Abstract
In 2020, the NSW Ministry of Health (the Ministry) contracted Flourish Australia, a community managed organisation (CMO), to establish the NSW Health National Disability Insurance Scheme (NDIS) Mental Health Officer (NMHO) Program. The aim of the program was to build capacity among Local Health District (LHD) and Specialty Health Network (SHN) mental health staff to assist people with psychosocial disability to access the level of NDIS support and coordination they need to stay well in the community. The NSW Ministry of Health commissioned UNSW Sydney to evaluate the effectiveness, processes and value for money of NMHO. Key evaluation findings NMHO was effective in the following ways: • Strengthened the mental health–NDIS interface. Facilitated access for consumers who would otherwise face significant barriers, improved the quality of evidence and NDIS plan appropriateness, supported effective NDIS plan utilisation and built lasting capability within the mental health workforce. • Built mental health workforce capacity. Clinicians approached NDIS processes with greater confidence, clarity and accuracy; multidisciplinary teams incorporated NDIS considerations earlier and more systematically. • Improved access and utilisation of NDIS plans. Improved the identification of eligible consumers, strengthened the quality and completeness of access documentation and removed delays and uncertainty of clinicians about the process. • Facilitated appropriate NDIS plans. Worked with clinicians to improve the clarity and completeness of evidence, engaging community services and providers to ensure plans appropriately reflected consumer needs. • Maximised NDIS plan utilisation and adjustments. Assisted multidisciplinary teams with consumers to use their NDIS plans and make adjustments when support was insufficient or changed. • Greatest achievements occurred where NMHOs were embedded within clinical teams, impacts were strongest with coordination and service navigation. Consumers with complex support needs experienced some of the greatest benefits from the NMHO model (e.g. consumers with comorbidities, limited informal support, or who experienced disengagement from services with complex support needs). • Achieved value for money. Delivered a substantial volume of activity across consumer navigation of NDIS, clinician capacity-building and system integration functions. These outputs aligned with the intended design of the NMHO role and demonstrated the breadth of support provided within mental health services and the NDIS interface. Next steps: Implications for future NMHO implementation The evaluation demonstrated that NDIS plan challenges primarily arose from system-level constraints at the mental health-NDIS interface. Future NMHO implementation could address these structural gaps by strengthening coordination across service systems. 1. Enhance capacity of rural and remote LHDs. Rural and remote LHD constraints included limited provider availability, workforce shortages, and geographic distance, shaped achievable outcomes independently of NMHO. Complementary strategies, such as the expansion of telehealth, development of a local psychosocial workforces, and broader NDIS market reforms may support NMHO effectiveness in these contexts. 2. Effectiveness indicators to reflect NMHO scope and complexity. Several high-impact aspects of NMHO work, such as prevention of failed discharge or resolution of complex coordination barriers were not captured through NMHO activity counts alone. Future monitoring could prioritise program monitoring indicators of process quality, workforce capability development and complexity-adjusted workload, alongside quantitative activity measures. 3. Consider the NMHO role in the interface with the broader system. Emerging NDIS reforms about psychosocial supports and pathways will have implications for the NMHO functions. The reforms potentially align with NMHO function and goals. Refining the NMHO role in the context of these reforms requires consideration of role clarity, funding responsibilities, and interaction with other NDIS navigator initiatives.