is essential to

recovery from a mental health condition

• MHCC has been working in regards to these issues for many

decades (eg, HASI, JGOS, MH Housing Agreement, training

of FaCS DoH and SHS staff)

• While change has occurred it has not been sufficient

• Not just more services but fundamental changes to the way in

which services are provided are required

• Significant sector reform is underway (MH, housing/homeless,

disability & more … )

Mental Health Reform

NSW

• Establishment of NSW Mental Health Commission (2012) & ‘Living Well’ strategic plan (2014)

• Ministry of Health ‘Strengthening MH in NSW’ (2014)

• ‘One Year On’ reports (2015)

National

• National MH Commission review (2014)

• Government response to review (2015)

• New role for Primary Health Networks in the ‘commissioning’ of services for people affected by MH conditions

NSW MH Strategic Plan

Five reform priorities of ‘Living Well’:

1. More consumer and carer involvement in decisions about care and service delivery

2. Shift towards more care and support in the community

3. Increased focus on prevention and early intervention

4. Different organisations and services needing to work together better (including health, mental health, justice, housing, employment, education, community services and local

government sectors)

5. All organisations considering and including mental health issues in their policies, decision making and services

Housing/homeless directions ….

• Living Well - Working together to deliver person-centred care– 6.1 Integrated care - Strengthen referral pathways to community living supports for

eligible for social housing and corrections clients

– 6.4 Housing & homelessness - Link2Home state-wide homelessness information and referral telephone service

– 6.4 Housing & homelessness - Investigate existing therapeutic housing/accommodation models in the context of the expansion of community-based care.

• Strengthening directions for the 2011 NSW Housing and MH Agreement (District Implementation and Coordination Committees)

• Numerous local projects including:– Like Minds pilot – Western Sydney & Nepean Blue Mountains (NSW Ministry of

Health funded innovation)

– St Vincent’s Health Network - development of an ‘urban partnership’ for integrated care (NSW MH Commission funded reform readiness project)

Building Community MH Support

New initiatives include:

Enhanced Adult Community Living SupportsHousing and Accommodation Support Initiative (HASI) expansion for 500 people

Pathways to Community Living InitiativeCommunity living supports for 100/460 people in hospital

Like Mind Pilot ExpansionMurrumbidgee and then Western NSW

Further NSW ‘Partnerships for Health’ and other reforms?

Commonwealth Joint Standing Committee on the NDIS

(2nd report November 2015, pp 88/89)

“The lack of a final approach has not prevented people with psychosocial disabilities from entering the Scheme or receiving services.

However, similar to ILC and housing, the committee is not in a position to assess the approach taken with regard to how mental illness as an issue is treated within the Scheme until there are some concrete decisions made.

The committee intends to consider the issue in significant depth throughout the next 12 months.”

National Disability Insurance Scheme

• NDIS and MH Partnership Project

– MHCC partnership with the NSW Mental

Health Commission from June 2013 to

explore and understand the NDIS from a

MH perspective

– 10 Community of Practice (CoP) Forums

have been held to maximise learning

– MHCC is developing additional resources to

support state wide roll-out

• At the end of December 518 people in

NSW and 1,406 national with a primary

psychosocial disability had accessed the

NDIS

NDIS Access

• Access issues for people with MH conditions being explored through trial experience and also a national project

• One of the largest barriers is lack of affordable housing

• NSW Ombudsman’s report ‘Denial of Rights’ (2012)

• Many people at Morisset Hospital eligible for NDIS but unable to exit due to lack of affordable housing

NSW Roll Out

Focus is on transition of ADHC funded clients

NSW ‘new entrants’

This includes Commonwealth funded MH program clients (ie,

PIR, PHaMS, D2DL, MH Carer Respite)? Other new entrants are

to have ‘urgent and exceptional’ needs.

Q1 Q2 Q3 Q4

2016/17 1,563 1,526 1,634 1,755 6,567

2017/18 6,107 6,138 6,405 5,999 24,650

Subtotal 31,217

2018/19 n/a n/a n/a n/a 26,404

Total 57,621

NDIS ILC Consultation Draft (December 2015)

Information, Linkages and Capacity Building (ILC) is for people ineligible for funded services and supports ….

“… the (National Disability Insurance)Agency does not consider there is sufficient clarity to be able to detail the exact role of ILC and the ways in which it will interact with the broader mental health system in this Consultation Draft. The Agency will continue to work closely with the Australian Government as these (national mental health sector) reforms progress”.

National MH Reform

Nine key areas of reform:• Locally planned and commissioned mental health services

through Primary Health Networks, and an associated flexible funding pool

• A digital mental health gateway• Refocusing primary mental health care programmes and services

to support a stepped care model• Joined up support for child mental health• An integrated and equitable approach to youth mental health• Integrating Aboriginal and Torres Strait Islander mental health and

social and emotional wellbeing services• A renewed approach to suicide prevention• Improving services and coordination of care for people with

severe and complex mental illness• National leadership

Thank you for listening

Would your organisation benefit from becoming an MHCC member

info@mhcc.org.au

Training

FaCS Housing NSW (2014 – 2016):

• Contributed trauma content for Housing NSW to develop an eLearning course for CSOs and managers

• Developed 1 day customised trauma informed care and mental health workshop for CSOs and managers (17 courses in Sydney, Hunter, Wagga, Queenbeyan and Wollongong)

FaCS Specialist Housing Services (2012 – 2016)

• 8 Mental Health Connect courses

• 9 Understanding and Responding to Trauma (2 days)

• 4 Trauma Informed Care in Practice for managers (1 day)

• Courses held in Sydney, Wagga, Port Macquarie, Queenbeyan and Dubbo