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New report on restraint and restrictive practices in Australia

Use of forced restraint and restrictive practices against people with disability violates international human rights: Australian governments must end the use of forced restraints and restrictive practices against people with disability, a new report says, amid recent concerns about their continuing and expanding use in disability, mental health, education, aged care, justice and other sectors.

Restrictive practices: A pathway to elimination, finds the practices violate international human rights laws, and cause life-altering effects and lifelong trauma for people with disability. The report recommends governments in Australia impose an immediate legal prohibition on the use of these practices.

Restrictive practices include using chemical, mechanical, physical and environmental restraint and seclusion – such as forced behaviour-modifying medication, tying people to chairs and beds, and locking people in rooms and houses against their will- and other non-consensual or coercive interventions including forced sterilisation and anti-libidinal medication.

Report co-author Dr Claire Spivakovsky, from the University of Melbourne School of Social and Political Sciences, said restrictive practices strip people with disability of dignity.

“People who have been subject to these practices have described them as cruel, humiliating, dehumanising and traumatising – completely at odds with the international human rights obligations for the treatment of people with disability,” Dr Spivakovsky said.

“If we are serious about ending violence against people with disability, then we need to stop the use of restrictive practices, not just reduce them.”

Current national and international approaches aimed at reducing the use of restrictive practices – including positive behaviour support – show mixed or inconclusive findings about effectiveness.

The report recommends that the systemic and structural drivers of the use of restrictive practices – including inadequate resourcing of sectors engaging with people with disability – be urgently addressed to bring an end to their use.

“A significant driver for restrictive practices is that the disability, mental health, education, aged care and other sectors have not been adequately resourced or staffed to support the needs and rights of people with disability in appropriate and meaningful ways, and this is creating unsafe environments,” Dr Spivakovsky said.

The report also calls for the full deinstitutionalisation and desegregation of people with disability in Australia, law reform to prohibit the use of restrictive practices, and society-wide acknowledgement of responsibility for the systemic violence, abuse, neglect and exploitation experienced by people with disability who have been subject to restrictive practices.

Restrictive practices: A pathway to elimination, was commissioned by the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, and is co-authored by University of Melbourne Dr Claire Spivakovsky, University of Technology Sydney Associate Professor Linda Steele, and University of Sydney Associate Professor Dinesh Wadiwel.

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