Restrictive practices

Restrictive practices issues paper

We are the Disability Royal Commission.

We have written an issues paper on an important topic. We invite you to respond.

Your responses will help us in our work.

We are interested in the use of restrictive practices on people with disability.

Restrictive practices stop a person from moving around freely, or how they want.

Restrictive practices include seclusion, for example, locking a person in a room.

Restrictive practices also include using restraints.

Examples of retrains might be holding a person down on the ground so they cannot move in hospital.

Or using medication to change their behaviour.

Or tying a person to a chair in a classroom or locking a fridge in a group home to stop a person from accessing it.

Or always telling a person that doing an activity is too dangerous even if it isn't.

Restrictive practices can hurt a person.

They can cause physical or psychological harm.

They may even cause death.

Approaches to restrictive practices

There are lots of laws and policies about restrictive practices.

There are national agreements to try to reduce or stop the use of restrictive practices in Australia.

The National Disability Insurance Scheme has rules about restrictive practices.

Many people believe restrictive practices are not needed.

Other people believe that they are sometimes needed to protect people from harming themselves or others.

Research shows that restrictive practices can be prevented or avoided.

Questions

This issues paper includes 13 questions.

These questions ask about different things such as:

• Where, when, how and why are restrictive practices used on people with disability?
• What is the impact of restrictive practices?
• Are restrictive practices needed?
• What rules should there be around restrictive practices?
• What alternatives are there to restrictive practices?

Your response

You do not have to answer every question.

You can respond in any way you like.

You can respond in writing or by a video recording.

To read the full issues paper, and for more details on how to respond, go to the Publications section on our website.

Thank you.

Overview of responses to the Restrictive practices Issues paper

Introduction

The Disability Royal Commission published an issues paper on restrictive practices in May 2020.   

We asked people to tell us what they thought about restrictive practices. We received 54 responses.

We have now published an overview of what we were told in these responses. The responses will help inform our work and our recommendations to make a better, safer society for people with disability.

What did the responses say?

People discussed the definition of restrictive practices we provided. Lots of respondents thought there should be clearer definitions of restrictive practices. Some people thought the term was too critical or negative; some thought it wasn’t critical enough.

Restrictive practices come in various forms. They include:

• physical restraints where a person is physically held down
• chemical restraints when medication is used to sedate or control a person’s behaviour
• mechanical restraints where devices are used to control someone, such as handcuffing them to a bed
• environmental restraints which limit a person’s access to their surroundings. For example limiting their access to food in the fridge.
• seclusion where a person is forced to stay in a space by themselves

The responses we received shed light on the extent and impact of restrictive practices.

Some people considered chemical restraints the most common restrictive practices.

We heard that that restrictive practices are used in different settings, including homes, group homes, schools, health settings (eg hospitals) and the justice system (eg gaols).

Some respondents suggested First Nations people with disability are more likely to experience restrictive practices.

Respondents said restrictive practices can have negative effects on people with disability. This includes trauma, poor health, shorter lifespan and death.

They said using restrictive practices can be degrading and cruel. It can create a culture which does not value people with disability, and make denying them their rights seem normal.

What contributes to use of restrictive practices?

Some people said restrictive practices are used when a person’s needs cannot be met For example, a disability support worker in a group home may come across a resident who is distressed and agitated. The support worker might use a restrictive practice, like giving them a sedative, to control the behaviour, rather than working out what’s wrong and helping to meet their need.

Another contributing factor is lack of training and resources. Restrictive practices may be used as a simpler and convenient way to address a complex situation.

Respondents also identified cultural factors as a cause for using restrictive practices. This includes workplaces that do not respect the rights of people with disability.

Permitting or prohibiting restrictive practices

Some people said that restrictive practices should never be legally allowed. Others said that they should be allowed, but only under strict circumstances where there is proper supervision and rules.

Possible solutions

Respondents discussed a range of ways to prevent, reduce or stop the use of restrictive practices. These included:

• changing workplace cultures to support human rights
• improving training and education
• ensuring restrictive practices are properly monitored
• ensuring disability sector professionals and the NDIS are properly trained and accredited, and accountable for how they treat people with disability.

There were also recommendations to try alternative ways to avoid restrictive practices, and recommendations on where funding should be increased.

More information

To read the overview and people’s responses to the issues paper, visit the ‘Publications’ section on our website.