To reduce the use of restrictive practices, service providers should work with people with disability and their families, according to a research report commissioned by the Royal Commission. The report, titled Reducing restrictive practices: A review of evidence-based alternatives has been published today.
Restrictive practices include the use of seclusion and mechanical, physical, chemical and environmental restraints. They may be used in a variety of settings including disability and health services and residential settings.
Researchers from The University of New South Wales (UNSW Sydney) reviewed research about ways to reduce restrictive practices. The researchers looked at studies and initiatives in disability, mental health, psychiatry and nursing settings in Australia, the Unites States, the United Kingdom, and other countries, between 2012 and 2022.
The report states reducing restrictive practices requires change at many levels. As well as working with people with disability and their families, service providers should train their staff, use data to inform their practice, ensure effective leadership and have clear crisis management strategies. Infrastructure, facilities and service cultures also need to improve. These changes should accompany legal and policy reform.
The report found that initiatives to reduce restrictive practices should be tailored to the people and environments where they are used, rather than adopted ‘off the shelf’. They should be evaluated to understand where they are working, and where further improvement is needed. The use of restrictive practices should be monitored nationally.
The report concludes that steps towards a human-rights based approach to eliminating the use of restrictive practices is needed. These steps should be informed by the emerging body of evidence-based practice outlined in the report.
