Psychiatrists will today tell a Senate inquiry that proposed changes to the National Disability Insurance Scheme (NDIS) risk excluding people living with severe mental illness and psychosocial disability before alternative supports are in place, potentially increasing pressure on hospitals, emergency departments and homelessness services.

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) will appear before the Senate Community Affairs Legislation Committee as part of its inquiry into the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026.

RANZCP President Dr Astha Tomar said psychiatrists support a sustainable and well-targeted NDIS but are concerned that people with some of the most disabling illnesses in the community could once again fall through the cracks.

“For too long, people living with severe mental illness have struggled to access disability supports despite experiencing profound and often lifelong impairments,” Dr Tomar said.

“Schizophrenia, bipolar disorder, severe depression, eating disorders and other serious mental illnesses can devastate a person’s ability to work, study, maintain relationships, manage daily living tasks and remain safely housed.

“For many people these are disabling illnesses with consequences that can last a lifetime.”

Dr Tomar said psychosocial disability remains one of the most poorly understood and underserved areas of the disability system.

“Unlike many physical conditions, mental illness often fluctuates. People can improve, deteriorate suddenly, relapse repeatedly, and experience significant functional impairment over decades.

“The fact that a condition is episodic does not make it any less disabling. In fact, it is often the episodic nature of these illnesses that makes ongoing support so important.

“Our concern is that the current changes risk narrowing access to the scheme before alternative supports are available, and before the new assessment framework has been properly tested.”

The College warns that removing people from the scheme before alternative supports are operating will have serious downstream consequences.

“If people lose access to disability supports without equivalent alternatives being available, the pressure does not disappear, it simply shifts,” Dr Tomar said.

“It shifts to already overstretched emergency departments, public mental health services, homelessness services, families and carers.

“We know that appropriate community supports help people remain well, stay connected to their communities, maintain housing and avoid crisis presentations to hospital.”

Around 10–11 per cent of NDIS participants have psychosocial disability as their primary disability, representing up to 80,000 people nationally. However, the Government has not publicly released modelling on how many of these participants may exit the scheme under the proposed changes.

“Without this data, it is very difficult for the Committee or the sector to understand the likely impact of the reforms, or to plan for additional demand on already stretched state mental health services,” Dr Tomar said.

Dr Tomar said the College is particularly concerned about the proposed use of the I-CAN assessment tool to determine access to the scheme.

“I-CAN was developed for intellectual disability and has not yet been demonstrated to be clinically valid for psychosocial disability,” she said.

“Assessing the functional impact of mental illness requires clinical judgement and an understanding of fluctuating conditions, which is not always captured through standardised tools.”

The RANZCP will also raise concerns about the pace of the legislative process, noting the limited time for consultation on a bill with significant system-wide implications.

“The consultation period for this 109-page bill is too short, particularly for people with psychosocial disability who may need more time to engage meaningfully,” Dr Tomar said.

Dr Tomar said psychiatrists are committed to working constructively with government to seize the opportunity the reform process presents to address a longstanding gap in Australia’s mental health and NDIS systems.

“We want to see a sustainable NDIS that continues to support people with complex and enduring mental illness,” she said.

“This is an opportunity to build a system that properly recognises psychosocial disability and responds to it effectively.

“We should be supporting people at the point where their trajectory can be changed and not waiting until they reach crisis points.

"The measure of success for these reforms will be whether Australians living with severe mental illness are better supported, or whether they continue to remain largely invisible until they present in crisis, emergency departments, homelessness services or the criminal justice system."

The RANZCP is calling on the Government to ensure no person with severe mental illness loses essential supports unless equivalent, accessible and adequately funded alternatives are already in place.

For media inquiries, please contact: Dishi Gahlowt on +61 437 315 911 or email media@ranzcp.org  

The Royal Australian and New Zealand College of Psychiatrists is a membership organisation that prepares medical specialists in the field of psychiatry, supports and enhances clinical practice, advocates for people affected by mental illness and advises governments and other groups on mental health care. For information about our work, our members or our history, visit www.ranzcp.org. 

In Australia: If you or someone you know needs help, contact Lifeline on 13 11 14 or www.lifeline.org.au or the Suicide Callback Service on 1300 659 467 or www.suicidecallbackservice.org.au. 

In New Zealand: If you or someone you know needs help, contact Lifeline NZ on 0800 543 354 or www.lifeline.org.nz or the Suicide Crisis Helpline on 0508 828 865 or  www.lifeline.org.nz/services/suicide-crisis-helpline.