Date post: | 14-Jun-2015 |
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Health & Medicine |
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Unpacking Psychosocial Disability and the NDIS
Margaret Springgay
Psychosocial Disability defined:
“ a term applicable to mental health to describe
the disability experience of people with
impairments and participation restrictions
related to [mental] health conditions. These
impairments and restrictions include reduced
ability to function, think clearly, experience full
physical health and to manage social and
emotional aspects of their lives”.
NMHCCF: Unravelling Psychosocial Disability
...the best outcome for people experiencing such disability will be achieved through supports that mitigate the effects of impairment or participation restriction and enhance the social and environmental opportunities to expand their capabilities.
The burden of disease and injury in Australia 2003. AIHW
Executive functioning: is an umbrella term for the management (control) of cognitive processes to enable planning, problem solving and, and execution of plans.
Working memory: has been described as the temporary "online" storage and the subsequent retrieval of information.
Episodic memory: is a category of long-term memory that involves the recollection of specific past & future events, situations and experiences. Past memories, play an important role in your self identity. – your first date; first day at school. Includes Prospective memory.
Visuospatial/problem solving: the sense of "whereness" in the relation of oneself to one’s environment and in the relation of objects to each other
IQ: intelligence quotient, or IQ, is a score designed to assess intelligence
Verbal ability: the cognitive ability to use and understand language.
Fluency: means the flow with which word, and phrases are joined together when speaking. "Fluency disorders" include pressured speech - florid speech.
Sustained attention: ability to focus on specific stimuli." cognitively activityrequiring sustained attention e.g. reading a newspaper. One must be able to focus on the activity of reading long enough to complete the task.
Problems occur when a distraction arises and interrupts and interferes in sustained attention.
The funding programs are as diverse as the various countries where they have been introduced. eg UK [Scotland, Wales, England, Ireland], Canada, USA, Australia, Netherlands etc
Various funding models:
1. Direct to individual
2. Fiscal intermediary [USA] – may assist in eg tax filings
3. Family host agencies [Canada – Vela Microboard] www.microboard.org/index
70-80% in USA go through a host agency
Vast majority of literature – big increase in qol, +ve outcomes, satisfaction, independence
Individualised Funding: A summary review of its nature & impact, and key elements for success. Robbi Williams 2007
Personal Capital - a person’s resources in themselves and their ability to assert themselves, inner strength and resilience
Knowledge capital – a person’s skills, knowledge and ability to use their knowledge for action
Material capital – a person’s resources and material goods
Social Capital – a person’s relationships and connections
Level of Capital
Level of Personal Capital
Significant Capital
Ability to be assertive, strong identity, ability to make decisions, confident in self-determination, control over physical environment
Reasonable Capital
Can make significant decisions known. Limited understanding of their identity, reasonable sense of confidence, reasonable control over physical autonomy
Fair Capital
Require support with decision making, limited self advocacy, limited understanding of own determination / direction including wishes & needs
Low Capital
Little personal capacity in making major decisions, limited communication, limited autonomy over physical space and limited ability to create direction [i.e. set goals]
Personal Capital [continued]
Risk High
1. Reduced cognitive capacity
2. Poor communication
3. Family not involved
4. Homelessness or living with potential exposure to people who are likely to exploit
Robbi Williams 2013
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