What you need to know

• The Disability Royal Commission has published a research report on eliminating restrictive practices of people with disability.
• Restrictive Practices — A Pathway to Elimination argues that restrictive practices contradict the human rights of people with disability, causing trauma, harm and dehumanisation.
• A collaboration between three universities, it recommends prohibiting restrictive practices, addressing historical injustices and promoting positive behaviour support.
• It calls for deinstitutionalisation and proper resourcing of independent living, plus approaches that are trauma-informed and recognise autonomy.

The Disability Royal Commission (DRC) has published a research report on eliminating restrictive practices of people with disability. Restrictive Practices — A Pathway to Elimination argues that restrictive practices contradict the human rights of individuals with disability, causing trauma, harm and dehumanisation.

The research report from the University of Melbourne, the University of Technology Sydney and the University of Sydney recommends prohibiting restrictive practices, addressing historical injustices and promoting positive behaviour support. It calls for deinstitutionalisation and proper resourcing of independent living, plus approaches that are trauma-informed and recognise autonomy.

The report guides the DRC in reducing and eliminating restrictive practices, such as physical, chemical, mechanical and environmental restraints, forced sterilisation, involuntary mental health treatment, and other non-consensual interventions. The report states these violate the human rights of people with disability. It argues the violence and coercion they perpetrate warrants immediate attention and action.

Findings

1. Violation of Human Rights: The report establishes that restrictive practices fundamentally contradict international human rights obligations. These practices strip people with disability of their dignity and expose them to trauma, harm, abandonment, fear and dehumanisation.
2. Ecological System of Violence and Coercion: Restrictive practices operate within an ecological system of violence, coercion and control. 'Behaviours of concern' are often misunderstood and misinterpreted as dangerous, leading to further segregation and clustering of individuals with disability.
3. Limitations in Positive Behaviour Support (PBS): While PBS is advocated to address restrictive practices, its evidence base is mixed and inconclusive. Some positive outcomes arise when staff demonstrate nonconfrontational communication, respect autonomy, enable meaningful activities and prioritise the wishes of the person with a disability.

Eight-Point Action Plan

The report presents a comprehensive eight-point action plan to eliminate restrictive practices:

1. Prohibition of Restrictive Practices: Governments in Australia should immediately enact laws prohibiting the use of restrictive practices on a discriminatory basis against people with disability. This step aligns with international human rights obligations and established principles of violence prevention.
2. Addressing Socio-Cultural Attitudes: The report recommends investing in changing discriminatory socio-cultural attitudes that drive restrictive practices. Awareness-raising efforts are essential to combat stereotypes, prejudices and harmful practices against people with disability.
3. Acknowledging Historical Injustice: Governments must publicly acknowledge past wrongs and support truth-telling processes to reckon with and be accountable for meaningful change.
4. Deinstitutionalisation and Desegregation: Governments should commit to full deinstitutionalisation and desegregation of living environments for people with disability, including 'special' schools, Australian Disability Enterprises, group homes, day centres and mental health facilities.
5. Recognising Autonomy and Leadership: Governments should respect and protect the autonomy of people with disability in making decisions about their lives and bodies, in line with the Convention on the Rights of Persons with Disabilities (CRPD).
6. Trauma-Informed Support Approaches: Service systems should adopt trauma-informed approaches, recognising that restrictive practices are traumatic experiences.
7. Adequate Resource for Independent Living: Governments must fully resource and realise the rights to independent living and inclusion as outlined in Article 19 of the CRPD.
8. Providing Redress for Victim-Survivors: Investment in law reform and a national redress scheme is necessary to acknowledge and rectify historical injustices perpetrated against people with disability.

Addressing Ambiguities and Recommendations

The report acknowledges the lack of clarity surrounding the definition of 'restrictive practice' and recommends a comprehensive definition that encompasses all interventions limiting the rights and freedom of movement of individuals with disability. It highlights the need for all forms of restrictive practices to be addressed uniformly to prevent lawful harm to people with disability.

What does this mean for the sector?

The disability sector is committed to reducing and eliminating the use of restrictive practices wherever possible. This requires a well-trained team, working together. Providers need to be adequately funded to provide high-quality, specific training to their staff on the use of positive, person-centred strategies.

NDS made a submission to the Disability Royal Commission on restrictive practices, which addressed the complexities of this issue.

NDS promotes the safeguarding of the rights of people with disability, most notably through the Zero Tolerance initiative, which provides free support and training for disability service providers. This initiative assists disability service providers to understand, implement and improve practices that safeguard the rights of the people they support.

If enacted, the findings in this report will require more reforms in disability support services. Service providers will need to increase knowledge and implement trauma-informed, person-centred and non-coercive approaches that respect the autonomy and dignity of individuals with disability.

For providers, this may mean more reform of service systems to recognise and respond to the traumatic experiences of people with disability. The report argues that deinstitutionalisation and desegregation would encourage more community-based and inclusive living arrangements, reducing reliance on ‘segregated’ settings.

The report’s call for more funding for independent living and trauma-informed approaches is something NDS has been advocating for a long time. Also, the report recommends that those who have undergone restrictive practices need more options for redress.

It says society's attitudes will also need to change. Awareness must be raised and discriminatory norms challenged to create a more inclusive and supportive environment for people with disability.

Conclusion

The report provides a crucial framework for the Disability Royal Commission to fulfill its objective of reducing and eliminating restrictive practices. By taking a comprehensive and holistic approach, which considers legal reform, societal change, acknowledgment of past injustices and trauma-informed support, it seeks to protect and promote the human rights and dignity of people with disability. The report urges swift action and a commitment to eliminating restrictive practices to create a society that upholds equality, autonomy, and respect for all its citizens, regardless of their abilities.

You can download the report from the Commission’s website in pdf, Word, and easy-read versions.

Article sourced from National Disability Services