Disability and mental health

Led by Associate Professor Dr Jen Smith-Merry

How can we understand mental health in relation to disability?

Mental Disorders account for nearly one quarter of all the Years Lived with a Disability in the World. This target group is also the main contributor to global costs related to the use of health and social services and to productivity loss. In spite of these facts, persons with mental illness have less support and lower access to care services that any other chronic health condition. In Australia only one third of persons with mental disorders access health services and this ‘care gap’ is much greater in South East Asia. Even in Countries where disability schemes have been implemented, persons with mental disorders experience more problems in accessing disability benefits than any other disability group. In addition, persons with MD experience more stigma and discrimination that other persons with disabilities.
Global Burden of Disease Study, Lancet, 2013

In order to maximise participation of persons with mental disorders, more needs to be known about two key issues:

1. How to ensure parity and equitable access to disability benefits, care provision and support for persons with mental disorders?

  • In Australia
  • In the Asia Pacific Region

2. How to measure and how to reduce the existing Mental Healthcare Gap between care needs and provision of services

  • In Australia within the new National Disability Insurance Scheme
  • In the Asia Pacific Region following the UN Declaration on the Rights of People with Disabilities

This workstream will focus on both of these areas:

1. Individual Assessment of Disabilities and Mental Health

In order to achieve parity and equitable access for persons with severe mental disorders we need to find better ways of evaluating, recording and reporting disabilities in persons with MD, which could be incorporated to the eligibility criteria and to the health monitoring systems in Australia within NDIS and in the Asia Pacific region. This will help governmental agencies and other stakeholders to incorporate this population group to the already existing and the new programmes addressed to reduce disability and to improve support for persons with MD; and to keep a track of progress in this endevour. It will help them identify areas where disadvantage and discrimination is being reduced. It will help them identify areas where it is getting worse. In Australia, it will help government and non-government organisations to assess the impact of major policy initiatives such as the National Disability Insurance Scheme.

We will work on three specific areas:

1.1. Incorporating the functioning approach to the development of case-mix models in persons with mental disorders, and to routine outcome assessment. We have previously worked in methods for improving case-mix and eligibility of persons with MD and severe disability in national disability programmes. View related publications

1.2. Incorporating the person-centered approach to the assessment of disabilities and functioning in persons with mental disorders. View related publications

1.3. Assessing environmental challenges in persons with severe mental disorders. View related publications

2. Mental Healthcare Gap

We need to know more about the care gaps for persons with mental disorders and long-term care needs. Members of GDRP have worked in the development of international tools for assessing and mapping mental health services and for producing comparative analyses across different territories (Countries, States or regions). This should be completed by the development of a suitable method to assessing and coding mental health interventions. Information on services and interventions would be related to information on costs and burden of these disorders to improve policy analysis and priority setting aimed at maximising participation. Our research is focused on the following areas:

2.1. To produce national,state and local maps of mental health care that could facilitate the analysis of the MH Gap in Australia and in the Asia Pacific region. View related publications

2.2. To produce tools for coding and mapping interventions for persons with mental disorders and long-term care needs View related publications

2.3. To explore the relationship between the Mental Health Gap and the maxisimation of participation of persons with MH problems, especially with regard to policy, financing mechanisms and costs consequences . View related publications

2.4. To explore new strategies to maximise social inclusion, participation and policies of integration for persons with mental disorders and long-term care needs, including ‘Arts and Disabilities’ and ‘Person-centered care’. View related publications

Publications and Enquiries

For publications and other information about Associate Professor Smith-Merry, please see the academic profile here

Associate Professor Smith-Merry also welcomes enquiries to her e-mail address jennifer.smith-merry@sydney.edu.au