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Overview of responses to the Restrictive practices issues paper published today

The Disability Royal Commission has published the Overview of responses to the Restrictive practices issues paper.

Respondents to the paper overwhelmingly called for the use of ‘restrictive practices’ against people with disability to be a method of last resort. They said the use of restrictive practices should be supervised by properly funded and trained professionals, and managed according to clear, legally enforceable restrictions. They also called for reforms to ensure those restrictions are consistent around Australia.

Last year the NDIS Quality and Safeguards Commission revealed in evidence to the Royal Commission that it had received reports of 302,690 unauthorised uses of restrictive practices for 2019/2020 - 78% of which were reported in just the second half of the year.

Reponses received by the Royal Commission to this paper make it clear that restrictive practices are ‘used every day in the lives of people with disability’, even though they often cause serious harm to the people subjected to the practices. Responses urged action to limit the use of restrictive practices.

Respondents highlighted many types of restrictive practices, including physical restraint (holding a person down); mechanical restraint (using or disabling a device to restrict a person’s movement); and environmental restraint (locking a person in a room).

A number of disability service providers told us that the most common form remains chemical restraint, such as using a drug to sedate someone whose behaviour is perceived to be challenging.

We were also told that it is ‘common for men with intellectual disabilities to be chemically castrated’ and that ’women are given birth control without consent so that staff do not have to assist with personal hygiene and to prevent pregnancy in case of sexual assault’.

The family member of a woman with disability acknowledged that restrictive practices might be used for the safety of the person with disability (or others), but they were just as often used for ‘operational convenience’.

Respondents explained that people with disability will encounter these various forms of restrictive practices in a variety of settings. These range from their family homes, disability accommodation settings, schools, workplaces, to the health and criminal justice systems.

We also received a range of responses outlining potential drivers of restrictive practices in different settings.

Respondents said the key factor driving the use of restrictive practices is cultural issues in the disability services sector. There is still a fundamental ‘lack of awareness and understanding of the rights of people with disability’, which normalises the use of restrictive practices as an ‘acceptable way of handling a situation’.

Inadequate training, a lack of proper staff ratios and casualisation of the disability workforce as well as underfunding of the sector generally were also highlighted as factors contributing to the use of restrictive practices.

Responses proposed recommendations to reduce the use of restrictive practices in the short and long term. These included enacting nationally consistent laws, better training, proper accreditation and independent monitoring of the use of restrictive practices. Responses also suggested that people with disability and the broader community require more education to better understand their rights in relation to restrictive practices.