Instrumentos

Compounding the conceptual and definitional confusion in mental health is the fact that there is also no single definition of ‘disability’ either.139 In Australia,

definitions and meanings can vary between Commonwealth and state policy and legislation, and even between agencies within jurisdictions, according to the context and purpose. In the policy context, the development of WHO’s International

Classification of Functioning Disability and Health140 in 2001 shifted the focus of disability from cause to impact which is reflected in the policy definitions of ‘disability’ that are broad, and socially inclusive. In contrast, in operational areas that provide services and financial benefits, definitions are generally much narrower and more exclusive, and are usually based on specific measures of impairment and/or incapacity.141

The Disability Services Act 2011 provides the legislative basis for disability services provision in Tasmania. The Act serves to define ‘disability’ and to set down the eligibility criteria for services. The Act states that a person who has a cognitive, intellectual, psychiatric, sensory or physical impairment142 that is permanent or likely to be permanent,143 although it may or may not be of a chronic nature144 that results in a substantial restriction in their capacity to carry on a profession, business or occupation, or to participate in social or cultural life,145 and who has a need for continuing significant support services146 is person who has a disability and is eligible under the Act. However, in recent years, Tasmania has suffered from funding growth well below the already insufficient national average with 454 Tasmanians in need of continuing significant support services reported to be waiting for services in 2008, many of whom had been waiting for two or three

139

Michell E Loeb, Arne H Eide and Daniel Mont, ‘Approaching the measurement of disability prevalence: The case of Zambia’ (2008) 2 ALTER, Revue Européenne De Recherche Sur Le Handicap 32.

140

World Health Organisation, ‘Towards a common language for Functioning Disability and Health ICF’ (Report, WHO, 2002).

141 _{Literature Review For Captivate: Local Participation for All: A Project Funded By Disability Services}

Commission Department of Sport and Recreation, February 2007 <

http://www.walga.asn.au/Documents/Walga/MemberResources/1623_CAPTIVATE%20Literature%20Review. pdf>

142

Disability Services Act 2011 (Tas) s 4 (a)

143 Ibid s 4 (b). 144_{Ibid s 4 (d).} 145 Ibid s 4 (c) (i). 146 Ibid s 4 (c) (ii).

years.147 Nationally, fewer than 50 out of every 1000 people with severe disabilities receive funded support for the most basic of tasks such as showering, dressing and toileting.148

The Disability Discrimination Act 1992 (Cth) defines disability broadly to include total or partial loss to mental function; and a disorder, illness or disease that affects a person's thought processes, perception of reality, emotions or judgment or that results in disturbed behaviour.149 The Tasmanian Anti-Discrimination Act 1998 reproduces the Commonwealth’s definition but extends the application of the criteria to a disability that ‘presently exists, previously existed but no longer exists, may exist in the future, whether or not arising from an illness, disease or injury or from a condition subsisting at birth’.150

The Guardianship and Administration Act 1995 (Tas) describes disability as ‘any restriction or lack (resulting from any absence, loss or abnormality of mental, psychological, physiological or anatomical structure or function) of ability to perform an activity in a normal manner’.151

In contrast to the more expansive rights and protections legislative approach to disability, specific disability operational legislation, most likely as a cost

minimising exercise, commonly restricts the definition of disability to a situation that is ‘permanent or likely to be permanent.’152

Those aged over 65, those with psychiatric problems, substance abuse

disorders, behaviour disorders (like ADHD or social and emotional problems), those in post acute care and those with chronic medical conditions are

excluded unless there is a permanent disabling condition and they are unable to benefit from medical services. Disability Services are not geared to

temporary conditions. These are considered to be medical issues which should be dealt with by health services...the bulk of the clientele are ‘traditionally’ people with intellectual disability (46%). Those with a physical disability

147

Advocacy Tasmania Inc., Submission to National Disability Strategy, November 2008, 5

<http://www.advocacytasmania.org.au/publications/ATI_national_disability_strategy_submission.pdf>.

148

Dr Ken Baker, National Disability Services, Link Disability Magazine

<http://www.linkonline.com.au/Link/article/169>

149

Disability Discrimination Act 1992 (Cth) s 4.

150_{Anti-Discrimination Act 1998 (Tas) s 3.} 151

Guardianship and Administration Act 1995 (Tas) s 3.

152

form 16% of the clientele and only 7% have acquired brain injury and 8% neurological disabilities and progressive conditions.153

Most mental illnesses, are not permanent, are episodic, and are treatable although the impact of the illness on a person’s life can be extremely severe, and their need for services necessary. Commonly, mental illness is seen as a low priority in the allocation of limited funds and services because it is largely an invisible disability competing against the strong advocacy of the family and friends of the people experiencing the more permanent and visible, physical, intellectual and cognitive disabilities. The jockeying of large and influential disability groups in competition for funding and furthering the interests of their members has succeeded in

emphasising the differences between disability groups rather than the

commonalities154 to the extent that people with psychiatric disabilities are arguably doubly marginalised in that they are unwelcome in both the non-disabled and the disabled communities.155