The quantitative data provides direct evidence of the views of carers regarding the impact of the NDIS on the choice and control they themselves have over the supports of the people with disability they care for. In both waves 1 and 2, carers reported very high levels of satisfaction regarding the amount of say they had about the supports the person with disability received (83 per cent in wave 1 and 77 per cent in wave 2, Appendix Table A4.11) and about where they were obtained (85 per cent and 82 per cent respectively, Appendix Table A4.12). A very small proportion of carers (less than 10 per cent in both waves) reported being dissatisfied with the amount of say they had over the supports of the person with disability.
The Impact of the NDIS on the Amount of Choice and Control over Supports – Evidence from Large Scale Surveys
Further analyses were conducted to examine the estimated impact of the NDIS on the amount of say people with disability have about which supports they receive and where to obtain these supports (see Introduction section). Estimations were also conducted using longitudinal data to explore the effect of time in the NDIS on levels of choice and control.
4.5.1 What do NDIS participants think about choice and control?
Figure 4.4 shows how people with disability felt about the amount of say they have over the supports they get, comparing the NDIS participant and comparison groups. In wave 1, 43 per cent of NDIS participants felt that they had a lot of say over the supports they received compared to only 29 per cent of the comparison group. This suggests that the NDIS is delivering more say to people with disability.
Figure 4.4 Person with disability: Amount of say over what supports received by treatment status (Wave 1, Adults)
Appendix Table A4.13 reports the estimated impact of the NDIS on the choice adult people with disability feel they have over the supports they receive. Using a binary measure of choice and control, NDIS participants were estimated to be 54 per cent more likely to report that they have a lot of say about what supports they get as a result of participating in the NDIS.
The difference in the impact of the NDIS on choice and control by type of disability (using a binary measure of choice and control) is shown in Figure 4.5 below. The average impact of the NDIS is represented by the horizontal line in the middle of Figure 4.5.10 All disability categories that are named above that average do better under the NDIS than all those below the line. Adult NDIS participants with a mental/psychosocial disability (at the bottom of the Figure) were found to benefit comparatively less from the NDIS than adult participants with other disabilities. Thus we see that adult NDIS participants with a mental/psychosocial disability were about 36 per cent more likely to report having a lot of say over the supports they received (compared to those in the comparison group, that is, they were 36 per cent more likely to report having a lot of say because of the NDIS), which is much lower than the estimated average impact of the NDIS, according to which all NDIS participants are on average 54 per cent more likely to report having a lot of say because of the NDIS.
Figure 4.5 Person with disability: Amount of say over what supports received - estimated conditional ATET by disability type (Trial, Adults)
Figure 4.6 below further illustrates the lower benefit from the NDIS on the choice and control of people with mental/psychosocial disability (compared to NDIS participants with other disability types). Poorer outcomes for people with mental/psychosocial disability were seen not only with regard to the average impact of the NDIS on choice over which supports were received, but also as to how the impacts were distributed between the two groups.
Figure 4.6 Person with disability: Amount of say over what supports received - estimated ATET by mental/psychosocial disability vs. other disability type (Trial, Adults)
The estimated impact of the NDIS on say over what supports were received by geographical location is show in Figure 4.7 below. Although the positive impact of the NDIS was estimated to be slightly smaller for NDIS participants living in a rural area, the difference is small and not statistically significant.
Figure 4.7 Person with disability: Amount of say over what supports received - estimated ATET by geographical location, binary measure (Adults)
4.5.2 What do carers think about choice and control?
Since the survey for families and carers elicited information on choice and control from all carers, the impact of the NDIS on choice and control for people with disability of all ages (i.e. both adults and children) could be estimated.
Appendix Table A4.14 and Appendix A4.15 report the estimated impact of the NDIS on the choice and control of carers of adult and child NDIS participants, respectively, using the binary measure of choice. The estimated impact of the NDIS on the say over supports that carers of adult participants have is very comparable to that found for the people with disability themselves (with an estimated impact of 46 per cent). The impact of the NDIS on the choice and control of carers of child participants was similar (41 per cent).
The impact of the NDIS on say over supports was also found to be positive, but of a smaller magnitude when using a continuous rather than a binary measure. On average, the NDIS was estimated to have led to a 15 per cent increase in carer satisfaction about the amount of say they have over what supports the person with disability they care for received (Appendix Table A4.16). The estimated impact of the NDIS on the say of carers of children with disability was smaller (7 per cent, Appendix Table A4.17).
Similar to the results obtained from people with disability themselves, the estimated impact of the NDIS on the reported amount of say carers of adult participants have over supports showed some heterogeneity with respect to the disability type of the NDIS participant (Figure A4.14 in Appendix). In terms of magnitude, when using a binary measure, the impact of the NDIS on choice and control for carers of adult participants with a mental/psychosocial disability was about half of that found overall (26 per cent compared to the 46 per cent for the whole sample). The impact of the NDIS on the choice and control of carers of child participants also showed some heterogeneity according to disability type but to a smaller extent.
When using a continuous measure of choice and control, carers of people with disability with physical, and more so with mental/psychosocial disability reported a smaller gain from participating in the NDIS (11 per cent and 3 per cent respectively) compared to other carers (Figure 4.8). Hence, for carers of people with a mental/psychosocial disability in particular, the benefit from the NDIS is quite negligible with respect to their ability to choose the supports they want.
Figure 4.8 Carers: Conditional average treatment effects by disability type and the amount of say about what supports the person with disability received (Adults, continuous measure)
In contrast, the impact of the NDIS for the carers of children with mental/psychosocial disability (8 per cent) did not differ greatly from the average effect found for all child NDIS participants (7 per cent, Figure 4.9). However, one must note that the estimates for the carers of children with a mental/psychosocial disability are based on a comparatively small number of observations.
Figure 4.9 Carers: Conditional average treatment effects by disability type and amount of say about what supports the person with disability received (Age 0 -15, continuous measure)
Figure 4.10 below shows the distribution of the impact of the NDIS on carer satisfaction with say over supports according to the age of the adult person with disability. For NDIS participants with a mental/psychosocial disability, we find that the impact is negative for carers of 55 years and older people with disability. This suggests that for older people with a mental/psychosocial disability, carers either do not welcome more choice, or perceive that their ability to make choices on the type of supports received has decreased since joining the NDIS.
Figure 4.10 Carers: Satisfaction with the amount of say on what supports people with disability receive - distribution of the conditional ATETs by person with disability age and mental/psychosocial disability vs. other disability type (Trial, Adults)
Figure 4.11 illustrates the relationship between the estimated impact of the NDIS on the amount of say carers have over supports and the age of their child. The estimated impact was not constant across children’s age; outcomes were lowest for the carers of children aged two to eight years old. The impact of the NDIS on say over supports increased sharply for carers whose child was aged eight years and older.
Figure 4.11 Carers: Satisfaction with the amount of say to what supports people with disability receive - distribution of the conditional ATETs (Trial, Age 0 – 15)
