The National Disability Insurance Scheme (NDIS) and mental health: A policy analysis

The National Disability Insurance Scheme (NDIS) is a landmark policy commitment made by the Australian Government in 2013. The NDIS has established market mechanisms to support the delivery of services that, according to the National Disability Insurance Agency, offer participants both choice and control. The NDIS is also remarkable as being the first disability policy that has included mental health (referred to as psychosocial disability). There is a large financial commitment to delivering the NDIS, with a projected $22 billion investment by 2020 when full national roll-out is achieved; it is therefore necessary to analyse if the policy is effective in delivering the outcomes it promises. The aetiology of impairment in mental health conditions is largely positioned within the social, economic, systemic and political environments, the primary impact of which can be observed as stigma. This aetiology of impairment necessitates that policy promising to offer a better life to people living with mental health conditions, must have ecological frameworks central to policy mechanisms. It is imperative to understand what the NDIS policy foundations are to analyse if it is a viable alternative to current service delivery for people living with mental health conditions. A policy analysis is presented in two parts; firstly, a discourse analysis is undertaken that provides an historical context to the problem and further identifies the theoretical assumptions embedded in the policy foundations. Secondly, an analysis of the effectiveness of the NDIS in achieving its desired outcomes for psychosocial disability is measured against economic and social criteria. It is identified that the NDIS is a policy founded on strong neoliberal ideologies and whilst an ecological perspective is occasionally cited within policy material it is not supported within a market driven service delivery model. Due to the NDIS rollout being in its infancy there is a dearth of research around its effectiveness, this policy analysis identifies that there is a critical need for such research. Future research must specifically focus on outcomes for people with mental health conditions to advise on the need for ecological frameworks as an economically efficient and socially inclusive alternative