Is living in aged care in Australia bad for your mental health?

An estimated 10–15% of older Australians who live in the community experience anxiety or depression (Haralambous et al. 2009). However, research has shown that certain sub-groups of the older population are at higher risk of experiencing poor mental health. For example, just over half (52% or 86,736) of all permanent aged care residents at 30 June 2012 had mild, moderate or major symptoms of depression when they were last appraised (AIHW 2013). [Australian Government, Australian Institute of Health and Welfare, Australia’s welfare 2015]

The Sydney Morning Herald, 7 January 2017:

Tens of thousands of elderly Australians are being  denied effective public health treatments because they live in nursing homes, with experts labelling it a "disgrace" and "blatantly discriminatory".

A Fairfax Media investigation has revealed the mental health of aged-care residents suffers as a result of widespread neglect that legal and health experts attribute in large part to a   "ridiculous" Medicare rule.

Under the rule almost all nursing home residents are denied GP mental health treatment plans and associated psychological therapies provided to other Australians under the Better Access Medicare program, because the government deems residents not to be patients "in the community".

Despite extreme rates of mental illness in nursing homes – with about 82,000 of 176,000 residents estimated to suffer a mental illness (excluding dementia) or significant mental distress – the Turnbull government reaffirmed the regulatory exclusion late last year.

While the government says its funding mechanism assesses depressed residents' care needs, a Fairfax Media investigation has discovered the homes almost never pay for clinical mental health treatments and experts say the government has neither legally compelled nor adequately funded them to do so.

Audits by Sydney and Deakin universities have repeatedly found that fewer than 2 per cent of residents suffering depression have received psychological treatments, such as cognitive-behavioural therapy,  that are clinically recommended for most depression experienced in the aged-care setting…..

Royal Australian College of GPs president and University of Tasmania clinical professor Bastian Seidel agreed the denial of treatment was "systematic" because "the data is out there" and he called for the removal of the Medicare exclusion.

Researchers have found only about half of all residents with depression receive treatment of any kind, whether from psychologists or other clinicians, and that almost all of those are put on antidepressants by GPs, despite their use in the elderly being linked to serious adverse effects, including falls and fractures.

Stigmatising attitudes and ignorance about mental healthcare have also been found to be widespread among nursing home staff, with unpublished Swinburne University survey data suggesting staff commonly dismiss depressed residents as "attention seeking" and lack basic knowledge about mental illness.

While many residents arrive in homes with depression or other mental disorders, others struggle mentally due to challenges experienced in care, such as chronic pain, disabling and terminal medical conditions, progressive loss of brain function and the loss of social role and sense of identity.

"There are commonly acute adjustment disorders … [involving] bereavement, grief, loss," said Adelaide older persons GP Johanna Kilmartin, who described the Medicare restriction as ridiculous.

"You lose your family home [for] … one tiny little room … so you've lost all your material possessions; you've lost your health, because that's why you've moved in; often you've lost your spouse as well.

"This is when you need [psychological help] … [but] we've got the opposite"……

A spokesman for the Department of Health said while Commonwealth-funded residents – understood to be all or almost all aged-care residents – were not eligible for Better Access services, the government's aged-care funding instrument "assesses residents' care needs, including in relation to depression".

He said approved homes were required to "facilitate … access" for residents to health practitioners of their choosing and gave as an example "arranging transport".

But the dean and head of the University of South Australia's law school Wendy Lacey slammed the "weasel words" of the Aged Care Act's care "principles", saying there was "a complete absence of any positive and mandatory legal obligation on the part of facilities to take proactive measures to promote mental health and wellbeing of their residents".

There was "no legal obligation on the residential care provider to pay" for mental health services, and the "current exemptions" –  arising from the Aged Care Act and Medicare regulation – were "a blatant denial of human rights involving discrimination on the basis of age and infirmity".

Australian Catholic University senior research fellow Tanya Davison, whose research has found that half of all clinical cases of depression received no treatment of any kind, cited funding "that runs out very quickly" as among contributing factors to the "critically low" psychological therapy levels…..

The Conversation, 28 July 2015:

More than half (52%) of aged care residents have symptoms of depression, compared with 10-15% of older people living in the community. As well as feelings of sadness and low mood, aged care residents with depression feel uninterested in activities, hopeless about the future, guilty about the past and may desire death.

Some actively contemplate taking their own lives. The prevalence rate of suicidal thoughts in residential aged care settings can be as high as 46%. This is more than three times the rate found in older adults who are housebound but in the community.

People entering residential aged care facilities are, on average, older than those living in the community. They have more complex care needs due to physical and cognitive difficulties. They may also have difficulties adjusting to their loss of independence and routine. These factors all increase their risk of depression and suicidal ideation.

However, mental illness often remains undetected among aged care residents.

There are several reasons for this. People living in residential aged care usually have complex care needs, making the identification of depression difficult, as the emotional symptoms become confused with those of other conditions. Older people are also less likely than younger people to recognise their own symptoms, often attributing them to normal ageing.

Further, although facility-based carers are in a position to act as informants, they often lack the training to detect symptoms of depression and do not routinely screen for suicide ideation.

