J Redwood – 02/10/2021

This requirement does not take into account that a person with a psychosocial disability may not be capable of undergoing appropriate treatment precisely because of the psychosocial disability.

For example: I have a psychosocial disability. It has taken exactly 50 years since the first symptoms appeared to get the right diagnosis. A diagnosis by a psychiatrist, psychologist or GP is nothing more than an educated guess based on what they see and what the person can tell them. Sometimes a person with a psychosocial disability cannot put into words what they are experiencing and cannot engage in appropriate treatment.

I have Complex PTSD and it is only this year that this diagnosis has been given. PTSD was diagnosed in 2017 and only then did I begin to be able to access appropriate treatment. Prior to that I couldn’t because I didn’t know what was wrong with me, just that nothing worked. Doctors guessed and I tried lots of things but none of it was appropriate. I consented to Electro Convulsive Therapy to treat my depression. Would this be expected for people with this diagnosis? It is a recommended treatment. What if a person refuses? Do they blow their chance for NDIS funding?

Until I understood my diagnosis I did not realise that the gender of a health practitioner would affect whether I could undergo treatment from them. With my PTSD I dissociate. I spent about 30 years in a semi-dissociated state in which I could not engage in treatment. As a result of my PTSD I have ended up homeless twice and again unable to undergo appropriate treatment.

One of the problems with some psychosocial conditions is that the most appropriate treatment comes at a great cost. There were times when I could not afford the medications recommended, to see within a reasonable amount of time a specialist or to pay for hospitalisations.

Psychosocial conditions are not catered for well in the public health system which is focused on life threatening situations, not ongoing treatment, wellbeing, behavioural improvements, emotional strengthening and capacity building. Unless you are an immediate threat to yourself or others, there is no place for you in the public system. 10 psychologist appointments a year is monumentally inadequate. I saw a therapist weekly for 5 years to get to the point where diagnosis was possible and this therapist was not a psychologist so not funded by anyone despite being the most appropriate treatment for my condition at that time.

It is not always possible for a person with a psychosocial disability to undergo appropriate treatment. If you can’t leave the house, how do you engage in treatment? If you believe you will die if you take medication, how do you satisfy this requirement of undergoing appropriate treatment? If the ultimate solution to your condition is to leave an abusive partner, what happens if you can’t?

There are too many variables and individual idiosyncrasies, triggers and behaviours that help with coping that are to others bizarre, clearly unhelpful or illogical that interfere with a person’s ability to undergo or have undergone “appropriate treatment for the purpose of managing the person’s mental, behavioural or emotional condition.” With a psychosocial disability logic and facts are irrelevant and cannot override fear. Undergoing treatment may be the logical thing to do, but it may not be possible and I do not believe people should be excluded from NDIS funding because of this. It actually goes in direct opposition to the intent of the scheme.

Yes, but a person with a psychosocial disability may be unaware of WHY they can’t do something or HOW it relates to their disability.

I didn’t know I dissociated and that this was why I never remembered things like doctor’s appointments, what shopping I needed, when I last changed the sheets on my bed, what day rubbish bins are collected and so many other things. All I knew was that I couldn’t remember them.

One of my children has a psychosocial disability and has had for over 10 years. They could not put their clothes away and just didn’t. They needed help to do it. They worked it out two weeks ago that the drawers were a trigger from their traumatic past and that’s why they couldn’t do it.

With psychosocial disabilities, particularly trauma related ones, it is perfectly possible to know what you can’t do and need help with, without having a clue why or how it relates to your disability.

Perhaps an unexpected consequence could occur in a situation that I am familiar with. A child has an early intervention NDIS plan. The parent is on an NDIS plan because of a psychosocial disability. Is it conceivable that this parent could considered to NOT be the “most suitable person to be the child’s representative?”

This parent has challenges in many aspects of their day-to-day life and requires considerable support. They are, however, absolutely clear and focused on the welfare, development, medical health, care and emotional wellbeing of their child. Is it possible that their intense concern for their child and determination to provide the absolute best possible assistance for them could be interpreted as a psychosocial overreaction to the situation? Could it be viewed as a negative and detrimental preoccupation that results in this parent again being seen as NOT the “most suitable person to be the child’s representative?”

Thirdly, I am concerned about what might happen in this same scenario when the practitioners involved do not agree on diagnosis and treatment options? At this point in time, the child concerned is younger than 3 years old and being so young, official diagnoses are still being investigated. The child displays difficulties that are clear to their parent, the occupational therapist that they see and their medical specialist, but their paediatrician, daycare providers and the local doctors in the Emergency Department, which has been required on many occasions, do not agree with the parent.

As a consequence of this, the parent is forced to decide whose advice to follow. Is it possible that the parent could be seen as NOT the “most suitable person to be the child’s representative” if they choose one course of action instead of another and a practitioner challenges this?

I searched high and low and could not find any reference to ín-kind’supports. As a result I do not have anything to say, though I might have if I understood what this question was referring to.