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Chapter 8 Section G: People with mental health conditions and other disabilities

8G.1: Introduction

This section has information about having a mental health condition and other coexisting disability. Co-existing conditions used to be called ‘dual diagnosis’ or ‘co-morbidity’. However, the preferred language now is ‘co-existing disability or impairment’.

There is information about having a mental illness and:

  • An intellectual disability
  • An acquired brain injury
  • Epilepsy
  • Dementia
  • Personality disorder
  • Other disability

8G.2: Intellectual disability

It’s not always easy to identify mental illness or a mental health condition in a person with intellectual disability. There are a number of reasons for this. People with intellectual disability:

  • can’t always describe their symptoms to a doctor or psychiatrist
  • may not be able to communicate very well or at all verbally
  • may have symptoms that are different from those described in the diagnostic guidelines for mental illnesses
  • may be wrongly assumed to have behavioural problems because of their intellectual disability rather than a mental illness
  • may have physical conditions that produce symptoms similar to mental illness
  • may experience side effects from medication that confuse people who come in contact with them in the community or as health professionals

The NSW Council for Intellectual Disability is the peak body representing the rights and interests of people with intellectual disability in NSW. Its website has factsheets and information both in standard and in ‘easy’ English, which can be accessed by clicking here.

The NSW Council for Intellectual Disability can also provide a confidential information and referral service on matters relating to intellectual disability. It has developed a comprehensive information database, ASK CID – that has the details of over 1,400 services and resources available to people with intellectual disability and their families, advocates and service providers.

Click here to go to ASK CID website or contact the NSW Council for Intellectual Disability at:

Freecall: 1800 424 065*
Phone: (02) 9211 1611
Fax: (02) 9211 2606
Street address: Level 1, 418A Elizabeth Street

Click here to access a list (with websites) of NSW disability and advocacy services; national disability advocacy services, relevant NSW government departments and agencies and other useful websites.

For free legal advice about intellectual disability issues, contact the Intellectual Disability Rights Service (IDRS). IDRS gives free legal advice and information to people with an intellectual disability or others acting on their behalf in NSW. Initial advice is provided over the phone by appointment.

Click here to go to the IDRS website.

IDRS also runs the Criminal Justice Support Network (CJSN). The Criminal Justice Support Network (CJSN) is a support and information service for people with intellectual disability who are victims, witnesses, suspects or defendants in criminal matters.

For more information about the Criminal Justice Support Network, click here.

To get a support person or legal advice for people with intellectual disability in police custody, please call 1300 665 908*.

* Remember, mobile phone calls to freecall numbers (numbers starting with 1800) and to Local call numbers (numbers starting with 13 or 1300) are charged to the caller at the usual mobile rate.

8G.3: Acquired brain injury

The Brain Injury Association of NSW defines an acquired brain injury as:

“… damage to the brain that occurs after birth but is not due to an inherited disorder or degenerative disease. Damage may be caused either by a traumatic or non-traumatic injury to the head.”

The NSW Brain Injury Association distinguishes between a ‘traumatic brain injury ‘ and ‘non-traumatic brain injury’.

Traumatic Brain Injury is damage to the brain caused by an external physical force to the head. This can happen as a result of a motor vehicle accident, assault or a fall.

Non-traumatic acquired brain injury can result from tumour, brain infection, aneurysm or anoxia, drug and/or alcohol abuse, stroke, or disease such as Huntington’s disease.

More information about acquired brain injury can be found at:

People with mental health conditions may also have an acquired brain injury and this can affect access to services and treatment.

Services that support people experiencing mental health conditions and psychosocial disability and services for people with acquired brain injury tend to be different organisations. Often these different services and agencies don’t have specialist knowledge and insight into the causes, symptoms and treatment of the ‘other’ condition.

There are some limited services that may be able to help a person with both a mental illness and a brain injury to get coordinated services for both of their conditions.

For more about acquired brain injury and mental illness, click here. For information about advocacy services for people with acquired brain injury and mental illness, click here.

8G.3.1: Acquired brain injury and mental health conditions

There are various ways acquired brain injury can be linked to mental illness:

  • Some mental illness may be either based on or associated with a physical condition or biological process.
  • Some people with an acquired brain injury have psychological problems that may be made worse by their injury.
  • Mental illness can develop as a direct result of the brain injury because of damage of specific areas of the brain.
  • A person with an acquired brain injury can develop mental illness in reaction to the traumatic stress associated with the accident that caused their injury or ongoing negative experiences in life linked to the injury.
  • Self-medication (such as the use of non-prescription drugs or alcohol) for mental illness may cause a non-traumatic acquired brain injury.

8G.3.2: Advocacy Services for people with a mental health condition and a brain injury

The NSW Brain Injury Association provides a case-management service to help people with acquired brain injury, aged between 16 and 75 years of age in NSW (currently restricted to those living within Metropolitan Sydney), who have complex needs and cannot access existing or appropriate services.

The Brain Injury Association also provides advocacy for people with acquired brain injury in NSW.