Depression is a manageable condition and the symptoms can be improved or managed through therapy and medication. Medications are effective but are often associated with side effects, and for older adults may not be recommended alongside some other medications and conditions.

Yet, when residents are recognised to have symptoms of depression, they are often only prescribed medications (particularly antidepressants) despite the effectiveness of non-medication approaches. Research shows interventions such as cognitive behavioural therapy (a talk therapy that addresses how you think and act) are at least equally effective as anti-depressants for improving late-life depression.

BACKGROUND

National Ageing Research Institute, Depression in older age: A scoping study, Final Report, September 2009:

4.1 Depression and anxiety in older people

It is a common misconception that depression is a normal part of ageing, but the evidence shows that multiple health problems often account for any initial association between depression and older age (Baldwin, 2008; Baldwin, Chiu, Katona, & Graham, 2002). Depression is essentially the same disorder across the lifespan, although certain symptoms are accentuated and others are suppressed in older people. For example, older people with depression typically report more physical symptoms and less sadness compared to younger people with depression (Baldwin, 2008; Chiu, Tam & Chiu, 2008). Additionally, psychotic symptoms, melancholia, insomnia, hypochondriasis, and subjective memory complaints are more likely to occur in older people with depression compared to younger people with depression (Baldwin, 2008; Baldwin et al., 2002). A recent review found that when confounding variables are controlled (for example, age at study entry), remission rates of depression in patients in late-life are not different from those in midlife, although relapse rates appear higher in older people (Mitchell & Subramaniam, 2005).

Anxiety disorders are also common among older people. However, research in this area is less compared to research undertaken in other mental disorders in older people, such as depression (Wetherell, Maser, & van Balkom, 2005). Of the anxiety disorders, phobic disorders and generalised anxiety disorder (GAD) are the two most common in older people (Beyer, 2004; Bryant et al., 2008; Rodda, Boyce, & Walker, 2008). There has been a certain amount of clinical interest in post-traumatic stress disorder (PTSD), because the survivors of the Second World War and the Holocaust are now well into old age. Moreover, Vietnam Veterans are also approaching old age with well-documented high levels of psychopathology (Owens, Baker, Kasckow, Ciesla, & Mohamed, 2005) that can also have serious effects on the mental health of family members (Galovskia & Lyons, 2003). Prevalence data on PTSD, however, are very limited (Sadavoy, 1997). American studies of Holocaust survivors have found that up to 46% meet criteria for PTSD (Sadavoy, 1997). Weintraub and Ruskin (1999)’s review emphasises the similarities between PTSD in older and younger groups. Other authors have disputed this, and further research is required to establish how different the presentation of PTSD is in older adults from that in younger people.

A recent Australian study found that 11.6% of men and 8.6% of women aged over 65 reported re-experiencing symptoms associated with past events (DSM IV criteria), and concluded that quality of life may be significantly affected in this group (Creamer & Parslow, 2008). This study highlights some of the difficulties in the application of the DSM IV criteria to older adults.

Research on interventions for older people with PTSD is very limited indeed. A recent review of assessment and treatment of PTSD in older combat veterans identified only five studies of psychotherapeutic intervention (Owens et al., 2005). All of these were case studies. A literature search carried out for this review did not identify any randomised controlled trials of psychological intervention for older people diagnosed with PTSD.

Comorbidity of depression and anxiety disorders is highly prevalent (Beekman et al., 2000). A community-based study in the Netherlands found 47.5% of older people with major depressive disorders also met criteria for anxiety disorders, whereas 26.1% of those with anxiety disorders also met criteria for major depressive disorders (Beekman et al., 2000). Mixed anxiety and depressive disorders (where symptoms of both anxiety and depression do not reach diagnostic criteria for either disorder) also frequently occur in older people (Chiu et al., 2008; Rodda et al., 2008). Older people with depression have a 35% lifetime and 23% current prevalence of a co-morbid anxiety disorder (Beyer, 2004). Furthermore, when anxiety symptoms first occur in a person over 60 years of age with no history of anxiety, it generally suggests underlying depression (Baldwin, 2008; Chiu et al., 2008). Indeed, it is quite uncommon that people develop late-onset anxiety disorders for the first time in later life (Chiu et al., 2008), although there are researchers who disagree with this (Wetherell, Maser et al., 2005). Older people with co-morbid depression and anxiety typically have more severe depressive symptoms, an increased likelihood of suicide ideation, lower social functioning (Beyer, 2004; Rodda et al., 2008) and poorer outcome (Schoevers, Beekman, Deeg, Jonker, & van Tilburg, 2003)…..

The 2007 National Survey of Mental Health and Wellbeing found that the 12-month prevalence for depression and anxiety was 2% and 5%, respectively for older people living in private dwellings (Australian Bureau of beyondblue depression in older age: a scoping study. Final Report - National Ageing Research Institute (NARI), September 2009 - 13 - Statistics, 2008). Another Australian study found that the prevalence of depression was 8.2% among a sample of 22,252 community-dwelling older people (Pirkis et al., 2009). However, the prevalence rate is much higher in residential aged care facilities and a recent Australian study found that 34.7% of aged care residents suffered from depression (Snowdon & Fleming, 2008).

