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Reforming the National Disability Insurance Scheme (NDIS) continues to face major hurdles, with one of the most contentious issues being who is responsible for funding and delivering disability supports for people who do not qualify for the scheme.
The Hawkesbury LGA had an estimated population of around 67,500 people in 2021 with about 5.6% of Hawkesbury residents were identified as living with disability in the 2021 Census. This means a significant number of residents are likely to be impacted by any changes to the NDIS.
These current services being targetted for reform are known as “foundational supports”. They are disability-specific programs for people who sit outside the NDIS. While some progress has been made for children with developmental delay and autism including the federal government’s planned Thriving Kids initiative from mid-2026, there has been little movement when it comes to adults with psychosocial disability.
Psychosocial disability can result from mental health conditions such as schizophrenia, major depression or post-traumatic stress disorder, and can significantly affect a person’s ability to function in everyday life.
A new report from the Grattan Institute argues Australia could establish a national system of psychosocial supports within five years without spending additional money, if governments adopt a clearer vision and better coordinate existing funding.
What are psychosocial supports?
Psychosocial supports are non-clinical services that help people with mental health challenges live independently and participate in their communities. They include programs to build social connections, develop daily living skills, and maintain stable housing.
Without these supports, people face poorer quality of life, social isolation, reduced employment opportunities and long-term economic costs.
The scale of the problem
In 2023, almost 223,000 Australians aged 25 to 64 were estimated to have a significant psychosocial disability.
Only about 58,000 received support through the NDIS, which spent more than $5.8 billion on this group in the past year. The majority of people with significant psychosocial disability do not meet NDIS eligibility criteria, leaving around 130,000 adults with no formal support.
Access to non-NDIS psychosocial programs varies widely between states. The Grattan Institute found a seven-fold difference in access, with Queensland offering the highest coverage and Tasmania the lowest. The type and intensity of services also varies sharply, creating what advocates describe as a “postcode lottery”.
A proposed national solution
The Grattan Institute report proposes a new national program of psychosocial supports for people outside the NDIS, commissioned through Primary Health Networks (PHNs) in partnership with local providers, hospitals and community organisations.
The proposed services include:
- support facilitation to help people navigate mental health and disability systems
- community participation programs such as clubhouses and activity groups
- family education and support
- assistance with housing, tenancies and daily living skills
The report argues this approach could deliver more consistent access across Australia while reducing pressure on the NDIS.
A rights-based critique: “This is not just a funding problem”
A Hawkesbury Gazette contributor and disability rights advocate Sarah Langston has raised serious concerns about this approach, arguing it misunderstands the purpose of the NDIS itself.
“The NDIS is not just a funding program,” the contributor says. “It is how Australia gives legal effect to the UN Convention on the Rights of Persons with Disabilities.”
Under the NDIS, people with disability have a legal right to individualised supports based on their own needs. These supports are meant to be personal, portable and enforceable in law not dependent on whether a local program has remaining funds.
The proposed shift to a separate psychosocial support system, Langston argues, risks reversing this principle.
“Creating a parallel psychosocial program would move people away from statutory rights and back into a welfare-style system,” they say. “Supports would depend on local budgets, service availability and postcode, rather than a person’s actual needs. That is exactly the old model the NDIS was designed to replace.”
Langston also questions the evidence base behind many existing psychosocial programs, arguing they are often delivered by large non-government organisations at low cost, with limited accountability to disabled people themselves.
“Many of these programs are not endorsed by the people they are meant to serve, and evidence about their effectiveness is often weak or selectively presented,” Langston say.
A rights issue, not an administrative one
While the Grattan Institute report frames exclusion from the NDIS as a systems and funding problem, the Hawkesbury Gazette Sarah Langston argues it is fundamentally a human rights issue.
“People with psychosocial disability are being locked out of a system that is meant to recognise them as rights-holders"
Langston also challenge the claim that reform can occur without additional funding, pointing to pressures already facing the sector, including rising costs, staff shortages and NDIS price caps that fail to cover providers’ expenses.
“Shifting money around inside an already strained system does not fix these pressures,” Langston says. “It risks making access even more uneven.”
“Rights, not welfare”
For disability rights advocates, the concern is that discretionary programs, no matter how well-intentioned, cannot offer the same protections as legislated entitlements.
“In the disability rights movement there is a long-held war cry: ‘rights, not welfare, we want supports that are guaranteed, cannot be rationed, and cannot be taken away.”
Langston and others argue that the original promise of the NDIS, championed by former prime minister Julia Gillard, must be defended if Australia is to meet its obligations under the UN Convention on the Rights of Persons with Disabilities.
“Real reform means honouring individualised, legally enforceable supports for all disabled people, not replacing them with cheaper parallel programs.”
Where Hawkesbury locals can get help with the NDIS
Disability Advocacy NSW (Nepean Blue Mountains region) and includes Hawkesbury. This service offers free individual advocacy support (including help with NDIS access, plans and appeals). Contact via phone or email (02 4708 3047 / 1300 365 085)
This article draws on research by Sam Bennett, Disability Program Director at the Grattan Institute; Mia Jessurun, Associate; and Reilly Polaschek, Associate, originally published by The Conversation, with additional local commentary and service information for Hawkesbury residents.
