Reducing restrictive practices: A review of evidence-based alternatives

Reducing restrictive practices: A review of evidence-based alternatives – Research Report

Background

The Disability Royal Commission was concerned about restrictive practices and wanted to know more about alternative strategies that could be used to reduce and eliminate them. We also wanted to better under the role of ‘positive behaviour support plans’ as a way of reducing the use of restrictive practices.

We asked researchers from the University of New South Wales to look into this. They have written a report, which we have now published.

This video is a summary of that report.

What are restrictive practices?

There are different types of restrictive practices:

• physical restraint – for example holding a person down on the ground

• mechanical restraint – for example handcuffing a person to a bed

• chemical restraint – for example giving a person medication to calm them down

• environmental restraint – for example keeping a person in a room by themselves.

In some circumstances, Australian laws and policies allows the use of restrictive practices on people with disability. For example, under the National Disability Insurance Scheme (NDIS), restrictive practices may be used as a last resort to restrain a person with disability who is behaving in a way that is considered harmful to themselves or other people.

Restrictive practices can be physically and mentally harmful, and they restrict the rights and freedoms of persons with disability. Australia is obliged to reduce and eliminate the use of restrictive practices as required under the Convention on the Rights of Persons with Disabilities.

What did the report find?

This report found there is not much research on what works to reduce the use of restrictive practices on people with disability. There is not much research on the experiences of people with disability, nor what they think should be done to reduce and eliminate restrictive practices. 

Support with housing and in the home can help people with disability stay out of places such as hospitals, where restrictive practices are most likely to be used.

This report says that change is needed at many levels to reduce and eliminate the use of restrictive practices on people with disability.

Many changes are needed in how disability services operate. This includes:

• how they collect data and monitor restrictive practices

• how they train staff

• how staff work with people with disability

• how people with disability are consulted and involved in decision-making.

Positive behaviour support

Positive behaviour support is an approach used to prevent and respond to behaviours that are considered ‘challenging’. Positive behaviour support usually involves developing behaviour support plans to:

• understand why people with disability use challenging behaviours

• ensure these behaviours are managed in personalised ways

• ensure that restrictive practices are only used as a last resort.

This report looked at studies on behaviour support. It found there is not much research in this area. Studies that have been done suggest that behaviour support plans are more effective if staff are trained to implement plans properly and if plans are easy to understand and follow.

More information

To read the full report, visit our website. Go to the ‘Publications’ section and click on ‘Research program’.

disability.royalcommission.gov.au