Australian Health Minister admits abusing her parliamentary entitlements

Sussan Ley admitted the error of her ways once she was found out, but then tries to restrict any investigation of her ministerial use of car and air travel allowances to only those trips to and from the Gold Coast area in Queensland.

Media Statement*

I have spent the past 48 hours examining my travel records.

I travelled to Brisbane on 9 May 2015 to make a major announcement about the availability of new medicines at a specialist breast cancer clinic and to meet with patients in Brisbane and on the Gold Coast. As I had to be in Canberra on Sunday 10 May I decided to stay the night of 9 May on the Gold Coast rather than incur considerable extra expense by flying back to Albury and then to Canberra the following day. This travel is within the rules provided.

However, I have always sought to apply higher standards for myself in using valuable taxpayers’ funds.

While attending an auction was not the reason for my visit to Queensland or the Gold Coast, I completely understand this changed the context of the travel undertaken. The distinction between public and private business should be as clear as possible when dealing with taxpayers’ money.

I have spoken to the Prime Minister and he agrees that this claim does not meet the high standards he expects of Ministers. I apologise for the error of judgement.

Tomorrow I will ask the Department of Finance to invoice me for the costs for the car and travel allowance claimed on Saturday 9 May 2015, including the relevant penalty applied to erroneous claims.

My examination of my travel records has also brought to my attention two other claims for accommodation on the Gold Coast in 2014 and 2015 where I should have stayed and claimed in Brisbane, as well as a single one-way flight from Coolangatta to Canberra in June 2015.

I will also ask the Department of Finance to invoice me the costs of these claims, as well as the relevant penalty.

In the interests of total transparency, I will ask the department to review all my ministerial travel to the Gold Coast.

As a member of federal parliament for over fifteen years Sussan Ley well knew the rules regarding parliamentary entitlements. 

If Ms. Ley wishes to be fully transparent then all her travel claims since she first entered the ministry on 18 September 2013 should be audited.

* Undated but believed to be on or about 8 January 2017

Remembering Australia's history

After my great grandparents were denied asylum in Aust they were murdered in Auschwitz. @TurnbullMalcolm please speak out against #MuslimBan pic.twitter.com/cr63PMJA1z

— Mireille Juchau (@MireilleJuchau) January 28, 2017

#NotMyDebt: stories from the trenches

When a government declares war on its citizens…….

I'm literally uploading scanned pages of my diary from FIVE YEARS AGO to prove to #centrelink that it's #notmydebt and I was overseas. pic.twitter.com/BUbq6B5M7Z

— Omnishambles (@AngelaChace) January 5, 2017

 News.com.au, 5 January 2017:

Like many Australians, Catherine Herir, from Brisbane, was sent a letter just last month telling her she owed thousands in overpaid unemployment benefits.

In FY2011 to 12, she claimed benefits after leaving her admin job for full-time study, but Centrelink’s new automated system — introduced in October to claw back money from claimants — had spread her wage across the whole year and calculated she needed to pay back $4500 she claimed while not working.

The 27-year-old told news.com.au she spent a month trying to sort out the issue online, making calls to Centrelink and chasing up old employers from five years ago.

“They suggested that I start a payment plan even before my review was complete to avoid being taken to a debt collector and they would reimburse me later if they found the debt was incorrect, which I refused to do because I knew it was wrong. Maybe that is what they are talking about their ‘recovery success rate’ because people start paying to avoid worse outcomes.

“I finally had enough and had a lengthy conversation with a Centrelink rep where the phone call went on for over an hour. I wouldn’t take no for an answer, so she did my review manually in minutes and then, sure enough, found I was not guilty at all. Human common sense overriding an incorrect computerised system.

“I was stressed and anxious about the debt and my case was straightforward, I couldn’t imagine any pensioner, person with a disability or illness trying to manoeuvre this system.”

Ms Herir’s ordeal is finally over, after she received a letter today confirming she owed nothing. The young woman is one of the lucky ones. Thousands of Aussies are being forced to pay back welfare payments because of suspected Centrelink computer errors.

News.com.au has been contacted by scores of scared and angry Australians who say they or their loved ones have been falsely accused of owing money to the social security program, and even pursued by private debt collectors. Several said they had begun paying the unexplained debt because of short timeframes given to sort out the mess, but others do not have a cent to spare.

They include people with autism, those in care, a woman undergoing chemotherapy, the elderly and people with other mental and physical disabilities.

The Guardian, 4 January 2016:

I received a letter from Centrelink two weeks before Christmas that resulted in a $3,197 debt. I knew that was wrong, so I documented how I believed the mistake happened.

In 2013/14 – the year Centrelink claimed I was overpaid – I earned $26,642. Centrelink divided this amount into 26 fortnights and falsely claimed I had earned $1,021 each fortnight, including the three months where I had no work and so claimed Newstart. You cannot give the necessary level of detail to avoid this error on the Centrelink web portal. They simply don’t give you the option to say anything other than your total annual income, essentially forcing you to go into debt. Then have to take complicated steps to have that false debt taken away. That’s when I contacted the media to tell them what was happening.

On Wednesday, my phone rang. The caller gave his name – the same name as an (in)famous radio shock jock. Oh no, are we on air, is he about to yell at me for being a bludger?

