4430.0 - Disability, Ageing and Carers, Australia: Summary of Findings, 2015 Quality Declaration 
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 31/05/2017   
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PSYCHOSOCIAL DISABILITY

Psychosocial disability can have an impact on a person's ability to participate fully in daily living and opportunities like education, employment, and social and cultural activities. For the first time in 2015 the Survey of Disability, Ageing and Carers (SDAC) collected information about people with psychosocial disability.

This referred to people who reported:

  • A nervous or emotional condition which causes restrictions in everyday activities that has lasted, or is expected to last for six months or more;
  • Memory problems or periods of confusion which causes restrictions in everyday activities that has lasted, or is expected to last for six months or more;
  • Social or behavioural difficulties which causes restrictions in everyday activities that has lasted, or is expected to last for six months or more;
  • A mental illness for which help or supervision is required that has lasted, or is expected to last for six months or more; or
  • A brain injury, including stroke, which results in a mental illness, memory problems, periods of confusion, social or behavioural problems or nervous and emotional conditions which cause restrictions in everyday activities.

Previous SDACs collected information about Psychological Disability, which was narrower in scope than defined above.

The differences between the 2015 SDAC and previous collections are explained in detail in the section below, “Changes to Data Collection.”

Population characteristics

This publication presents information from the SDAC 2015 about persons with psychosocial disability. This is irrespective of whether they also have another disabling condition. The population referred to as persons with ‘Disability other than psychosocial disability’ excludes all people with psychosocial disability, regardless of whether they also have another disability (such as a hearing impairment, for example). The psychosocial disability population groups are summarised in Figure 1.

Figure 1: Psychosocial disability population group diagram







In 2015, 4.5% of Australians (1,045,900 people) reported having psychosocial disability, with similar rates for males and females (4.3% compared with 4.7%). Of all people with any type of disability, almost one-quarter (24.4%) had a psychosocial disability.

Age

The prevalence of psychosocial disability generally increased with age, to one in every four women (27.1%) and one in every five men (20.7%) aged 85 years and over (see graph below).

There was also a significant difference in the prevalence of psychosocial disability in the youngest age group. Boys aged 0 to 14 years were twice as likely as girls of the same age group to have a psychosocial disability (3.1% compared with 1.5%). This is due largely to the higher prevalence of autism amongst this age group (see Table 2.3, Autism in Australia, 2015 (cat. no. 4430.0), which predominantly affects males.

Graph Image for ALL PERSONS Proportion with a psychosocial disability by Age and Sex, 2015

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings - 2015

There were differences in the prevalence of psychosocial disability across Australia's states and territories. These differences were driven in part by the differing age structures in the states and territories, given that psychosocial disability increases with age. In 2015, Tasmania and South Australia had the highest rates of psychosocial disability (6.5% and 5.9% respectively). The Northern Territory, Western Australia and Australian Capital Territory had the lowest rates (2.3%, 3.3% and 3.5% respectively).

Severity of disability

For people with disability, the SDAC collected information about whether they had a specific limitation or restriction in the core activities of self-care, mobility or communication, or were restricted in schooling or employment (for more information see Appendix 1 – Limitations and Restrictions).

Of all Australians with psychosocial disability, almost two in five (38.2%) reported profound levels of core activity limitation, and a further one in five (21.7%) reported severe levels of core activity limitation. Of the remaining people with psychosocial disability, 9.7% reported moderate levels of core activity limitation, 17.8% reported mild core activity limitation, and 8.7% reported school or employment restrictions. Just 3.9% of all people with psychosocial disability reported no core activity limitation, schooling or employment restrictions.

Males with psychosocial disability were less likely to have a profound core activity limitation (35.9%) than females (40.2%).

Graph Image for ALL PERSONS WITH PSYCHOSOCIAL DISABILITY Severity of Disability by Sex, 2015

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings – 2015

Coexisting disability

The 2015 SDAC showed that the majority of the 1,045,900 people who reported a psychosocial disability reported having one or more other impairments or restrictions (87.4%). Two-thirds (66.2%) of those people with more than one impairment or restriction had a physical disability.

