Counselling and the NDIS

I want to share my experience of trying to engage the NDIS as a Counsellor. Shortly after I graduated my Masters and started my online practice, I decided to look into becoming an NDIS registered provider. My intention was to reach people who were vulnerable and in need, who would have the cost for accessing talk therapy covered by a government scheme.

I have always believed that healthcare, including mental and emotional healthcare, is a universal human right, not a privilege. I still believe this, including that it should be free, accessible and of a high standard. The reality of my options as a recently graduated Counsellor, with nearly 30 years of experience prior to formal qualifications, and with 50 years of lived experience under my belt, was a rude shock.

As a mature aged graduate raising three school aged children and living in an area where there are limited employment opportunities in this field, it was difficult to find work that suited my circumstances. I even struggled to find placement when I was studying, and was forced to defer twice, until the right online opportunity came along, where I am still currently employed.

Starting a boutique private practice seemed like the only viable option, a pathway many in this profession take to ensure they can deliver services that align with what most of us believe healthcare should look like. Something that is not always reflected in the complex system provided by the government.

Becoming an NDIS provider was something I considered immediately as a way to be able to participate in the system and reach those most in need who wouldn’t have to pay for Counselling. Unfortunately, as a still unregulated profession, unlike Psychology, Counselling is not included as a healthcare service covered by Medicare. There are developments underway, including the recent initiative through St Vincent’s Hospital called Medicare Mental Health Check In, which employs Counsellors with my level of tertiary qualification and peak body membership, but this does not yet provide diverse employment opportunities or accommodate diverse experience. I applied anyway, but was unsuccessful.

In fact, I have applied for too many jobs to count, mostly that would allow me to continue to work online and have flexibility around my carer responsibilities. I have secured some contract work that is yet to take shape, so building a private practice and registering with the NDIS was a viable option.

There are many changes taking place in the NDIS, but as recently as 12 months ago, there were two options for becoming a registered provider for Counsellors. The first is called Certification and costs around $10,000 for an audit of your service to take place to fulfill the NDIS registration obligations. This allows a range of item numbers to be covered and included being able to work specifically with children. This cost was out of the question for a sole trader like myself, running an online practice that has limited capacity for complex service provision.

The second pathway which I proceeded with is called Verification. It costs around the $1500 mark, depending on the auditor, and only includes one item number (initially it was two but this has changed), to allow for Counselling of individuals. Group Counselling was the second option which has since been removed from the NDIS.

I went ahead with the audit. The NDIS application process was straightforward enough, generally user friendly, but more complex than it needs to be. To be honest, I am not completely across the system that providers should use, as it changed from one system to another and I am yet to use it.

The audit process was easy enough, the auditors were helpful and it allowed me to refine my policies and procedures to not only adhere to the requirements of the audit and the NDIS registration, but also to elevate the structure of my service and ensure best practice for my potential clients.

I have now been registered with the NDIS as a provider for almost 12 months. In that time I have received zero referrals or inquiries from NDIS participants or their support coordinators. The auditor I went through also no longer provides audits for NDIS registrations.

I am hearing that many NDIS support coordinators are being encouraged to exclude Counselling from NDIS plans, even reducing options for Psychology services, as there is a push to move emotional and mental health support towards Mental Health Plans. I understand the government doesn’t want people to “double dip”, but this disadvantages Counsellors and harms participants who may want ongoing emotional support not covered by any existing schemes. Many people living with disabilities need ongoing emotional support that Counsellors can provide, without needing complex and medicalised mental health management, on top of their already heavily medicalised and over scheduled lives. They just want to be able to talk to someone about their feelings occasionally, a vital support service and I would argue human right, particularly for those most vulnerable in our community, already living through difficult circumstances. The cuts to the NDIS, the manner in which the scheme is being managed to address fraudulent use, and the messaging has been abhorrent and almost always impacts people living with a disability the most.

At this stage it is unlikely that I will renew my NDIS registration when it lapses in a couple of years and I understand that perhaps it was not the best decision to make at a time when there is so much restructuring of the NDIS scheme.

At the same time, I don’t regret the process, as it was valuable to engage with the scheme and audit my service to ensure that my policies and procedures align with best practice models. But it is disappointing that genuine, qualified and valuable service providers are not able to reach those most in need, as the NDIS scheme and the Counselling profession, like the healthcare system itself, are overburdened by bureaucracy and manipulation, that increases demand and prevents supply and access.

For the next two years I am still a registered NDIS provider. If there are support coordinators or NDIS participants who are curious about what service and value a Counsellor like myself can provide, don’t hesitate to reach out and have a conversation. My FREE introductory session is a great place to start.

I will continue to advocate for NDIS participants and carers of people living with a disability to be able to access Counselling services, at a time when there is so much confusion and so many barriers to quality healthcare. My service will always be available, accessible and flexible - including considering ways to ensure affordability and include family members and carers of people living with a disability who want to talk things through and feel better.

If you or someone you know needs to talk to a Counsellor, please reach out. I look forward to meeting you.