Aims of the session

• To learn about DisabilityCare Australia, the National Disability Insurance Scheme

• To explore how to prepare for DisabilityCare Australia• To reflect on how families can support practical goal

setting and choosing the supports and services that will best help people achieve their life plans

• To identify any supports and resources families might need

What is DisabilityCare Australia? Group Exercise

• Universal health care scheme• Comparing Medicare with DisabilityCare

Australia• Exercise – list features of Medicare

What is DisabilityCare Australia, the National Disability Insurance Scheme?

• Universal health care scheme• Has been implemented in other countries in the world

(eg Scotland) successfully and will be implemented here in Australia over the next few years

• There are many details of the NDIS still to be worked out • Focuses on those who are most in need who have a

permanent disability • Focuses on intensive early intervention • The NDIS will be launched at 4 trial sites from mid 2013

Current model of PDRSS service

Psychiatric Disability Rehabilitation Support Services & Carer Respite Services

• Supported accommodation• Community activities • Learning activities• Socialising activities• Sporting activities• Employment support• Housing support• Group learning • Family education• Personal development/recovery group learning• Breaks away from caring roles

Features of current model

• People are only entitled to services within the region that they live

• Services are funded to provide a certain number of hours of service

• The types of services don’t necessarily suit everyone• Not many services have catered to the needs of people

from diverse cultures

The DisabilityCare Australia model of service

1. Referral to DisabilityCare Australia

2. Assessment by DisabilityCare Australia• Assessment of eligibility

3. Planning and choosing services and support• Form a plan of what the person wants and needs to achieve independence• Must be ‘reasonable and necessary’• Establish an individual budget based on the plan• Identify and access services and supports with Local Area Coordinator

4. Review process• Review outcomes of support • Changes made as needed

Features of the DisabilityCare Australia model• Individuals can decide what types of services they need • Individuals can choose services that are not necessarily

in their local area• Individuals can choose services from mainstream

providers• Individuals can choose culturally appropriate, religiously

appropriate services

Principles that inform DisabilityCare Australia

Principles that inform DisabilityCare Australia• Individualism • Choice for the individual• Control for the individual

Current vs. DisabilityCare AustraliaService Delivery

Current System DisabilityCare Australia System

Individuals can choose from the services that are offered within the local PDRSS services and Commonwealth Respite Services for families

Individuals can decide what types of services they need and from a broader range of services

Catchment area bound Individuals are not confined to services provided within a given area

Services are funded to provide a certain number of hours of service

Length and intensity of service is provided according to need

The types of services that are available don’t necessarily suit everyone

Individuals have the option of seeking services from mainstream providers

Not many services have catered to the needs of people from diverse cultures, religious groups, varying sexuality

Individuals will be able to choose to purchase what they need from ethno-specific services and those who cater to the needs of different religions and sexualities

What does ‘reasonable’ & ‘necessary’ mean?

Supports and services;• Should support the individual to achieve their goals and maximize

their independence• Should support the individual’s capacity to undertake activities of

daily living to enable them to participate in the community and/or employment

• Are effective, and evidence informed• Offer value for money• Should reflect community expectations, including what is realistic to

expect from the individual, families and carers• Are best provided through an NDIS rather than through other

systems of service delivery and support

Carer support

Families can help the person take control by:• Knowing what helps them manage their illness• Knowing what they want from life and what they need so

they can reach their goals • Helping to find information about different options • Assisting the person to clearly communicate their choices • Knowing who else can support or advocate for the

person as they choose the support / services they need to help them reach their goals

Assessment & planning

• What support would be helpful for a family to provide in the assessment and planning process?

• What things would the family offer? • How could the family try and ensure that the person was

as involved as possible in making choices? • What would the family need to ensure they also feel

supported in this process?

Assessment & planning during acute illness

• Listen to what the person is communicating, both verbally and non-verbally – carers and families will often be able to “translate” some of the concerns and fears a person may have about the assessment and planning process

• Whenever possible, attend to the person’s preferences about how meetings or conversations are conducted: e.g., the person may only be able to tolerate short conversations, or may wish to sit outside rather than inside

• Draw on plans that were discussed or in place while the person was less unwell – that way their needs and choices can still be heard

• Carers and family may need to take a more active and assertive role if the person’s insight and judgement is affected

Assessment & planning during early recovery• Ask the person how they would like you to support them in

the process • Assist the person to access information about their rights and

the options that are available to them• Encourage the person to access advice or support from peers• Resist the urge to expect too much or too little: give the

person space to set their own goals and articulate their own needs

• Offer messages of hope and encouragement• Notice small achievements

Assessment & planning in established recovery• Encourage the person to take the lead in the process: ask if

they would like your support• Respect the person’s autonomy • Offer positive feedback • Notice small and large achievements

What makes a good life?

• Feeling well• Having good nutritious food that you enjoy• Having regular exercise that is enjoyable• Having something to do each day that is meaningful to you• Adequate, secure, affordable accommodation• Strong family support• Good friendships and relationships • A positive vision of the future life• Financial support to sustain a good lifestyle

Recovery factors

• Acceptance of illness• Hope and courage• Managing symptoms• Education• Reconstructing identity and purpose• Supporting others• Choice, responsibility, control and empowerment• Meaningful activity• Advocacy

(Pat Deegan)

Reflective exercise

Take a moment to reflect on what you know about the person you care for. Discuss with the other person:

• What areas do you think they have made small progress in already?

• What areas have they made large progress in?• What types of questions could you imagine using in a

conversation with your family member to prompt conversation about issues?

• Which areas that we have identified do you think will be a priority for them?

• Do you have ideas about what you think would be the most helpful types of support and services that might be able to be purchased through DisabilityCare Australia?

Change

• ‘You can’t change other people – you can only change yourself’

• Changes to our own communication and actions may result in more effective support for the person with the mental illness and more effective care for ourselves as carers

New Strategy for Carers

• Change in Thinking

• Change in Behaviour

• Change in Results

• Learning current information about mental illness• Learning new communication skills• De-stigmatising mental illness• Learning about the biological/psychological/social

model of mental illness

• Using new communication skills • Using new assertiveness skills• Considering own limits • Seeking biological support if necessary• Seeking psychological support• Seeking social support• Implementing a Wellness Recovery Action Plan• Managing change and helpful interventions

• Recovery & hope• Improved relationships• Increased independence• Less family stress• Increased Wellness• Better chance of sustained recovery

Examples of life domains

• Family – How do you want your family to feature in your life? • Physical and mental – What fitness or health goals do you want

to achieve?• Social - How do you want to enjoy yourself and with whom?• Creativity - Do you want to achieve any artistic or creative goals? • Work - What do you want to achieve?• Financial - How much do you want to earn, by when? How is this

related to your career goals?• Education - Is there any knowledge you want to acquire in

particular? What information and skills will you need to have in order to achieve other goals?

• Advocacy/volunteering - Do you want to make the world a better place? Do you want to be involved in a social cause? If so, how?

Being an effective advocate

1. Know what the person needs to achieve their life goals; and know what you (as a carer/family member) need to support their goals. Be ready to talk about this

2. Know about the most effective service providers and be ready to offer advice or information when required

3. Know about the rights of the person with mental illness and your rights as a carer