Phew, no, it was a different man with the same name, from Centrelink’s appeals department ringing to review my debt claim. He started by saying that Centrelink’s records showed that when I first applied for Centrelink back in 2013, as part of my approval process they had contacted my employer and confirmed that I was let go due to lack of clients at the time.

So Centrelink’s computer records this whole time has known that I legitimately wasn’t working for the whole year. Perhaps that’s something that the automated computer system could have flagged in the first place, before sending me a $3,197 bill.

The Centrelink staff member and I spent a few minutes on the phone as I talked through my payslips and I read out the amounts. All the amounts matched the information I had given to Centrelink at the time. He said he thought there would be little or no debt, but that he’d go over the numbers properly and call me back in half an hour. Mr Shockjock was lovely to deal with. The staff at Centrelink are victims in this situation too.

I asked if he was calling because of the appeal request I submitted through the Centrelink website, or because I’d been kicking up a stink in the media? He said the former, that it was a standard review process. I know that friends of mine who started an appeal before I even received my debt haven’t been phoned yet, but who knows – there are lots of kinks in the system. He then said that someone had informed him my case was sensitive as I had been taking my story to the media.

About 45 minutes later, he called again. I missed the call but he left a message to call him back. I was terrified dialling his number and waiting. I knew I was in the right but it was still scary.

He told me my debt had been reassessed, and he had confirmed with another staff member to be doubly sure, I suppose because my case is sensitive. He confirmed that my new corrected debt amount was $54.

This is a legitimate debt. He explained that it was to do with my restarting employment on a Monday, and my day of the week to report earnings (which is different for everyone, depending on when you sign up) was, I think, Tuesday. Then I had some working credit saved up in the system, which is why the amount came down to $54.

Working credit is a system where when in fortnights you make no income, it adds to the credit, so that when you start work you have a buffer before receiving your first pay slip. It means that the system will deduct from your working credit before they deduct from your Newstart payment. Without it, people who have started a full time job could find themselves not eligible for Newstart whilst their first pay packet may be weeks away.

Centrelink had my working credit data saved and used it in my appeal. But as I understand the automated system doesn’t use the working credit data, which if true is itself leading to extra false debts.

I’d like to tell Malcolm Turnbull and Christian Porter and Hank Jongen that I’m very keen to pay that legitimate debt back. I’d tell Alan Tudge too, but lord knows where he is right now. I hope that he’s having a lovely holiday. I like to imagine him coming in through the front door, Hawaiian shirt, sun tan, saying, “Country, I’m hoooommmeee! I wonder if anything happened while I was gone. Ooh, let’s check my messages.”

Mr Shockjock and at least one of his staff spent a few hours just on my own claim. It probably cost a thousand dollars in wages and admin, just to recover a debt of $54.

Read the full article here.

How to get a response pic.twitter.com/boftrMNtv8

— Asher Wolf (@Asher_Wolf) January 5, 2017

NITV, 4 January 2017:

Indigenous Australians have fallen victim to the growing Centrelink debt notice scandal, in which hundreds of thousands of people have received official letters demanding welfare money be repaid; only many of the alleged ‘debts’ have turned out to be wrong. NITV News has been inundated by stories from more than 100 people claiming they were erroneously told they owed Centrelink money. 

Since July 2016, a total of 170,000 debt recovery notices have been sent out to Centrelink recipients informing them they had committed fraud for underreporting their income and demanding they pay back thousands of dollars or face debt collectors. In some cases, the alleged outstanding balances exceeded $20,000.

Rachel Singe’s husband Travis received a letter demanding $23,000 from Centrelink in 2016, claiming the couple had not reported their income correctly.

“We went through all our tax reports and payslips and were told that he had not reported properly when he was working casually, even though we both reported every fortnight and usually reported that we had earned more than we actually did,” she told NITV News.

“It's so frustrating when you do everything by the rules and get a higher paying job so you no longer need Centrelink payments, and then get stung with a fine like this.”

The demands for non-existent debts come as a result of a new information sharing agreement between Centrelink and the Australian Tax Office (ATO), which is averaging people’s annual income across a whole year. Periods where people reported no income have now been incorrectly recorded against them by Centrelink as income earning periods.

The algorithm used is unable to differentiate between fortnightly reported income and the total income earned in a financial year. It’s been reported that no one at Centrelink foresaw the problems this would create.

School teacher Nicholas Kuilder received Newstart payments for 6 months in 2012 while looking for new work after relocating to a new city. Once he obtained work he cancelled Centrelink and thought nothing more of it.

“I then receive a letter claiming I owe Centrelink over $3800 from that financial year,” he told NITV News.

“This didn't seem right as I always reported my income correctly and was pretty diligent with my paperwork.

“Once I was able to get a hold of someone, I spoke with a person who seemed to have the ‘guilty until proven innocent’ stance, they were incredibly hostile over the phone.”

Nicholas had to wait another two weeks before he could get someone on the phone.

“We then found that the fault in the problem was that their system did not recognise that the schools I was reporting as having worked at all fell under the banner of the Department of Education, and were not separate ABN's from my Payslips. So essentially, they had doubled all of my reported earnings from the time I was on Centrelink,” he said.

