The $3 billion blowout in the amount the Federal Government spends on disability pensions, revealed recently, highlights the financial side of a crisis in our midst. The following story reveals a personal side.
'Jason', a close relative of mine, is on a disability pension and is addicted to substances. Over the years it has been alcohol, heroin, marijuana, speed, prescription drugs, over-the-counter drugs, you name it. Often a cocktail of substances.
This 28-year-old has stolen to feed his habits, contracted HIV and Hepatitis B and C, downed bottle after bottle of vodka till he passed out and had to be hospitalised, permanently damaged his liver, lived a chaotic and unproductive life, and caused deep distress to those around him.
To a large degree he understands the harm he does to himself and others, and he frequently attempts to change his ways, to stay 'clean', to try to get work or return to study. He is intelligent and can be sociable and helpful, making delicious mushroom soup, washing the dishes, discussing fine food or a sci-fi novel he has read.
But given his ingrained habits, his history, his lack of a 'respectable' CV, and his indistinct speech that seems to be a permanent consequence of his life to date, he just can't seem to keep it together for long enough to make a difference.
And so he falls back onto substances. He told me recently that the high he gets from them is irresistable, a more intense high than he is able to get from anything else.
Even when he is trying to be clean, he tends to treat occasional binges as rewards for, or 'holidays' from, periods of abstinence. He simply cannot countenance the thought of being totally and permanently free of drugs and alcohol. When I last saw him he had illicitly taken an antipsychotic drug that left him so zonked out that couldn't feed himself or tie his shoelaces and he didn't know what day it was.
Jason currently lives in a rooming house run by a community housing agency. It is full of people like himself but there appears to be no supervision. The resident in the next room assaulted Jason and stole his property.
He has lived with his mother on and off during his adulthood. 'Denise' is deeply concerned about his wellbeing, has been a devoted mother to him his entire life, and over his adult years has made strenuous efforts to support him and help him turn his life around: assisting him financially, encouraging him, remonstrating with him, discussing options and helping him plan, caring for him when he is sick, and taking him to hospital.
But often she reaches a point where she simply can't have him living with her. She can't bear to see him doping himself out, or simply sleeping or watching TV all day. He is also incredibly messy, and Denise fears for the safety of herself and her house.
For example, when he is high on speed late at night and frenetically tries to make things with a soldering gun in his bedroom, she fears he will start a fire. He often loses things like house-keys, wallets and phones, and has walked out of Denise's empty house and left the door wide open.
Jason's issues have brought him into contact with enough professionals and agencies to service the health and welfare needs of a small town: GPs, psychiatrists, psychologists, hospitals, housing workers, probation officers, detox centres, rehabilitation centres, an HIV organisation, job agencies, TAFE counsellors, to name just those I know about.
Given that he is also on a Disability Support Pension and gets concessions on many things, he costs the state — and thus society — a not inconsiderable amount of money.
The problem is that, with few exceptions, these agencies and professionals have no contact with one another, and no-one has a co-ordinating role. It is left to Jason — a man who often can't manage simple tasks of daily life — to be his own case coordinator: to reconcile disparate and potentially conflicting advice and approaches, to remember appointments, to pick up the threads when appointments are missed (as they frequently are) and to keep the process rolling along. Of course he doesn't do these things, so progress keeps being derailed.
And in a bizarre kind of symmetry, each of the professionals deals only with Jason, not with Denise or any other people in his life. They therefore only get his persective, and given that he often talks in monosyllables, this is probably not much information. When, over the years, Denise has tried to talk to the professionals, she often feels that she is seen as the villain in the piece, as the one who surely must be responsible for Jason's condition.
Moreover, client confidentiality is privileged over all other values — such as effective treatment — so the possibility that professionals and agencies involved with Jason, and the people in his personal life, might all come together in one cooperative effort to help him address his problems is completely off the radar.
It's a recipe for failure. And because the process is so ineffective, it will simply continue indefinitely. What's more, if you multiply this one case by the countless other Jasons out there, it's also a tragic waste of money and lives.