When the Productivity Commission recently released their draft report into mental health, there was a somewhat surprising focus on structural issues – particularly the role that the social safety net plays in supporting people with mental health conditions, their family members and carers. This is a particularly important issue for women, who have higher rates of diagnosis of mental health conditions and are more likely to be in unpaid caring roles. In today’s analysis, Yvette Maker of the Melbourne Social Equity Institute provides a summary of the draft report’s main concerns and what will be needed for the final report to make a real difference to current government policy trends.

The Productivity Commission’s Draft Report on Mental Health identified numerous problems with the eligibility requirements for people claiming income support on the basis of disability or caring responsibilities. The report recognises that many mental health consumers and people with psychosocial disabilities, and their carers and supporters, are falling through the social safety net. Substantial reforms are proposed to tackle this, although some issues remain unaddressed.

Recent changes to DSP eligibility for people with mental health conditions

Australia’s social security system makes provision for income support payments for some people with disabilities or medical conditions and the family members and friends who assist them with care or support. These payments are provided on the basis that a person’s disability or medical condition, or their caring responsibilities, preclude them from supporting themselves through paid work.

Many people claiming these payments do so on the basis that they, or the person they provide care and support to, have a diagnosis of a mental health condition or psychosocial disability. Recent reports show that a growing proportion of people claiming Disability Support Pension have a ‘psychological/psychiatric’ condition listed as their primary medical condition. Tightening of the eligibility rules for accessing Disability Support Pension mean a growing number of people who would previously have qualified can now only access Newstart Allowance. It is now widely agreed that the current rate of Newstart is grossly insufficient. Newstart claimants (along with some younger Disability Support Pension claimants) are also generally required to meet ‘participation requirements’ or ‘mutual obligations’ such as paid work, job-search, work experience or training via a Jobactive or Disability Employment Services provider. Failure to do so can result in payment suspensions. The reduced financial security can further exacerbate mental distress.

People claiming Carer Payment are not obliged to fulfill these kinds of participation requirements, although they will only be eligible for payment if they are providing ‘constant’ care and engage in 25 hours or less of paid work, training, education or volunteering per week.

The Productivity Commission report

The shortcomings of the income support system for mental health consumers and people with psychosocial disabilities, and their carers and supporters, were the subject of discussion and recommendations in the Productivity Commission’s Draft Report on Mental Health published last week.

The lengthy report identifies several problems with the existing system of determining eligibility for both Disability Support Pension and Carer Payment, and the employment support system for Newstart Allowance claimants who are required to look for work or meet other participation requirements.

The Productivity Commission’s draft report says keeping people with mental health conditions and their carers off of the Disability Support Pension is shortsighted and counterproductive. Photo by picjumbo.com from Pexels — The Productivity Commission’s draft report says keeping people with mental health conditions and their carers off of the Disability Support Pension is shortsighted and counterproductive. Photo by **picjumbo.com** from **Pexels**

The Productivity Commission describes income support as ‘an important safety net’ and suggests that many mental health consumers and people with psychosocial disabilities, and their carers and supporters, are falling through that net because they cannot access adequate income and employment support. This creates real risks of poverty and hardship. Recent NATSEM research commissioned by the Australian Federation of Disability Organisations confirmed that households with a member with disability claiming either Disability Support Pension or Newstart are much more likely to experience financial hardship and insecurity than Australian households generally.

Carers’ advocacy organisations have expressed their concern about the implications of these findings for all members of households, and raised other concerns about the availability and adequacy of Carer Payment in submissions to the Productivity Commission inquiry.

The Productivity Commission flagged a range of problematic aspects of the current system. These included:

the requirement that carers be providing ‘constant’ care does not capture situations where lower or fluctuating time commitments nevertheless impact a person’s ability to sustain employment;
the Adult Disability Assessment Tool (ADAT) used to measure the type and intensity of care being provided does not accurately capture the responsibilities of mental health carers;
the instruments used to assess the level and nature of employment support that a Newstart Allowance claimant should receive are not tailored to the needs and circumstances of people with mental health conditions;
service providers, advocacy groups and service users have raised serious concerns about the effectiveness of mainstream employment services for this group;
the Targeted Compliance Framework used to penalise Newstart Allowance claimants are deemed to have not met their participation requirements is inflexible and has ‘adverse impacts’ on claimants; and
the eligibility criteria for Disability Support Pension, including requirements that the person’s condition be ‘fully diagnosed, treated and stabilised’, may preclude people with fluctuating conditions and those who cannot or do not access treatment.

In response to some of these issues, the Productivity Commission’s draft recommendations include:

expanding access to Carer Payment to those with ‘regular’ but not necessarily ‘constant’ responsibilities;
giving carers greater scope to participate in paid work or volunteering by moving from a 25-hours-per-week test to a more flexible 100-hours-per-month test;
reviewing the test used to measure carers’ care responsibilities to better capture the nature of caring for someone with a mental health condition;
improving the assessments currently used to determine the level and nature of employment support for people with disability claiming Newstart Allowance;
introducing greater flexibility in the application of the Targeted Compliance Framework; and
assessing whether the Job Plans that set out Newstart claimants’ participation requirements are sufficiently customised to the person and are not simply an exercise in compliance.

The Commission identified other issues of widespread concern in the sector but declined to make recommendations about them. This perhaps reflects the Commission’s focus on supporting the employment of mental health consumers and people with psychosocial disabilities which, while crucial in light of the discrimination and other barriers that often impede people’s workforce participation, must be accompanied by real social protection.

For instance, the Commission noted the submissions it had received about the inadequacy of the rate of Newstart Allowance but declined to recommend that this be addressed directly. It also discussed the difficulties that some Disability Support Pension claimants may face in establishing that their condition is ‘fully diagnosed, treated and stabilised’, but did not recommend reforms to the eligibility criterion. Finally, the report did not recommend a review of the rate at which Disability Support Pension is paid, despite the growing evidence of its insufficiency.

Clear and comprehensive recommendations needed

It is promising that the Commission has identified many of the fundamental problems with income support for mental health consumers and people with psychosocial disabilities and their carers and support. However, policy trends in this area in recent decades have tended towards restricting access, especially to Disability Support Pension. Clear and comprehensive recommendations in the Commission’s final report, alongside sustained advocacy, will be necessary to achieve the systemic change that is so desperately needed.

This post is part of the Women's Policy Action Tank initiative to analyse government policy using a gendered lens. View our other policy analysis pieces here and follow us on Twitter @PolicyforWomen

What the Productivity Commission has to say about income support and mental health consumers