“They also did not take into account that I was only on Centrelink for 6 months and that the previous 6 months were where a majority of my earnings from the financial year took place.”…..

Many people said they had repaid debts they did not owe because the challenge of going back over many years of tax returns and pay slips was either too much or they found the Centrelink process for challenging the debt extremely difficult.

Daniel Hayes told NITV News he was halfway through repaying the debt when he started seeing news articles about the debt scandal. He has since stopped paying Centrelink.

“I’m in the middle of repaying them $3350 for apparently not declaring correctly in periods where I didn’t even have a job. When I asked for proof, they told me I had to go through my bank records, so I’ve paid it for a year down to $1600,” he said.

Other people reported receiving Centrelink payments during part of the year and correctly declaring, then going off Centrelink once they found work. Because that work occurred in the same financial year as the Centrelink payments, the new algorithm has taken that income and averaged it out evenly, so it appears recipients had earnings whilst receiving Centrelink payments. The result is a demand for a debt that never actually existed.

Davis Darren is seeking legal advice after receiving a debt notice for $2,500 for allegedly failing to declare income for periods he was not working.

“The dates they say I failed to declare I wasn't actually working, and they are impossible to call and deal with. I don't have time during the day to go to a centre due to working. I don't understand why this has come up four years later,” he told NITV News.

Michelle Lotarski was hit with a staggering $25,000 debt demand relating to her parenting payment over a period of three years.

“In 2011 I was working part time when I made a parenting payment claim. There was no problem and I started receiving payments,” she said.

“They told me at my first interview for claim that I only had to provide my payslips and an estimate earned for the year. I submitted my tax each year, did Centerlink’s annual income estimate each year, was getting paid fine for three years, then all of a sudden I received my outstanding debt of a massively scary $25,000.”

ABC TV 7.30, 4 January 2017:

AMANDA STILBE: I feel like I've been treated like I'm a liar and a thief and that they just believe that I've done the wrong thing and they're making it extremely hard to do anything to rectify the situation.

PAT MCGRATH: Amanda Stilbe has been trying to explain to Centrelink that the $1,300 bill that it demands she pay is incorrect. The money is due in a month but she hasn't been able to make her case.

AMANDA STILBE: I went down to Centrelink and lined up and when I got to the front of the line, the lady just said, "No, you can't do that in person, you have to do it on the phone, because the people here don't have access to it".

PAT MCGRATH: The error, she believes, has been with the way Centrelink has matched the fortnightly income she declared during 2011/12 and her tax records from the same year.

AMANDA STILBE: Of course, there's going to be a discrepancy because I only started on partial Newstart at the end of December and I was working full-time, then went to part-time, then went to part-time with Newstart and then wasn't working at all. So of course the figures between the two aren't going to match. 

 The Age, 4 January 2017:

Janette Suffield was shocked when she received a letter out of the blue from Centrelink telling her she owed $2350 for payments she received in 2015.

The registered nurse who lives in Campbelltown in Sydney's west received a notice to repay the money in late November and has lodged an appeal.

Ms Suffield said the dispute is over payments she received in 2015 while she was on leave to recover from surgery.

"I seriously do not owe this money," she said.

"Since being alerted to this alleged debt I have been asked to report my income for the year in question no fewer than three times, both online and over the phone.

"I have been told I have to set up a payment plan to repay the debt or it will go to collections which to me seems ridiculous since I am appealing the debt."

The New Daily, 3 January 2017:

One former welfare recipient told The New Daily he received a letter five days before Christmas saying he “owed $2,105.17 including a $150.30 recovery fee” over payments made between 2011 and 2013.

“They have taken just over $1000 income earned from a single two-week contract and averaged it out to $72 per fortnight over a year,” the man, who did not want to be named, said.

Describing himself as “low-income”, the man has challenged the ruling but was told he would have to pay back $60 a fortnight while his case was being reviewed.

“I find the whole thing depressing, it taps into years of feeling powerless and on the edge of homelessness,” he said.

“While I was receiving benefits I did everything I could to get work. If I hadn’t worked or earned anything at all I wouldn’t be in this position.

“I think a lot of people will just submit and pay off incorrect debts out of fear.”

Another former welfare recipient, who preferred to be known only as Josh, told The New Daily he was now paying debts he believed he did not owe after Centrelink said it would go to his employer to garnish his wages if he did not agree to a repayment plan.

Josh said he first heard about the debt in August last year when he started receiving calls from a private debt collector, which told him he owed $4800 from the 2011-12 financial year.

Josh, who did not have access to all his payslips from the period, said he was now awaiting the results of a third review of his case.

“It’s one thing to fight them in private, but it’s a scary thought to think that I could lose my job or have my reputation tarnished because I was being accused of something I didn’t do,” he said.