Almost two in five (39.5%) people with psychosocial disability also reported difficulties in learning or understanding, that is, an intellectual disability, a rate more than four times higher than that for people with a disability other than psychosocial (8.9%).

Around one-third (34.9%) of people with a psychosocial disability reported having a sensory disability (that is, loss of sight or hearing or speech difficulties).

Impairments

People with psychosocial disability may have one or more psychosocial impairments which cause restriction in everyday activities and may contribute to their psychosocial disability. Over half (57.7%) of people with a psychosocial disability had a nervous or emotional condition, while just under half had memory problems or periods of confusion.

Around two in five people with psychosocial disability reported that they had a mental illness for which they needed help or supervision (40.7%), or a social or behavioural impairment (40.5%).


Long-term health conditions

Many people with psychosocial disability reported that they had more than one long-term health condition. These conditions may contribute to or coexist with their disability. Understanding the types of conditions that affect those with psychosocial disability can provide insight into their overall health.

In 2015, the most common long-term health conditions among all people with psychosocial disability were anxiety related disorders (which included phobic and anxiety disorders, nervous tension and stress) and depression—39.5% and 37.6%, respectively.

Other long-term health conditions commonly reported amongst people with psychosocial disability included arthritis (27.4%), back problems (24.5%), and hypertension (22.2%), in part reflecting the older age structures in this population. One in six (15.4%) people with psychosocial disability had dementia (including Alzheimer’s disease).


Graph Image for ALL PERSONS WITH DISABILITY Proportion with selected long-term health conditions, by disability type, 2015

Footnote(s): (a) Excludes all people who have a psychosocial disability, regardless of whether they also had another disability.

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings – 2015





Need for assistance

It is important to understand the type and amount of assistance people with disability require. This information helps the planning and funding of services to support people with disability to be as independent as possible and to participate more fully in society. The following data refers to the population living in households which excludes those living in establishments.

In 2015, most people (94.9%) with psychosocial disability (living in households) reported needing assistance or experiencing difficulty in at least one of the ten activities of daily living considered in the SDAC (for more information on the activities, see Appendix 1 – Limitations and Restrictions). As many of those with psychosocial disability had one or more other disabilities, their need for assistance may not always be due to the person’s psychosocial disability alone.

The three most common areas where people reported needing assistance were cognitive or emotional tasks, (including making decisions, maintaining relationships and making friends) (84.9%), mobility (54.8%) and health care (50.7%).

Graph Image for ALL PERSONS WITH PSYCHOSOCIAL DISABILITY REQUIRING ASSISTANCE(a), activity requiring assistance

Footnote(s): (a) or experiencing difficulty in at least one of the ten activities of daily living. Living in households.

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings – 2015

Assistance Received

People with psychosocial disability may receive assistance from formal and/or informal providers of assistance. In 2015, almost all (95.1%) people with psychosocial disability (living in households) who needed assistance with activities of daily living, reported receiving assistance with at least one area of activity. Almost two-thirds (63.7%) received care from informal providers, while half (47.0%) received assistance from formal providers. More than one-third (36.1%) of people reported receiving care from both informal and formal care providers.

Informal assistance

Around two in five (39.9%) people with psychosocial disability (living in households) who received assistance reported that a parent was the provider of their care, while over a third (34.9%) reported that their partner was the provider of care.

Parents of people with psychosocial disability were the most common informal care providers of assistance with tasks such as oral communication (66.5%) and cognitive or emotional tasks (49.4%).

In contrast, partners of people with psychosocial disability were the most common informal care providers for most other tasks including household chores (44.3%), meal preparation (38.2%) and self-property maintenance (41.9%).

Formal assistance

Formal assistance can come from a range of sources, and people can receive formal care from more than one provider. In 2015, of people with psychosocial disability (living in households) who received formal assistance, almost two-thirds (62.0%) received assistance from a private commercial organisation, half (50.6%) received assistance from a government organisation, while one-fifth (20.0%) received assistance from a private non-profit organisation.

Private non-profit organisations were more likely to provide formal assistance to people with meal preparation, providing this support to almost half (47.6%) of those receiving formal assistance with their meals. In contrast, government organisations provided the majority of the formal assistance with self-care (54.9%), mobility (58.1%) and communication (64.3%) for people receiving formal assistance with these activities.

