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Understanding How Mental Health Claims and NDIS Work

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Written by Caitlin Louey

Medical Student

10 Jan, 2023

For those managing a National Disability Insurance Scheme (NDIS) plan or acting as the guardian of someone who receives NDIS funding, understanding mental health claims and the associated processes is essential. The NDIS provides a range of services and supports to people with disability, including those related to mental health. In this article, we will take a look at how mental health claims work within an NDIS plan and how to find the right therapy support service. Read on for all you need to know about making a successful Mental Health Claim through the NDIS!

What are NDIS mental health claims? 

Mental health claims refer to any additional cost incurred in managing your mental health needs that are not covered by your standard NDIS package. This can include costs for professional therapy such as psychology or counselling sessions and other services related to managing your mental health needs.

What is the NDIS, and how does it work?

The National Disability Insurance Scheme is designed to provide participants with the long-term support they need to achieve their goals. The NDIS provides tailored funding that allows individuals and families to build, access, and manage the support they require. This funding comes in different levels depending on need and eligibility, determined by an individual's age, location, type of disability, and other factors. When a person first accesses the NDIS, they will develop a plan with NDIA staff or an independent planner to decide how best to use their funding package. This plan is reviewed regularly so care packages can be updated as needs change and progress is made toward meeting goals. The NDIS provides an inclusive approach to engaging with people of all abilities, helping ensure that everyone has the possibility of meaningful participation in society.

How do mental health claims work with the NDIS?

It works with mental health plan managers, who assess mental health needs and develop a mental health plan tailored to the individual's unique situation. The mental health plan outlines the types of support and strategies that could help improve a person's mental well-being. This plan will also identify how NDIS funds will cover any needed mental health support. Potential mental health supports include access to mental health professionals, counselling programs, and other therapies tailored to a participant's mental well-being needs.

How do I make a mental health claim? 

When it comes time to make a mental health claim, you first need to contact the NDIS on 1800 800 110 or via their website at www.ndis.gov.au. You will then be asked to provide documentation outlining your unique circumstances and detailing what type of support or assistance you require for your mental health condition. With this information, the NDIS will assess your eligibility for additional funding and create an individualized plan tailored to meet your needs. 

What NDIS support item number do I use to make an NDIS mental health claim? 

To ensure that the correct support item number is included on your NDIS invoice, you need to ensure that the support item number matches the current NDIS pricing guide. You can use the NDIS to see either a counsellor, psychotherapist, psychologist, or social worker.

Counsellors and psychotherapists must be either a member of the Australian Counselling Association or an accredited registrant with the Psychotherapy and Counselling Federation of Australia. Psychologists must be a person who has a current AHPRA Registration as a psychologist. Social workers must be a person who is a member of the Australian Association of Social Workers. If you are unsure what the difference is, you can read our article on the topic.

The relevant support item numbers for each therapist are:

  • for a counsellor or psychotherapist: 15_043_0128_1_3

  • for a psychologist: 15_054_0128_1_3

  • for a social worker: 15_621_0128_1_3

What can my mental health claim include? 

Depending on the specifics outlined in your individualized NDIS plan, your mental health claim may include various items. These can include medical services such as counselling or therapy sessions and medications prescribed by a doctor to manage your condition. The types of support included in your mental health claim can also extend beyond traditional treatments to more holistic approaches such as yoga classes and mindfulness activities. 

How do I track my mental health claim? 

It is important to keep track of all the details associated with any mental health claims you make through the NDIS. This includes the cost of each service you receive and any additional costs incurred in managing your condition. You should also keep records of any reports or documents you submit supporting your claim so that you have evidence if you need to dispute or appeal any decisions made by the NDIS.

If you use Talked as your NDIS therapy support service, you can easily access copies of the relevant records and reports from your dashboard.

What are some benefits of using the NDIS for mental health claims?

The mental health claim process through the NDIS is safe, secure and private, enabling mental health patients to be in charge of their care without fear of being judged or discriminated against. Issues that are commonly addressed during NDIS therapy sessions include depression, trauma, and relationship issues.

The NDIS allows mental health plan managers to access mental health professionals, therapies, services and treatments tailored uniquely to individual needs, enabling people to take a more holistic approach to healthcare. Consequently, this facilitates better mental well-being and improved outcomes for mental health clients overall.

How to access the NDIS for mental health support?

Accessing mental health support through the NDIS can initially seem daunting, but it can be a straightforward process with the proper assistance and resources. Mental health supports, such as Talked, are available through a mental health plan manager or mental health practitioner who will work with you to ensure that your mental health needs are adequately assessed. They'll then create a tailored mental health plan aligned with your goals and budget.

This plan can access services such as counselling, psychologist appointments, community participation plans, and programs to help address mental illness. NDIS funding can also provide access to specialized support workers for home care or day activities to empower people with mental illness to reach their full potential.

To ensure that you find the right mental health support, Talked allows you to see the ratings and reviews of all therapists who offer NDIS therapy support services. That way you can be confident in choosing the right mental health support for you.

How can people prepare for their meeting with an NDIS planner?

To ensure you get the most out of your meetings with the NDIS planner, it is essential to come prepared. Ensure your mental health plan managers are up to date and provide sufficient information relevant to the areas you need support. Find out beforehand what questions will be asked during the meeting and consider potential responses. Doing some research on your local access requirements within the NDIS can also inform your conversation with the planner and make sure that all your needs are acknowledged. Compiling a list of desired outcomes for the meeting will help you stay on track during discussions and be proactive about tracking progress afterwards. Preparing for a meeting with an NDIS planner can seem daunting, but don't forget – the goal is always to create an effective plan tailored to each person's needs and wants.

Tips for managing your mental health under the NDIS

Navigating mental health care can be challenging, and this is especially true under the NDIS. Having a mental health plan manager guide you through the process can significantly help. Mental health plan managers provide advocacy and mental health support to individuals who have difficulty managing mental health issues or activities of daily living.

They can help individuals access services and supports within the NDIS and apply for access to specialist mental health services in their area. Additionally, mental health plan managers educate individuals about mental health and how it impacts different parts of life. Overall, mental health plan managers are invaluable in managing your mental health following the NDIS.

Conclusion

Understanding how mental health claims and NDIS work is important in managing your condition and ensuring you receive the right level of support. By keeping track of all the details associated with each claim and any additional costs incurred in managing your condition, you can make sure that you are getting the most out of your NDIS package. If you require assistance understanding or tracking a mental health claim, don’t hesitate to contact the NDIS or Talked for further information or advice.

If you are ready to begin your mental health journey, you can register and book the right therapist for you today.

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Caitlin Louey

Medical Student

Caitlin is a final year medical student on her Emergency Department Rotation in Regional Victoria. She has a passion for all things health, including mental health. She hopes that her knowledge of the Australian Medicare and NDIS systems can help improve the well-being of all Australians.

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