Centrelink flat out telling people to call Life Line. Terrified someone will make a bad decision and socialising the risk. pic.twitter.com/qWLAAOJ10C

— Gordy (@GordyPls) January 4, 2017

If Centrelink makes a decision you disagree with, such as you have a debt, challenge the decision #notmydebt https://t.co/RRg4F2e5Ic

— Victoria Legal Aid (@VicLegalAid) January 4, 2017

notmydebt.com.au:

Debt amount: 

$8786

Date debt issued: 

Tuesday, March 1, 2016

Period debt occurred: 

July, 2010 to June, 2011

Payment Type: 

Sickness Benefit

Appealing Debt?: 

Yes in process

How has this affected you? e.g. anxiety levels, financial and accommodation stress: 

The first that I heard that I had a debt was when the debt collection agency contacted me in January 2016.The debt collection agency gave me 48 hours to contact Centrelink to investigate why I had a debt. When I called Centrelink on 5 January 2016, I was told that Centrelink had sent me several postal letters, none of which I had received as I was no longer at the address Centrelink held for me. I had received a vague text message from Centrelink telling me to access MyGov, which I did only to find that there was nothing there. I assumed it was a mistake and they had sent the message to the wrong number as it had been so long since I had received any benefits. None of this information about the employment review, assessment, or outcome is available to me online, despite having a MyGov account, which is linked to Centrelink. 

I have felt upset that I was made out to be in the wrong - of defrauding the system and having a debt, when I had declared my income correctly. Centrelink had me working for the full financial year, when I had only worked five months of the year, presumably why it had flagged my income. When I was contacted by the debt collector, I was shaking and was unable to sleep all night worried that it would jeopardise my new job as a senior public servant and my credit rating. My partner stayed home with me comforting me as I worked on how to prove that I had done the right thing, gathering evidence from past employers and working on how to submit it to Centrelink. 

When I spoke to Centrelink they told me that I should fax the supporting documents to Centrelink as I did not have the level of access to the online portal that would allow me to upload documents as it had been so long since I had been on benefits. I couldn't even prove easily that I was in the right! A friend sent through the documents to Centrelink via fax, as otherwise I would have to go in to a Centrelink branch, prove my identity, get the level of access (if it worked) and then go back home to upload it myself presuming that I could access the system. 

It has been a very traumatic process, that has taken time and effort and grief to sort out.

How do you feel about the way the Government has handled this process?: 

It has been very poorly handled, with no attempt made to get in touch with me to find out the reasons behind the supposed overpayment. They had not only my correct address (from the ATO via MyGov) and my email and mobile phone, yet all communications is via letter. It's appalling that the first I hear about a debt is from a debt collector who actually bothered to get in touch with me, for particular reasons, but nonetheless...

When I spoke to the lovely Centrelink officer (I have nothing but respect for those officers who are doing a tough and thankless job), she said that it sounded like the reason why I had an alleged debt was because Centrelink had incorrect dates in the system. There should be a manual check by a review officer before it goes this far. The automated system doesn't work, trying to marry a fortnightly system (Centrelink) with the annual system (ATO), which more often than not raises fictitious debts.

Debt amount: 

$523

Date debt issued: 

Friday, December 16, 2016

Period debt occurred: 

July, 2016 to December, 2016

Payment Type: 

Family Tax Benefit

Appealing Debt?: 

Yes & I won

How has this affected you? e.g. anxiety levels, financial and accommodation stress: 

We both work on contracts and don't get paid over the Christmas break and are under enormous financial stress. We tried calling repeatedly but with a demanding baby we had to hang up around the 30 minute point. We were then contacted by debt collectors, so waited 45 mins to get through to Centrelink who explained that (despite our called to rectify this problem several times) our medicare and Centrelink records were not linked and our payment was being recalled as we had not had our son immunised. Our son has had all of his immunisations and we have even sent them documented evidence of this. Despite it not being our error, we were then told that although we would not have to make the payment we would have to call the debt collectors to 'call off the hounds'. We're still on hold Probe Group trying to sort it all out.

How do you feel about the way the Government has handled this process?: 

Why couldn't they have detailed why we were being asked to make the payment in the letter? It would have been far better, we'd have known it was an error straight away, rather than feeling like the Government thought we were thieves. Then to have to manage the debt collection agency ourself... The government can not be efficient in managing our son's immunisation records through their agencies, making repeated errors, but they can get a debt collection agency on to us to retrieve a legitimate payment in no time at all. It's a disgrace, it shows a contempt and distrust that this government reserves for low income earners. When you consider the perks and rorts of parliamentarians, it just makes you give on believing the government is capable of anything good. The government reduce us to units, consumers and burdens on the system, they hate us.

Background

The Dept. of Human Services and Centrelink decided that a form of profiling based on socio-economic status accompanied by an implied threat of arrest was the best way to kick of its debt recovery program, which is now producing evidence of numerous false debts being created by the automated software program in use.

Image from No Place for Sheep

The Advertiser, 20 March 2016:

WELFARE recipients from areas identified as being at high risk of fraud or noncompliance are about to get a shock, with stern letters arriving in the mail from the police telling them to update their details.

The letters started arriving at the weekend from Taskforce Integrity, the joint Australian Federal Police/Department of Human Services operation targeting welfare fraud.

The letters contain the AFP logo next to the Centrelink one, and are designed to remind people that intentionally giving wrong details to Centrelink is a crime.

It is the first time a police logo has been included in correspondence with welfare recipients.

Human Services Minister Alan Tudge said those who received welfare payments must ensure their information is correct.

