Welfare and social services exist to help improve the wellbeing of people who need financial support or have multisystem needs. For people who manage complex presentations, such as those living with complex mental health issues, welfare and other social services can play a critical role in coordinating their care. Too often, these services are more geared towards physical illness and lack appropriate models to adequately assess and support mental health experiences. This creates inequity, unnecessary barriers, and can result in withdrawal from support altogether. Survey participants indicated that that interactions with staff/providers and inflexibility within the system itself, were driving perceptions of stigma and discrimination in this domain. Some participants explained that their applications for welfare and social services had been denied because of mental health issues that were deemed to be ‘too complex’ or they were told they were ‘not sick enough’. The Disability Support Pension (DSP) and National Disability Insurance Scheme (NDIS) were identified as incredibly challenging for people with complex mental health issues to access, navigate, use, and maintain due to a host of systemic barriers like changes to eligibility criteria. Concerningly, a significant proportion of participants endorsed concerns that their welfare benefits, disability pensions or disability schemes might be unfairly suspended or cancelled in the future. "It’s impossible to get a DSP and it is hard to gain evidence. I’ve felt that NDIS was never likely and have started and stopped applications. […] I manage [my] way through the system being polite and not asking for support I might be eligible for as I’m fearful it will come back to bite me down the track. It’s a punitive system and does little to understand individual need and is more and exercise of box ticking. – Our Turn to Speak participant, Victoria Creating systems that are compassionate, inclusive and responsive to the needs of people affected by complex mental health issues will help ensure that people can access the support they need. Further work is required to reform welfare and social services so that eligibility and assessment processes are inclusive of complex mental health issues and that they provide sustainable support for those who need it. Recommendations for action Provide training for client-facing staff and decision makers working for welfare and social services (such as Centrelink, Child Services and the National Disability Insurance Agency) to increase awareness and capability in responding to the needs of people living with complex mental health issues. Ensure advisory and governance groups overseeing the delivery of welfare and social services include people affected by complex mental health issues, embodying co-design principles. Reduce barriers to income support and social services support by: increasing flexibility for the Disability Support Pension to allow for increased engagement in the workforce without the threat of losing access to the pension; raising the rate of unemployment benefits to permanently align with the current standard of living and other welfare payments; increasing access to the National Disability Insurance Scheme (NDIS) for eligible participants living with complex mental health issues who meet the criteria; and improving access to information about available support services.
