Perspectives of individuals receiving occupational therapy services through the National Disability Insurance Scheme: Implications for occupational therapy educators

Abstract

Introduction:With the introduction of the National Disability Insurance Scheme (NDIS) in Australia, occupational therapy graduates need to be adequately prepared to support service users in this new policy context. There is, however, limited research informed by service users themselves to inform contemporary occupational therapy curriculum redesign. The aims of this study were: (a) to explore the experience of occupational therapy service provision from the perspective of service users with lived experience of disability; (b) to gain an understanding of the perceptions of people with lived experience of disability regarding the NDIS and whether it will change how they work with occupational therapists; (c) to gain an understanding of the perspectives of people with lived experience of disability regarding the NDIS, and how this influences curriculum content for occupational therapy education. Methods: A pragmatic qualitative design, underpinned by the constructivist paradigm was utilised. Demographic surveys and semi-structured interviews were completed with 10 participants who were purposively recruited. Peer debriefing and use of an audit trail were undertaken to enhance the rigour of the analysis. Results: Three themes were identified: (a) Occupational therapists as gatekeepers for equipment provision; (b) experience of the NDIS (Knowledge and understanding of the NDIS; Uncertainty regarding the NDIS; Choice and control in the NDIS); (c) curriculum content for occupational therapy. Conclusion: The insights provided by the people with lived experience in this studyinform key areas of focus for occupational therapy curriculum to adequately prepare graduates to work in the evolving NDIS environment. Involving service users in an authentic manner in curriculum design, content delivery and student assessment is crucial for "real-world" applicability of student education. K E Y W O R D Sdisability, education, occupational therapy, policy, qualitative research

The National Disability Insurance Scheme and people with severe and persistent mental illness/psychosocial disability: A review, analysis and synthesis of published literature

“… NDIS: National Disability Insurance Scheme; NDIA: National Disability Insurance Agency; PSD: psychosocial disability. † Numbers listed in this column refer to the following publications: 1, Aitken et al (2019); 2, Barclay et al (2020); 3, Cashin (2014); 4, Dickinson and Carey (2017); 5, Diminic et al (2019); 6, Furst et al (2018); 7, Gillieatt et al (2018); 8, Hancock et al (2017); 9, Hayes et al (2018); 10, Horsfall et al (2018); 11, Isaacs et al (2018); 12, Kay and Kendall (2017); 13, Maker et al (2017); 14, Malbon et al (2019); 15, McGorry and Hamilton (2016); 16, Mellifont (2017); 17, Mulder (2017); 18, New South Wales Nurses’ Association (2019); 19, Pereira et al (2020); 20, Reppermund et al (2018); 21, Rosenberg (2017); 22, Rosenberg et al (2019); 23, Salvador-Carulla and Einfeld (2014); 24, Schweizer et al (2018); 25, Simpson et al (2016); 26, Stewart et al (2018); 27, Trollor (2014); 28, Williams and Smith (2014). …”

“…Of the eight publications focused specifically on the NDIS, only one publication (Barclay et al, 2020) explored the experiences of NDIS participants themselves and only two of these participants had a psychosocial disability. Equally, there was an absence of exploration of family member experiences or perspectives.…”

“…Other themes related to the NDIS itself. An inherent weakness of the NDIS was the disconnect between the language of 'recovery' and 'hope' promoted within the mental health system (Leamy et al, 2011) and the language of 'disability' and 'permanence' used within the Scheme (Barclay et al, 2020;Furst et al, 2018;Horsfall et al, 2018). This was described as potentially distressing and considered an obstacle to Scheme access, as many individuals do not view their conditions as 'permanent' or a 'disability'.…”

“…'maintenance') rather than capacity building (i.e. growth and recovery); and a potential lack of access to appropriate services that could provide required supports, especially for regional and remote communities, Aboriginal Australians and people with co-occurring conditions (Barclay et al, 2020;Furst et al, 2018;Horsfall et al, 2018;Maker et al, 2017;Rosenberg, 2017;Simpson et al, 2016;Williams and Smith, 2014).…”

Controlled choice, not choice and control: Families' reflections after one year using the National Disability Insurance Scheme

“…They compared past (localised) and the current centralised scheme, noting that the past localised scheme was more personalised and skilled compared to the NDIS, with mixed reviews as the system matured and improved. This concept was supported by Barclay et al (2020) where participants found that the NDIS planners ability to support choice and control was largely impacted by their knowledge of disability and corresponding needs. Previous literature further supports the notion that participants are more likely to feel supported when their planners demonstrated knowledge of the NDIS and offered advice about options (Collings et al, 2019).…”