“Australians should be proud that we have a strong social security safety net, but we must remember welfare payments come from taxpayers, who have a right to expect integrity in the system,’’ he said.

“There are serious consequences for those who deliberately defraud the system. The Australian Federal Police have partnered with us to crack down on welfare cheats.’’

Australia’s welfare bill currently stands at $150 billion a year and is tipped to grow to almost $190 billion over the forward estimates.

The Government is using firm integrity and compliance measures to rein in the growth and is targeting those who commit fraud, or who fail to provide full details of their earnings when claiming welfare.

The first batch of letters is now arriving in letterboxes and email inboxes in southern Queensland and will then be rolled out to other geographical areas around Australia considered to be at high risk of fraud or noncompliance.

Legislation.gov.au, August 2016:

The Guardian, 6 January 2017:

The man handpicked by Malcolm Turnbull to head the government’s digital transformation has said the error rate in Centrelink’s data-matching process is so unfathomably high that it would send a commercial enterprise out of business.

Paul Shetler, the former digital transformation office head, criticised the government’s response to its latest IT crisis, telling Guardian Australia it was symptomatic of a culture of blame aversion within the bureaucracy.

“It is literally blame aversion, it is not risk aversion,” Shetler said. “They’re trying to avoid the blame, and they’re trying to cast it wide.

“The justifications that have been given I think are just another example of the culture of ‘good news’, reporting only good news up through the bureaucracy.

“I’m sure that the bureaucracy was being told at every single level that everything was OK.

“That’s how it works in the bureaucracy. Bad news is not welcomed, and when bad news comes, they try to shift the blame.”

It is the first time Shetler, formerly the government’s chief digital officer and a former chief digital officer for the UK ministry of justice , has broken his silence on the series of IT failures that have plagued the government in recent months: the census debacle, the failure of the Australian Tax Office systems and now Centrelink’s debt recovery problems.

Shetler resigned in November after being hired by Turnbull to transform the government’s approach to digital technology.

He said it was difficult for him to watch successive IT failures, which he described as “cataclysmic” and “not a crisis of IT” but a “crisis of government”.

“I said when I came in that this would be happening, I said this was already happening, I said it was unacceptable and I made that case the entire time I was at the DTO [digital transformation office], and the DTA [digital transformation agency],” he said.

“I was very explicit about it internally, not nearly as much so externally. It was a fight that I fought from day one, not an easy fight to win, because you’ve got an entire bureaucracy of IT bureaucrats who are backed by large vendors, who have large numbers of staff, and because ministers, I’m going out on a limb here, very quickly become captive to the departments that they deal with.”

Shetler said the consequences of the failures of the Centrelink system were different from problems with the census or the ATO because they were felt by those least able to deal with it.

He said data-matching systems must have human oversight to deal with mistakes.

“The way they did it, obviously it’s dangerous, because their algorithms are flawed in the first place,” Shetler said.

“Secondly, you have to be careful with data. Much of the data that’s in the federal government, how good is it really? There is this sort of a blind faith in data.”

The government has continued to deny any problem with its automated compliance system, which relies on data-matching income reported to Centrelink with tax office records.

The Huffington Post, 4 January 2017:

People are reporting having to make hundreds of calls to Centrelink before the phone line even connects, and spending hours on hold once their call actually goes through, as the nation's welfare debt recovery saga continues…..

Understandably, people are trying to contact Centrelink to ask questions, provide more information or dispute the debt -- but some say they have made hundreds of calls to various Centrelink phone lines only to spend hours on hold…..

Dan Buzzard, from Perth, showed the Huffington Post Australia evidence he had called 132 490 -- for enquiries about Austudy, the Low Income Health Care Card, the Pensioner Education Supplement and Youth Allowance -- 350 times on Tuesday before even getting a dial tone, being rejected with messages that the line was busy.

"I went into the office four times but they wanted me to do it online or on the phone. [On Tuesday] I tried the phone, the line was busy, and it took 24 attempts to even get through the first time. Then I spent an hour on hold and the line went dead," he told HuffPost Australia.

"Then I had to make 350 calls before I even got a dial tone, then it was an hour and a half on hold before I even spoke to a person."

The Guardian, 5 January 2017:

Senior levels of government would have known the risks posed by Centrelink’s new automated debt recovery system before it was rolled out, according to a former high-ranking departmental official…..

Australians with a disability say they have been chased by debt collectors over inaccurate debts, and the Australian has reported that the visa status of asylum seekers has been threatened in instances of non-payment.

The main focus of complaints continues to be on the system’s automated comparison of an individual’s reported income to Centrelink and information held by the Australian Taxation Office.

The Department of Human Services source, who is no longer with the agency, told Guardian Australia the risks of using the automated data matching system in such a fashion would have been known at senior levels before it was rolled out.

“Knowing the process, a risk assessment would have been done,” they said. “The risks would have been discussed at very senior levels. The minister would have been briefed – if he wasn’t, it would be extremely rare.”……

The source said using data matching to detect potential overpayments could work but it needed manual oversight to ensure flaws and inaccuracies were weeded out.

