Above: ‘I talk about how I have made services redundant in my life,’ says Daniel. PHOTO COURTESY OF DANIEL REYNOLDS
By Daniel Reynolds Senior Peer Worker
It’s been great to work for an organisation that champions lived experience and values each individuals’ recovery journey not only for the person accessing our services but also our staff. Before coming into this role I worked in construction where I didn’t feel comfortable to bring my whole self to work. It wasn’t until I had finished uni and applied for a job with Flourish Australia that I understood what a Peer Worker was and how my lived experience of mental health issues is valued. In my role as a Senior Peer Worker I am involved in a number of different tasks including community engagement and intake where I assist people wanting to access our service through their NDIS plan. A major part of this has been supporting people to transition to NDIS from block funded programs that were ceasing, for example the Personal Helpers and Mentors program.
Flourish Australia Newcastle has been working in the NDIS framework for many years as we were the trial site for the rollout of the scheme in 2013. I will admit it has had its challenges but it has also given opportunities for service providers to provide support to a larger number of people and of course to people who never would have been able to access services under the old system.
The NDIS is a new way of funding support. Instead of the funding going directly to service PROVIDERS, it goes to the person, and THEY get to decide which support services they want to purchase. This means they are in charge, and they choose the supports that will enable them to live the life they want.
So essentially it is moving choice and control to the people, giving them the power to decide who they want supporting them. It’s also given people the opportunity to say to services that they aren’t happy with what is being provided because they have the ability to shop around to other providers to see who is providing a better service.
The Mind the Gap report that was released at the start of this year by the University of Sydney and Community Mental Health Australia noted some gaps when it came to people with a psychosocial disability applying for the NDIS. When I read through it, I related to four of these gaps in particular which I had come across very regularly in my everyday work. Mind the Gap can be found at http://sydney.edu.au/health-sciences/documents/mind-the-gap.pdf
In my role I have tried my best to fill these gaps around people’s understanding of the scheme, supporting them through the process and giving people the opportunity to have someone they can consistently rely on to answer questions about the NDIS process at any time.
These were some of the recommendations from the report around how we can best support people to access the scheme. When looking at these it was already something we had been doing in our day to day practice at Flourish Australia in Newcastle but the report had highlighted a lot of gaps where we all could be doing better to support people through this transition.
“One of the toughest conversations I can have…is explaining the difference between a psychosocial disability and living with a mental health issue.”
One of the toughest conversations I can have with people who are enquiring about the NDIS is explaining the difference between a psychosocial disability and living with a mental health issue.
I think this is a great and empowering peer conversation for some (not all)around what support we need within our day to day lives and how our mental health can impact on how we function in our home and in the community. So I sit with people most days and talk briefly about my journey and how I have made services redundant in my life as I don’t require any support other than that of the public health system such as my GP and psychologist.
So just to clarify, the NDIS will assess your needs based around your functional capacity not your mental health issues. I would not classify myself as having a psychosocial disability just because of my diagnosis. I feel a label has little to do with my ability to do things in the community but this is also because I have had a lot of support throughout my own recovery and I’m now at the point where I don’t need that support.
It’s also important to acknowledge though that many people may have had a very different journey to me. They may not have had the supports that I had when I first became unwell, supports which have led to my mental health issue having a different impact.
So the NDIS will assess you on these six domains: mobility, communication, learning, self management, self care and social interaction. This is where I see my lived experience as being valuable and going through these domains and explaining when I was unwell where I would have needed support. People relate to me in this situation on a very different level and I feel people are able to be more open when talking about their experiences with their mental health as some people do find the impacts challenging to speak about with someone they had only met five minutes ago.
For example the first one, mobility which majority of people including clinicians believe is more related to someone’s physical ability. From my own journey I know that my major challenge was leaving my room due to feelings of fear and anxiety. When I’m using examples like this from my own journey it clicks in people and they seem to understand a bit more how it can impact on them in ways they never thought of.
So I sit with people and go through the six domains and we talk about different tasks such as shopping, cooking, work, education, community access and what that looks like for them day to day. We break them down into steps and work out where they would need support.
Take cooking for example- we speak about budgeting and if that’s something they need support with. We speak about public transport and whether they are able to manage the timetable and feel comfortable on the bus. We speak about healthy choices and managing a healthy diet and if that’s something they need support with. There are so many elements to one task like shopping and so many things to take into account and this is the evidence that the NDIS requires… not just that they need support with shopping but why and what is stopping them from doing this without support. I’ve provided a story in the adjacent box as an example to illustrate what I mean.
The Challenge: Strengths versus deficits
One of what we call our ‘three vital behaviours’ at Flourish Australia is using ‘strengths based language.’ This is key to our role. But in regards to the NDIS this isn’t very helpful when it comes to providing supporting documentation for the application. I remember getting a call from a person at the NDIS telling me that my support letter for someone who had accessed our services for the last 16 years was no good because it was strengths based! They needed deficit language which kind of goes against everything I had studied and everything I do in my day to day work.
For me to write down something on paper about a person saying that they can’t do this task and can’t do that task, went against everything I believed in. The most challenging part is to sit with people and talk about a bad day and then write it down saying they can’t do these things because I knew they could with a little bit of support. Being honest and upfront with people made this process easier for me to accept and explaining to them this not about what they can’t do its about getting support around these tasks to achieve these goals. I feel being really open and transparent with people and writing that support letter with them and wording it how they wanted made it a much better process.
So you can see through my experiences that having a peer worker engage in conversations around the NDIS application process can have positive outcomes.
Psychosocial disability: It’s about ‘function’
When I was working with a young person who lived with schizophrenia he assumed that he would just get the NDIS straight away because that’s what someone had told him. I sat down with him and went through daily tasks like work (he had a part time job working in hospitality which he loved) we spoke about Education (he was completing his Diploma at TAFE) so looking just at these two activities I wasn’t sure he was able to qualify..
But then I started to ask him about looking after his home and doing other tasks like cooking and shopping. At first he mentioned that he was OK with all this because he was a proud, strong young person. Unfortunately he wasn’t able to do these tasks independently. After asking a few more questions I found out that he didn’t have the skills to cook a meal at home and relied on microwave meals, he also paid someone to come do his lawns and clean his home and this was due to experiencing ill mental health at home and he would retreat to his room for long periods of time. So when I asked him if he would like support around this he was unsure.
Change was a big thing for him and this would have to be a slow transition. So he returned in a few days and we wrote out a support letter for him together to take with him to the clinicians that supported him to show them where he recognised he would need support so they could complete the access request forms to the best of their ability. He currently is using his NDIS plan and part of that is with Flourish Australia and every time he is in the office he always comes up and thanks for me all the support I gave him throughout the process and always thanked me for understanding.
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