Whether need for assistance was met

Almost half (47.5%) of people with psychosocial disability (living in households) and who needed assistance with activities of daily living reported feeling their needs were only partly met, leaving 2.1% who felt their needs were not met at all. These results varied with level of core activity limitation or restriction.

Graph Image for ALL PERSONS WITH PSYCHOSOCIAL DISABILITY(a) Whether need for assistance was met by Severity of disability, 2015

Footnote(s): (a) Living in households.

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings – 2015

Use of Aids and Equipment

In 2015, more than half (56.9%) of all people with psychosocial disability reported using aids or equipment because of their condition(s). As many of those with psychosocial disability had one or more other disabilities, their use of aids or equipment may not always be due to the person’s psychosocial disability alone.

The type of activities for which people with psychosocial disability most commonly used aids or equipment were managing their communications (26.6%) health conditions (23.9%), showering or bathing (22.9%) and moving around places away from home (21.7%).


Education

Living with disability can impact on educational opportunities and participation. In 2015, just over half (51.8%) of all people (living in households) aged 15 years and over with psychosocial disability had completed Year 12 (or equivalent) or higher, compared with 55.6% of people with other disabilities and 75.8% of people without disability.

Educational attainment differed depending on the level of limitation. Of all people with psychosocial disability, 43.0% of those with a profound or severe core activity limitation had completed Year 12 (or equivalent) or higher, while proportionately more people with a moderate or mild core activity limitation, or a schooling or employment restriction only had completed this level (56.3% and 66.6%, respectively).

Of all people aged 5 years and over with psychosocial disability living in households, 20.7% reported they were currently studying. This compared with 11.8% of people of a similar age with a disability other than psychosocial, and 29.9% of people with no disability.

More than two-thirds (70.1%) of all people with psychosocial disability aged 5 years and over who were studying reported experiencing difficulties at their school or educational institution due to their condition. This compared with 39.0% of people studying with a disability other than psychosocial. The main difficulties reported by people with psychosocial disability were learning difficulties (41.4%) and difficulty fitting in socially (40.1%).

Over half the students with psychosocial disability reported that they received educational support or special arrangements (56.5%). Almost one-third (32.3%) received special tuition and almost one-quarter (23.3%) received other support, such as special assessment procedures, special equipment, special access or transport arrangements and/or a counsellor or disability support person.


Employment

Disability can impact on a person’s opportunities to participate in the labour force. In 2015, one in four (25.0%) people aged 15 to 64 years with psychosocial disability (living in households) were employed, compared with just over half (57.3%) of people of the same age with a disability other than psychosocial, and 78.8% of people without disability.

Graph Image for ALL PERSONS LIVING IN HOUSEHOLDS AGED 15 TO 64 YEARS, Labour Force Status by Disability Type

Footnote(s): (a) Excludes all people who have a psychosocial disability, regardless of whether they also had another disability.

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings – 2015

The level of unemployment for people with psychosocial disability was also significantly higher (7.5%) than for people with a disability other than psychosocial (4.5%) and for people without disability (4.4%).

The likelihood of people being employed full-time also varied depending on the type of disability people had. Of the people with a psychosocial disability, 8.1% had a full-time job, compared with 34.4% of people with other types of disabilities and 53.8% of people with no disability.

The differences are not as great when looking at part-time employment, with 16.5% of people with a psychosocial disability having a part-time job, compared with 22.9% of people with other disabilities and 25.1% of those with no disability.

Employment restrictions

Of the 151,900 Australians aged 15 to 64 years with a psychosocial disability (living in households) who were employed, almost three quarters (73.9%, or 112,300) reported employment restrictions because of their disability (for example, inability to work, restricted hours, or restrictions in the type of work that can be undertaken). In comparison 48.9% (430,500) of people who were employed and had a different type of disability had employment restrictions.

Income

Psychosocial disability can affect a person’s capacity to participate in the labour force and their ability to earn income. The following 2015 SDAC results relate to people of working age (15 to 64 years) who were living in households.

