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Improving access to disability support for refugees and humanitarian entrants

Cover of Diversitat Disability Findings reportAuthor: Lauren Quayle

More people with disabilities are being resettled in Australia due to welcome changes in health requirements. However, the support for these people remains inadequate.

Many of them are likely to be eligible for the National Disability Insurance Scheme (NDIS). Yet, in the trial phase of the NDIS, very few humanitarian entrants benefited from the NDIS.

Many of these people often find it difficult to navigate the Australian welfare system. This makes them vulnerable to unemployment and poverty. Those who come with a disability are even more vulnerable because there is no specific funding for case management in these circumstances. There is also no  support system for new arrivals who are waiting to be assessed for NDIS.

There is an urgent need for early intervention and for disability support on arrival for those who are resettled in Australia. A recent report by Diversitat outlines the main barriers to accessing NDIS support faced by humanitarian entrants with disabilities. Based on its engagement with the NDIS trial, Diversitat suggests that people with disabilities who are resettled in Australia are likely to remain “lost in the system”, unless substantial changes are made before the NDIS is rolled out nationally.

Language and understanding the system

Humanitarian entrants may be illiterate (in English and/or a different first language) or unable to access translated information. They are also often unaware of benefits and how to apply for them. This severely restricts their access to services. Another challenge is that there are very few interpreters with disability awareness.
The current NDIS model “assumes empowerment”. It assumes thatthat new arrivals to Australia understand the system and how to apply for support. This assumption is inappropriate in the case of humanitarian entrants, who may have no experience at all with welfare services.

Cultural awareness

There are also not enough diverse and culturally appropriate disability services. Mainstream disability services are often unfamiliar with the particular needs of people from a refugee background. Their staff are not generally trained in cultural competency.
There are very few people who have experience working with culturally diverse people with a disability, so they are not represented on advisory groups to the National Disability Insurance Agency (NDIA).

Assessment and Diagnosis

Disability assessment processes are also often not culturally appropriate. This discourages some new arrivals from seeking out a diagnosis.
Diagnoses from overseas may not be clear, and are often not accepted by Australian service providers. As well, humanitarian entrants generally do not have records of their medical history, which can make it difficult to get referrals and prescriptions. Many refugees have had to leave equipment or aids behind when fleeing their homes. They face long delays in getting replacements.

Stigma

There are negative stereotypes about ethnicity as well as about disability in the general community. This can deter people from seeking help for those who already feel marginalised. Another problem is that stigma and shame may also be prevalent within a person’s own ethnic community. This can further compromise proper diagnosis and treatment.
Humanitarian entrants are also sometimes unwilling to disclose information about a disability, because they fear that it may negatively affect their visa status.

Organisational cooperation

Refugee resettlement services are not linked to disability services. This means that unless there is a previous relationship with NDIS staff, disability service providers may not have all of the information needed to meet a client’s particular needs.
This gap means that settlement service providers also often have to act as intermediaries between their clients and the NDIA. This is particularly true there is a language barrier or the client is required to fill out certain forms.
As well, service providers are often confused about which services a client might be entitled to because of confusion about their visa status.

Eligibility limitations

Eligibility for the NDIS may be based on the date of community resettlement. This is determined by the Australian Government’s administrative processes. This means that the urgency of a person’s need for support may have little impact on their ability to access NDIS assistance.
As well, it is often especially difficult for refugee arrivals to obtain the evidence required to support an NDIS application. Although it is possible to appeal a negative NDIS eligibility assessment, information about appeals is not always available and much of it requires English literacy.

Impact on family carers

Families and carers of the person with a disability can become housebound because of delays in getting support, especially as there is often no extended family or community network to help out. This makes it enormously difficult for caregivers to integrate into a new community.
Diversitat observed that many caregivers do not seek out assistance until they are at crisis point. This is often because of language barriers, a lack of awareness about welfare entitlements, and the complexity of navigating the welfare system. Guilt, denial and a sense of duty to the person in their care may also prevent carers from reaching out for help.

Recommendations for the NDIS

Diversitat made the following recommendations for improving access to the NDIS for culturally and linguistically diverse (CALD) people, including humanitarian entrants and refugees:

  • Fund activities to engage CALD with disability in shaping the NDIS
  • Foster inclusion through addressing access and equity issues
  • Ensure there is CALD representation on National Disability Insurance Agency advisory and reference committees
  • Improve data collection on CALD people with disability and their carers to help plan adequate and appropriate disability services and supports
  • Make sure there is culturally accessible information, and culturally competent processes and support before a national roll out of the Scheme
  • Promote the NDIS to CALD communities by translating and promoting information to CALD groups
  • Widen the pathways into NDIS: for example, people should e able to nominate others who can either refer on behalf of, or in partnership with, the individual with disability
  • Produce NDIS information and resources in all languages and in various accessible formats
  • Promote the awareness of rights and responsibilities of CALD people with disability, in particular eligibility regarding visas
  • Raise awareness about options for complaining
  • Comprehensively map disability in established CALD communities CALD communities
  • Ensure the NDIA considers workplace diversity in its workforce strategy for the NDIS.

A key challenge in implementing the NDIS will be making sure the disability services sector is equipped to meet the individual and diverse needs of people with disability, particularly those from CALD communities. The National Workforce Strategy needs to ensure the complex and diverse needs of CALD communities are being met, and for the sector to be responsive to these communities.

Recommendations for Disability Service Providers

A lack of cultural competency among disability service providers is a major obstacle to proper treatment for recently resettled people. It urges that disability service providers should:

  • Conduct a cultural audit to highlight gaps and areas in need of improvement
  • Procedures and policies to ensure access and equity
  • Provide cultural competency training for staff
  • Use interpreters when necessary
  • Translate resources and materials
  • Increase multicultural staffing, and
  • Promote opportunities for CALD people to work as paid carers.

Disability service providers who are also Registered Training Organisations should promote disability-related training courses to CALD communities to increase the CALD disability workforce.

Read Diversitat’s Disability Findings report

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