For further information about the Brain Injury Association of NSW please click here.

The Brain Injury Association of NSW can be contacted on (02) 9868 5261 or on 1800 802 840* if you live outside Sydney.

There are a number of disability advocacy services in NSW that can provide individual advocacy support for people with mental health conditions who also have an acquired brain injury.

Disability Advocacy NSW works in the Hunter, Mid-North Coast, and New England Regions. It may be able to provide individual advocacy assistance help you get fair treatment:

  • from government departments, disability services, other services and businesses;
  • at work, university, school or TAFE;
  • with accommodation, transport and access;
  • with legal, healthcare or money issues.

For more information click here.

Disability Advocacy NSW can be contacted at:

Telephone (02) 4927 0111
Freecall: 1300 365 085
Facsimile: (02) 4927 0114
Address: (Head office)
Suite 3, Level 1,
408 King Street, NSW 2000

People with Disability Australia has a free individual and group advocacy service for people with disability. The service provides non-legal advocacy to individuals and groups of people with disability who have serious and urgent problems. The service also gives information to people with disability and their associates about how to advocate for themselves. This service is available to people with all kinds of disability no matter where they live in New South Wales.

Click here to go to the People with Disability Australia website.

People with Disability Australia can be contacted at:

Phone: (02) 9370 3100
Freecall: 1800 422 015*
Fax: (02) 9318 1372
Teletypewriter (TTY): (02) 9318 2138
TTY Freecall: 1800 422 016*
Street address: Tower 1, Level 10. Lawson Square Redfern NSW 2016

Postal address: PO Box 666

*Remember, mobile phone calls to freecall numbers (numbers starting with 1800) and to Local call numbers (numbers starting with 13 or 1300) are charged to the caller at the usual mobile rate.

8G.4: Epilepsy

Epilepsy is not a mental illness, but is a common neurological condition that affects approximately 1-2% of the Australian population. Although it is more likely to be diagnosed in childhood or in later life, it can affect anyone at any stage of their lives. People with Epilepsy experience sudden recurrent episodes of sensory disturbance, loss of consciousness, or convulsions, associated with abnormal electrical activity in the brain which are called ‘seizures. Some seizures are severe and are easily recognised as a seizure, whilst others are subtle and may not be noticed by most people.

Epilepsy is usually effectively treated with anti-convulsant medication (such as Epilim (or Sodium Valproate)). With regular medication and a sensible lifestyle most people with Epilepsy are able to live a full and active life.

Epilepsy Action Australia is the largest non-government provider of specialist epilepsy services for people with epilepsy and other seizure disorders, their carers, families and the broader community. It has developed a range of on-line resources and fact sheets that provide information about Epilepsy and its treatment, as well as about other support services for people with Epilepsy, their families and carers. People with mental health conditions sometimes have Epilepsy as a co-existing condition, and their treatment plan will have to take this factor into account.

Follow this link to find further resources.

Epilepsy Action Australia

Free-call line: 1300 374 537
Mail: PO Box 879
Epping NSW 1710

*Remember, mobile phone calls to freecall numbers (numbers starting with 1800) and to Local call numbers (numbers starting with 13 or 1300) are charged to the caller at the usual mobile rate.

8G.5: Dementia

Dementia is a general term that is used to describe a collection of symptoms that are caused by disorders affecting the brain. Alzheimer’s disease is the most common form of dementia, accounting for around two-thirds of all cases. Dementia can happen to anybody, but the risk of developing dementia increases with age. Most people with dementia are in the older age group, but mostly older people do not get dementia. Dementia is not a normal part of ageing, it is a brain disease.

Dementia affects the way people think, behave and their ability to perform everyday tasks. Dementia may be diagnosed if a person becomes impaired in two or more cognitive functions such as in memory, language skills, ability to understand information, spatial skills, judgement and attention. The primary feature of dementia is an inability to carry out everyday activities as a consequence of diminished cognitive ability. People with dementia may have difficulty solving problems and controlling their emotions.

They may also experience personality changes. Dementia is usually progressive, gradually spreading throughout the brain resulting in a person’s symptoms becoming worse over time.

People with dementia may also have or develop mental health conditions, including symptoms of mental illness, such as mood and perceptual disturbances which may be treated with mood stabilising or anti-psychotic medication.

Alzheimer’s Australia provides a range of services and supports for people with dementia, their families, and carers, including the National Dementia Helpline, counselling and support and social and therapeutic programs. It also provides a wide range of on-line information and education resources, including Fact Sheets that provide information about a wide range of topics including diagnosis, treatment and day-to-day care and support. There are specific resources available in relation to dementia and depression and dementia and hallucinations and false beliefs concerning this condition.

Follow this link to find these resources.
National Dementia Helpline: 1800 100 500
National Dementia Helpline Email:

National website
NSW Website
For NSW locations and contact information follow this link.

* Remember, mobile phone calls to freecall numbers (numbers starting with 1800) and to Local call numbers (numbers starting with 13 or 1300) are charged to the caller at the usual mobile rate.