Before July, Centrelink staff manually checked discrepancies and followed up with customers via telephone and letter, a process that was stopped to allow the government to ramp up its efforts to claw back $4bn of debt in the next four years.

The Sydney Morning Herald, 5 January 2017:

Linda Burney, Labor's human services spokeswoman, has written to the Australian National Audit Office requesting they investigate Centrelink's controversial $4.5 billion debt clawback project amid ongoing accusations that it is unfairly targeting people and miscalculating bills.

The opposition and community groups are maintaining pressure on the government as the new system, enabled by data-matching with Australian Taxation Office information, causes consternation by handing out mistakenly oversized debts and contacting some social security recipients who don't owe Centrelink any money.

Ms Burney's letter to Auditor-General Grant Hehir requests that, in light of "overwhelming" constituent complaints about the contentious process, the ANAO examine the effectiveness, risk management and planning of the system and the actual value of the resulting budget savings, including analysis of whether falsely calculated debts have already been banked.

"Recently the acting Minister for Human Services, Hon Christian Porter MP, stated that since the beginning of the financial year the program had made savings of $300 million but Mr Hank Jongan, General Manager of [the Department of Human Services], later claimed that this number represented the identified debts," she wrote.

"This discrepancy requires investigation given that the program has a failure rate of at least 20 per cent."

Australian Lawyers for Human Rights, 6 January 2016:

ALHR slams unethical behaviour of Centrelink as abuse of legal process

January 6, 2017

MEDIA RELEASE

For immediate release – 4 January 2017

 The current attacks upon past and present pension payment recipients by Centrelink and the Minister for Social Services are “wrong at so many legal levels that it’s hard to know where to begin,”, ALHR President Benedict Coyne said.

“At the most basic level, no entity should be issuing legal demands for money unless they are absolutely certain the money is owed and can substantiate this in court. It is for the creditor to prove any debt. It is also up to the creditor to ensure the alleged debtor receives the repayment demand. It is entirely wrong for Centrelink to put alleged debts in the hands of debt recovery agents when the debts are not proved and/or the alleged debtor never received the original claim, or to claim interest or process fees on money that is very probably not owing at all.”

“The whole procedure is quite unethical and a complete abuse of legal process,” he said

“In this case it appears clear from numerous reports that the computer software the Minister is relying on is flawed. Legally, it is for Centrelink as purported creditor to substantiate its calculations, not for individuals as alleged debtors to prove that Centrelink is wrong. But of course Centrelink threatens to cut off recipients if they don’t pay, putting them in a terrifying situation. This could well be described as ‘demanding money with menaces.’”

“It is also clear that Centrelink has made minimal efforts either to check its calculations, despite having the ability to cross check information with Tax Office records, or to track down current addresses of alleged debtors.”

“The situation is even worse in that Centrelink is targeting individuals with minimal resources who may be in particularly vulnerable situations, including asylum seekers and people with disabilities. According to a recent news article, asylum seekers have been reminded in their debt notices that ‘an outstanding debt to the commonwealth can affect future visa grants and/or re-entry into Australia.’ The repercussions, therefore, could be dire.”

Further, Centrelink is refusing to provide any means by which individuals or their solicitors can readily contact a human being at Centrelink to do what Centrelink is [wrongly] demanding, which is to prove that the individuals don’t owe the money being claimed.

This refusal on the part of Centrelink to facilitate normal methods of contact enormously exacerbates the emotional stress of those targetted and again indicates unethical behaviour and an abuse of process.”

“ALHR believes that the behaviour of Centrelink and the Social Services Minister involves numerous breaches of the human rights of those being targeted for alleged debts, contrary to Australia’s international law obligations. Under the Universal Declaration of Human Rights the following rights are being breached:

• to be treated with dignity (Preamble, Article 1)
• to the protection of the rule of law (that there must be proper laws, a legal system that allows appeal against government decisions, and the laws of the country must be properly enforced) (Preamble) and the related right to freedom from attacks upon one’s reputation (Article 12)
• to non-discrimination on the basis of property (or lack of it, the persons being targeted being those who have received a government payment)(Preamble, Article 2)
• to equal protection of the law without discrimination (Article 7)
• not to be arbitrarily deprived of property (Article 17)
• to equal access to the public service (Article 21)
• to social security (Article 9 of the International Covenant on Economic, Social and Cultural Rights, ICESCR, which is binding on Australia)
• to protection against unemployment and to have employment income supplemented ‘if necessary, by other means of social protection’ (Article 23)
• to an adequate standard of living, including the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond one’s control (Article 25)

“ALHR calls on the Minister to immediately halt the operation of the current process and to refund, with interest, all moneys incorrectly claimed by Centrelink.”.....

Need Help?

Thousands of people all over Australia are receiving intimidating letters from Centrelink, many of which are falsely claiming debts are owed. If you have received one, or know someone who has, consider your options before paying. Our friends at Victoria Legal Aid have prepared something to help:

https://www.legalaid.vic.gov.au/find-legal-answers/centrelink/get-help

Sign a Petition

You may wish to sign a Change Org petition

North Coast Voices:

Singing the Centrelink Blues - with lyrics straight from Looney Tunes, 3 January 2017

#NotMyDebt: those who feel able begin to fight back, 5 January 2017