13 April 2021

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

People with disability responded to the paper calling for the use of ‘restrictive practices’ against people with disability to be used as a 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 changes to ensure those restrictions are consistent across Australia.

In 2021, the NDIS Quality and Safeguards Commission revealed that it had received reports of 302,690 unlawful uses of restrictive practices for 2019 and 2020. That means that 78% of reports were reported in just the second half of the year.

Responses from people with disability to the Restrictive practices issues paper:

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 cause serious harm.

The Disability Royal Commission received submissions from people with direct experience of restrictive practices. These submissions were confronting and often disturbing.

Please note, the information below contains sensitive material that may be triggering for people with disability.

Respondents highlighted many types of restrictive practices:

• Physical restraint (holding a person down)
• Mechanical restraint (using or disabling a device to restrict a person’s movement)
• Environmental restraint (locking a person in a room)
• Chemical restraint (using a drug to sedate someone whose behaviour is challenging)

Many disability service providers told the Disability Royal Commission that the most common form of restrictive practice is chemical restraint.

The Commission also heard 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 said that restrictive practices might be used for the safety of the person with disability (or others), but they were just as often used for convenience.

Respondents explained that people with disability will encounter these various forms of restrictive practices in a variety of settings. These range from:
• Family homes
• Disability accommodation settings
• Schools
• Workplaces
• Health and criminal justice systems

The Disability Royal Commission also received a range of responses outlining potential drivers of restrictive practices in different settings.

People with disability responding to the Restrictive practices issues paper said there is still a ‘lack of awareness and understanding of the rights of people with disability’, which makes it acceptable to use restrictive practices as a ‘way of handling a situation’.
• Inadequate training
• Lack of proper staff ratios
• Casualisation of the disability workforce
• Underfunding of the disability sector

were also highlighted as factors contributing to the use of restrictive practices.

Recommendations by people with disability

• Reducing the use of restrictive practices in the short and long term
• Creating nationally consistent laws, better training, proper accreditation, and independent monitoring of the use of restrictive practices
• Greater community education to better understand the rights of people with disability in relation to restrictive practices.

For more information, please visit the Disability Royal Commission website.