8G.6: Personality Disorder

Personality disorder refers to an individual’s long-term pattern of thinking, behaviour and emotions that cause them distress and makes it difficult for them to function in everyday life. People with personality disorders find it hard to change their behaviour or adapt to different situations. They may have trouble sustaining work or forming positive relationships with others.

There are several different types of personality disorders. More common personality disorders include Borderline Personality Disorder, Obsessive Compulsive Personality Disorder and Narcissistic Personality Disorder each of which has distinctive features. Unfortunately these disorders have become stigmatising diagnoses that frequently lead to people being discriminated against both in the community and in services, because of the difficulties these people tend to experience with interpersonal relationships.

Depending on their specific condition, some people with a personality disorder may appear withdrawn, some distressed and emotional, and others odd or eccentric. The one thing they have in common is that their symptoms are severe enough to affect many different areas of life. People often develop early signs of developing a personality disorder in adolescence. The exact number of Australians suffering from personality disorders is not known. People with personality disorders also have high rates of coexisting mental health conditions such as depression and substance abuse.

Due to the nature of these disorders, it can be difficult for people to recognise they have a problem or to seek help. Treatment is available for people with personality disorders, and psychotherapy can help them to develop insight into their condition, manage symptoms and relate more positively to others. The first step in seeking help is to visit a doctor or mental health professional and arrange a mental health assessment.

To find out more about personality disorders, their diagnosis and treatment, and other support services that may be available, click on the following links:

Australian Government Department of Health

MindHealthConnects (an Australian government E-mental health strategy) (Australia’s on-line youth mental health service)

Sane Australia (a non-government advocacy and support group for people with mental health conditions, their families and carers)

Generally the best ways to get help for a personality disorder is to visit a General Practitioner, Community Health Centre, or Community Mental Health Centre.

Some people with personality disorders may be at risk of harming themselves or others. You can call Lifeline on 13 11 14, or dial triple zero (000) if you or someone you know has attempted to or is at risk of attempting to harm themselves.

8G.7: Other disability

People with disabilities are at greater risk of mental health problems than other members of the community. Many factors contribute to this association including the life consequences of disability, the poor health of people with mental disorders and the circular relationship that exists between disability, social exclusion and mental health problems. There is a poor understanding across service systems as to the relationship between mental health and other disability and the integration of health care delivery at all levels.

Having a mental disorder has been shown to influence both the chances of illness or impairment and the chances that an illness or impairment will have a disabling effect. The physical health of people with mental disorders is notoriously poor. Mental disorders have been shown to increase the risk of disease including heart disease, diabetes, stroke, HIV/AIDS and tuberculosis and to contribute to accidental and non-accidental injuries. This is partly due to: the associations between mental disorders and lifestyle risk factors such as obesity, smoking and the negative side effects of psychiatric medications including heart disease.

For those with an existing illness or impairment, having a mental disorder as well is associated with worse outcomes (such as complications and poor functioning), than for those without a co-morbid mental disorder. Evidence shows that people with mental disorders do not receive the same level of treatment as other people. Often the physical health of people with mental disorders are accorded less priority than other patients, and people with mental health conditions may be at greater risk of non-adherence to medical and behavioural treatment programs.

There are a number of physical health initiatives in NSW and some examples are:

YMCA Brightside Mental Health and Wellbeing Program

Mental Health Association (MHA) in partnership with YMCA’s Brightside Project (Mental Health Association. P: (02) 9339 6005)

This mental health program run by the YMCA is to encourage people with mental health issues to participate in a health & fitness training program at a YMCA health club. It promotes exercise as a recovery mechanism for people in the prodromal and remission phases of mental illness. The free program runs for 60 days with unlimited access to the YMCA’s gym facilities during this time.

The Linking physical health and mental health …it makes sense initiative.

The initiative is focused on improving the physical health of people with a mental illness and supporting those who use a mental health service to access physical health care.

NSW Cancer Council, Tackling Tobacco Program: Action on Smoking and Disadvantage.

RichmondPRA – Back On Track Health (BOTH)

A range of BOTH resources encourage and support active participation in self-management and give consumers confidence in asking for specific physical health care screening and monitoring from GPs and other health care professionals.

Schizophrenia Fellowship NSW – The Mental Health Sports Network (MHSN)

The Mental Health Sports Network (MHSN) is a network of community managed organisations that work together to provide sporting opportunities for people with mental health conditions. The MHSN provides a supportive environment for people to engage in sporting opportunities and helps participants build their confidence so they may transition to mainstream sporting events.

New Moves healthy lifestyle program

The New Moves healthy lifestyle program incorporates exercise activities, healthy meal preparation and educational discussion topics to help participants learn skills to better manage their physical health. The activities are performed in a group environment with peer support, which encourages social interaction and interpersonal skill development.

Fitness Australia – Lift for Life

Lift for Life® is a unique resistance training program designed for adults with (or at risk of developing) type 2 diabetes and other chronic conditions. Lift for Life participants get an individualised program is it’s perfect for any age and any fitness level. 

Updated January 30, 2015