This report has been written as an educative and evidenced based document to inform the people responsible for the rollout and sustainability of DisabilityCare Australia (National Disabilities Insurance Scheme or NDIS) concerning the needs of Carers and Families of people with Tier 3 mental health disabilities in Indigenous regional centres, and rural and remote communities in Western Australia.

Reflections

• If the NDIS is rolled out homogeneously across Australia it will fail. If the NDIS fails to adapt to Indigenous kinship, social, traditional and cultural imperatives it will also fail to impact on the most highly disadvantaged and socially excluded people in Australia. This is especially the case for carers and families of Indigenous people with psychiatric disabilities.
• The Arafmi visits to rural, isolated and remote Western Australian Indigenous communities have identified serious issues in relation to the ability of carers and families to support people especially, but not exclusively, during critical episodes of acuity. Carers and families acknowledge they have very few skills to support people with a psychiatric disability; they have identified that they require education, training and support infrastructure within actual communities, and not infrequent visits from the outside by service providers. Many carers and whole families are becoming mentally unstable and ill as a result of their inability to cope with their roles. This is a major issue in these communities that needs to be a very high priority for the establishment of the National Disabilities Insurance Scheme.
• The NDIS framework needs to be highly flexible, based on person centred planning and adaptable to the wisdom of local kinship, social and cultural imperatives including traditional practices. Indigenous people need to be included and trained in real decision making when it comes to applying and managing the NDIS for individuals with a psychiatric disability within their communities. The issue is not always about the individual but the contextual framework of the Indigenous community and their traditional values and belief systems.
• The NDIS needs to tap into the complexities of Indigenous culture, existing sector knowledge and expertise and to identify practical solutions and innovative approaches that will assist Indigenous people with mental health disability, their families and carers, the disability workforce and disability service organisations or segments of this population in managing issues of NDIS transition when it occurs. We may have to re-think our entire approach to these challenges and we should be open to this. The risk is that if we don’t, the scheme may fail Indigenous Australians with psychiatric disabilities, their carers and families, and perhaps other people with other disabilities. To achieve NDIS integration Indigenous people need to be at the centre of the planning, implementation, management and administration of the NDIS in regional areas and remote communities. An exclusive service provider model will most probably not work. Indigenous ‘ownership’ of the NDIS is imperative if the aims and objectives of this scheme are to be achieved.