In 2015, two in three (66.8%) people of working age with psychosocial disability reported that their main source of cash income was a government pension or allowance, followed by wages or salary (15.6%). Those with a psychosocial disability were more than twice as likely to report a government pension or allowance as their main source of income than those with another disability (32.1%).

People with psychosocial disability were more likely to have lower levels of income than those people with other disabilities and those without disability. In 2015, almost half (49.5%) of people with psychosocial disability lived in households in the lowest two quintiles for equivalised gross household income, compared with 43.4% of those with other disabilities and 20.0% of those without disability (including those for whom their income was not known). People with psychosocial disability were also less likely to live in households with incomes in the highest quintile (3.9%) compared to those without disability (16.9%).

Given the smaller proportion of people earning a wage or salary and their greater reliance on government pensions and allowances, it follows that income levels for those with disability would be lower than those without disability. In 2015, the median gross income for a person with psychosocial disability aged 15 to 64 years was $400 per week, less than half the $950 per week income of a person without disability.


Discrimination

Over one in five Australians with a psychosocial disability aged 15 years and over living in households (126,400 people or 21.5%) reported they had experienced discrimination or unfair treatment because of their disability in the last 12 months, which was higher than the rate experienced by people with other disabilities (5.8%). The rates of discrimination reported amongst people with psychosocial disabilities were similar for men (20.5%) and women (22.6%). Experiences of discrimination decreased with age.

People with psychosocial disabilities most commonly reported that family or friends were the source of discrimination (32.6%) followed by health staff (doctors, nurses, hospital staff) (23.6%). Employers and strangers in the street were also commonly reported sources of discrimination (both 22.9%).

People with psychosocial disabilities were also more likely to report avoiding situations in the previous 12 months because of their disability (65.3%) than people with disabilities other than a psychosocial disability (24.5%).

Over half (54.1%) the people (aged 15 years and over) with a psychosocial disability who avoided situations because of their disability reported that they had avoided visiting family or friends. Other places that were commonly avoided were shops, banks and similar public venues (42.8%) and restaurants, cafes and bars (39.6%).


Changes to Data Collection

Changes to the 2015 SDAC included asking questions about whether people had social or behavioural difficulties, memory problems or periods of confusion that impacted their ability to do everyday activities. The questions were included to better measure the impact conditions such as Dementia and Autism spectrum disorders have on people’s everyday lives.

As these questions were introduced in 2015, it is not possible to look at how the prevalence of psychosocial disability has changed over time.

For readers wanting to understand the evolving impact of disabilities associated with mental health conditions however, there is an alternative measure. The two impairments: a nervous or emotional condition which causes restrictions in everyday activities that lasts at least six months; and a mental illness for which help or supervision is required that lasts for six months or more, have been aggregated as a measure of psychological disability in previous SDACs. Using this alternative measure to look at people with psychological disability over the period from 2009 to 2015 provides some insights into the changing nature of psychological disability in Australia. See Psychological Disability, 2012 (cat.no. 4433.0.55.004) for more detail about the definition of psychological disability.

The overall prevalence of psychological disability has increased over time, from 2.8% (606,000 people) in 2009 to 3.5% (823,200 people) in 2015. The largest relative increase was seen for people in the 15-24 year age group, where the prevalence has more than doubled in this 6 year period (from 1.2% in 2009, to 2.9% in 2015).

This increase is associated with growth in the prevalence of some mental and behavioural conditions that can lead to psychosocial disability. For example, in 2009 there were 726,800 people with an anxiety related disorder. In 2015 this had risen to 1,044,700 people. Similarly in 2009 there were 64,600 people with an autism related disorder, but this had grown to 164,000 in 2015.

For those readers interested in the impacts of mental health conditions on functioning, data about psychological disability is available from the ‘psychological disability’ file available under the ‘downloads’ tab of this publication.

Looking forward

Understanding the characteristics of people with psychosocial disability is critical to ensure that they receive the support services they require. The wide range of long-term health conditions and disabilities that can coexist with psychosocial disability highlights the importance in considering the overall health of people with psychosocial disability. Understanding this and their need for assistance helps with planning and funding the support services people with psychosocial disability need to improve their independence and capacity to participate more fully in society.