More than 130,000 Australians living with significant psychosocial disability are currently receiving no support services, a situation described as a national failure driven by a stark postcode lottery.
A System of Extreme Inequality
The availability of crucial non-clinical mental health support varies dramatically between states and territories, according to a new report from the Grattan Institute. While the National Disability Insurance Scheme (NDIS) provides packages averaging $89,000 per year for approximately 65,000 Australians with psychosocial disability, those who don't qualify face a landscape of sparse and inadequate services.
Psychosocial supports are distinct from clinical treatment. They help people build social connections, manage daily life, and maintain stable housing, reducing the risk of hospitalisation or contact with the justice system. The report highlights that more people miss out on these supports altogether than receive them through non-NDIS government programs.
Seven-Fold Disparity in Service Access
The analysis reveals impossible-to-justify gaps in both who gets help and how much they receive. The proportion of the population accessing services in Queensland is seven times higher than in Tasmania. In the Australian Capital Territory, the rate is less than a third of Queensland's but still far exceeds states like New South Wales and Tasmania.
The intensity of support also varies wildly. In NSW, a small proportion of recipients get an average of nearly 340 hours of support per year. In Queensland, where access is broader, individuals receive less than 30 hours annually on average—a difference between an hour each day and an hour per fortnight. In the ACT, the average is closer to one hour per week.
A Roadmap for Fairer Support Without New Funding
The Grattan Institute report, authored by associate Mia Jessurun, argues that this inequity cannot continue. It proposes a solution: a new National Psychosocial Disability Program that could provide services to the 130,000 people currently missing out, and it can be achieved without governments finding new money.
This is possible due to a significant imbalance in current spending. Last year, Australian governments spent $5.7 billion on NDIS support for people with psychosocial disability. In contrast, expenditure on the entire rest of the mental health system, supporting millions, was around $13 billion. The report advocates for a slow rebalancing of these funds to create a more equitable system.
The proposed four-year program would establish a national workforce of support facilitators and increase funding for psychosocial supports, including services tailored for First Nations communities. It would build on existing best practices to deliver consistent support nationally, while allowing for local adaptation.
Despite a national cabinet commitment to bolstering these supports made almost two years ago, progress has been stalled by overlapping responsibilities and fiscal constraints. The report urges immediate action, stating the reforms are both urgent and achievable to create a system where access is determined by need, not postcode.
