The NDIS commenced 1 July 2013 and reached full national roll-out in 2020. As of June this year there were 610,502 participants receiving package support for a range of disabilities. This is 49 percent larger than original predictions. Support packages have also increased in price and scope leading to budget blowouts. The NDIS now costs taxpayers more than $35 billion dollars a year and was on its way to $100 billion before the government imposed an 8% growth limit.1
To give you some idea of the types of disabilities supported by the NDIS the chart below provides the number of active participants by primary disability:
Source: https://data.ndis.gov.au/explore-data
More urgent though than the cost of the Scheme is the extraordinary number of young people registered as having disabilities. As of June this year 313, 476 participants aged 18 years and under had an NDIS package, more than half of total participants. Of these 75 per cent were diagnosed with autism or developmental delay.
The most common disabilities covered by the NDIS are autism, intellectual disability, psychosocial disability and developmental delay. Also, 11 per cent of boys and 5 per cent of girls between the ages of five and seven have an NDIS package.2 The chart below clearly shows the prevalence of age groups with highest NDIS participation:
Thomas Szasz’s book from the 1950s, The Myth of Mental Illness, helps us explain the situation:
Everything I read, observed and learned supported my adolescent impression that the behaviors we call “mental illnesses” and to which we attach the hundreds of derogatory labels in our lexicon of lunacy are not medical diseases. They are the products of the medicalization of disturbing or disturbed behaviors – that is, of the observer’s construction and definition of the behavior of the persons he observes as medically disabled individuals needing medical treatment.3
The fundamental cause of this plague of autism and other “mental diseases” in the young has more to do with a preference for medicalising dysfunctional behaviour than any real outbreak of a medical illness. In a discussion paper from The Actuaries Institute on providing better support for children with Autism, author Maathun Ranjan writes that “the NDIS was envisioned and legislated based on a social model of disability but has been implemented using a medical model.”4
The result is inflated diagnosis rates. According to Professor of Autism Andrew Whitehouse, “It is without question that clinical behaviour has become biased towards making certain levels of an autism diagnosis (more severe) in order to provide families a better chance at receiving the support they need through the NDIS.”5 The situation highlights the elasticity of mental health diagnoses in the case of autism.
Aside from the financial incentives there are other reasons why a parent might seek a diagnosis. Finding the cause of disturbing behaviour in a medical explanation absolves both the parent and child of responsibility and hands it to a third party – an expert, clinician or school. It is a way of defining a very real problem which delivers everyone from the need for self-reflection and judgement, even when the well being of our children is at stake. Who is the therapist to argue with repeat business.
Szasz would describe the cause of disturbing behaviour more in terms of what he calls “problems of living.” Nobody doubts that factors ubiquitous in our society such as family breakdown, poor nutrition, lack of sleep, excessive screen time, isolation, exposure to stylised violence and pornography, lack of meaning, direction and discipline all contribute to the sorts of problems which would qualify a person in the current regime for a diagnosis of mental illness. Is it reasonable to continue to use the language of mental illness when we know this?
For instance, on the Evidence for Psychosocial Disability Form6 the clinician must provide descriptions of difficulties the patient experiences in the domains of social interaction, self-care, self-management, communication, learning and mobility. Within each of these domains details of impairments are asked for in areas of life such as making and keeping friends, interacting with the community, completing daily tasks, hygiene etc. There are more than twenty of these prompts. A kid who plays games all day, is neglected by his parents and lives on chips and lollies will be dysfunctional in most if not all areas, so would likely qualify for the NDIS. Does not common sense says it is misdirection to define the problem as a psychosocial disability?
In a presentation entitled Self-Deception in Psychopathology Jordan Peterson says:
Human health is a matter of moral action perhaps more than it is a matter of anything else and I think the reason that we don’t want to admit to that or even discuss it generally because I don’t think people want to think of their own lives in that manner because it would burden them with too much responsibility. So I think all the coverage, the pseudo-scientific, objective claptrap that characterises much of our diagnostic strategizing is a form of sin of omission.7
There are important political and economic dimensions which deserve attention. The extent to which we surrender responsibility for our own condition is the extent to which we grow the therapeutic state. Ground lost to this technocratic machine is difficult to recover. The latest Intergenerational Report predicts that of the five areas of spending growth over the next forty years, three of them, aged care, health and the NDIS, are in the ‘care economy.’8 The chilling message is that the government fully intends to look after you.
Furthermore, Australia’s economy is seriously asymmetrical, with more than 90% of people working in service industries.9 No reversal of this situation is seriously considered anywhere. Its a done deal. We can expect to see a precipitous rise in care services fueled by government stimulus and a care industry fully aware that diagnosis and therapy is what is required to keep the good times rolling. With little or no training or capital requirements for becoming a ‘support worker’, the government will soak up labour disrupted by the integration of digital technology to grow a care bureaucracy just as fast as people can be labelled disabled. All of this will help mask the accelerated breakdown of the employment system and expand social welfare dependency under the cover of ‘our most vulnerable.’
It’s a formula for a zombie nation. I don’t want to lecture, but I really don’t like the outlook for a society that comes increasingly under the sway of the health technocrat elevated to riches and power by making the world in their own narrow image. The answer was put simply by Michael Collins just before his death, “When we make ourselves fit we shall be free.”10
Lunn, S. 3.9.23. NDIS creating winners and losers among children with autism, says Institute. Retrieved from: https://www.theaustralian.com.au/nation/ndis-creating-winners-and-losers-among-children-with-autism-says-institute/news-story/e1aca6cea0d01a5ec89ce9241d3d9e16 retrieved 17.9.23.
Editorial. 5.9.23. Autism Services need Overhaul. Retrieved from: https://www.theaustralian.com.au/commentary/editorials/autism-services-need-overhaul/news-story/d8fce65427c51f817e4faf741695b40f. Retrieved 17.09.23
Szasz, T. 1974. The Myth of Mental Illness. HarperCollins, New York.
Lowe, A., Ranjan, M. June 2023. Providing better support for children with autism and development delay, Retrieved from: https://lnkd.in/gPewdzRS The Actuaries Institute.
Ibid. 2.
Mental Health and the NDIS. Current May 2022. Retrieved from: https://www.ndis.gov.au/understanding/how-ndis-works/mental-health-and-ndis. Retrieved 17.9.23
Peterson, J. 2012. Dr. Jordan Peterson – Self-Deception in Psychopathology. Retrieved from: https://www.youtube.com/watch?v=pxJzWcwcRd0. Retrieved: 17.9.23
Intergenerational Report 2023. 2023. Retrieved from: https://treasury.gov.au/sites/default/files/2023-08/p2023-435150.pdf. Retrieved: 17.9.23.
Ibid.
Quoted in: Mackay, J. 1996. Michael Collins, A Life. Mainstream Publishing Company, Edinburgh.