Those responsible for implementing the NDIS should keep in mind the advice of a certain Roman emperor – “to make haste slowly”, says Frank Quinlan, the CEO of the Mental Health Council of Australia.
The NDIS and Mental Health: Make change quickly – but don’t rush
Frank Quinlan writes:
Around 27 BC, Rome’s first emperor, Augustus, began his reign and ushered in the period of Roman history known as Pax Romana – the Roman Peace – with a significantly expanded empire, and 200 years of relative prosperity and stability.
The Australian Government, together with the states and territories, is ushering its own “new empire” to ensure people who live with disability are able to take control of support they may need to enjoy the same opportunities as the rest of the community.
As the NDIS rolls out across the country, we should not underestimate the scale of welcome disruption that this reform will bring – after all, that is the point.
Previous government policy and service systems let down people who live with disability. Too often, services failed to empower people to take control of their own care. Too often, our systems prioritised the wrong kind of services. And too often, there was simply not enough funding released to make appropriate services available in a timely way.
If it is implemented successfully, the NDIS will disrupt and disturb our existing systems. In fact, it will turn them on their head.
The law will change; funding arrangements will change; the types of services available will change; the governance of organisations will change; the skills and abilities of the workforce will change; and people living with disability will have new and better choices.
Emperor Augustus’ advice to us is telling. Famously, Augustus’ motto was festina lente – usually translated to “make haste slowly”. As he led his armies on a relentless march into vast new territories and quashed civil unrest within the Empire, he implored his military leaders with the advice “what is done well enough is done quickly enough.”
In essence, if change is overly rushed, mistakes are made and good long-term results are not achieved.
It is a profound understatement to say that many people living with disability are anxious for change. But we have a responsibility as a community to ensure no one in need will be left without services before the new systems are in a position to operate effectively – we don’t want to leave people with no choice at all.
We owe it to those people and the community to make certain that our pursuit of change is not so enthusiastic that we actually increase hardships for people who are already disadvantaged.
This is particularly the case for those whose mental illness leads to psychosocial disability. For these people there are immediate challenges to be resolved for the NDIS to achieve its great promise.
Questions to resolve
There are an estimated 489,000 people living with serious mental illness in Australia, with 200,000 or more of these living with ongoing significant psychosocial disability.
By contrast, in laying the groundwork for the scheme, the Productivity Commission estimated that just 57,000 people with psychosocial disability would be eligible for the highest level of support through the NDIS. It is very hard to understand why these numbers should be so radically different.
So how will we ensure that those who are not eligible for the scheme, but whose needs are all too real, don’t miss out?
There are other critical questions that are just as pressing:
- How will eligibility for the scheme be resolved for those who experience episodic mental illness, or those who do not recognise their illness?
- What exactly constitutes the “reasonable and necessary” support that the scheme will offer?
- What supports and programs will be offered early to prevent people from progressing into permanent disability and lifelong support?
- What funding sustainable arrangements will ensure that psychosocial disability supports are available to people who are not eligible to access funded support under the NDIS?
If we don’t think through these questions in detail, we risk implementing a scheme that will fail some of the very people who the scheme was intended to assist.
Our pursuit of answers to these questions should be as determined and as relentless as Augustus’ expansion of the Roman Empire.
But if we are to build an NDIS that is lasting and effective we may be wise to heed the Emperor’s advice. Make haste slowly.
• Frank Quinlan is the CEO of the Mental Health Council of Australia, the peak body representing mental health organisations in Australia. He was previously the Executive Director of Catholic Social Services Australia, a peak national body for social services organisations providing social and community services to over a million people each year.