Responsibility: State and territory governments
Response:
ACT, SA, TAS, VIC, WA, NT: Accept in principle
NSW, QLD: Subject to further consideration
Australian Capital Territory
Response: Accept in Principle
Status: In progress
What has been achieved to date
The ACT Government is currently considering implementation opportunities for this recommendation in the territory, noting the ACT’s existing Senior Practitioner regulatory settings, other relevant legal and policy settings, and potential gaps in coverage across systems.
Canberra Health Services aims to minimise and where possible eliminate the use of restrictive practices. Canberra Health Services policies and procedures aim to ensure that the human rights and dignity of any person who may be subject to an episode of seclusion are protected and that seclusion where indicated is provided in the least restrictive environment. The Mental Health, Justice Health and Alcohol & Drug Services Restraint, Seclusion and Restrictive Practices Review Committee look at restrictive practices and discusses any learnings. The committee membership is made up of representative from the Official Visitors, Public Advocate and consumer and carer groups.
ACT government response July 2024
A regulation outlining the prohibited practices for providers under the Office of the Senior Practitioner was notified by the ACT Government in December 2023. This regulation included the list of practices set out by the Disability Royal Commission in 2019.
Within Canberra Health Services, internal policies and procedures are in place regarding restrictive practices for people who are or are not detained under the Mental Health Act 2015 (ACT). These documents outline the process that all Canberra Health Services staff must follow when considering the use of restraint, minimising and where possible eliminating the use of restrictive practices. If required, the documents outlines the appropriate care and monitoring of the person whilst restraint is in place. There are evaluation measures included in these documents, including monthly review of episodes of restrictive practices.
The ACT Government will consider whether there are gaps in coverage that require further action.
New South Wales
Response: Subject to further consideration
Status: Subject to further consideration
What has been achieved to date
Work is underway across Health, Education and Communities and Justice portfolios to consider how best to address the matters raised by recommendation 6.36.
The current NSW Health Seclusion and Restraint in NSW Health Settings Policy Directive (PD2020_004) provides a list of prohibited practices which closely align with DRC Recommendation 6.36.
The additional practices outlined in this DRC recommendation will be carefully considered as part of the review of the NSW Health policy, currently underway.
The Department of Communities and Justice is currently examining the NSW Restrictive Practices Authorisation Policy, which covers NDIS settings in NSW. Consideration is being given to strengthening prohibitions on the use of certain restrictive practices in disability settings, in line with the list agreed by the former Disability Reform Council in 2019.
NSW government response July 2024
NSW Government is committed to ensuring people with disability are not subjected to prohibited restrictive practices. Reducing and eliminating the use of seclusion and restraint where possible remains a priority of NSW Health. Seclusion and restraint are only used in accordance with legislation, to manage the risk to the safety of the patient, staff and public. NSW Health is undertaking further analysis, consideration and consultation on this recommendation.
The NSW Department of Education remains committed to the national goal of reducing and eliminating the unnecessary or inappropriate use of restrictive practices. The department supports clarity on prohibited forms of restrictive practices. However, further consideration and agreement of the definitions are required state-wide or nationally.
Northern Territory
Response: Accept in principle
Status: Further work required
What has been achieved to date
The Health Care Decision Making Act 2023 provides a legal framework for the use of restrictive practices for adults, without decision-making capacity, in the context of healthcare. The Department of Health and Department of Education and Training both mandate de-escalation training for staff to ensure school and health settings continue to be safe places for and meet the needs of all Territorians.
NT government response July 2024
The Northern Territory supports the intent of this recommendation and further consideration of current legislation and frameworks will be required.
The Northern Territory Department of Education and Training is committed to eliminating the use of inappropriate restrictive practices to ensure schools continue to be safe places for everyone. Development of improved policies and training in de-escalation to support staff has been undertaken and student wellbeing programs continue to be refined and improved to meet student needs.
Queensland
Response: Subject to further consideration
Status: In progress
What has been achieved to date
The Queensland Government will continue working with people with disability, their families and carers, advocates, disability support providers, behaviour support practitioners and other stakeholders on the next steps for reform of Queensland’s restrictive practices authorisation framework.
This includes further consideration of the legal frameworks for the authorisation, review and oversight of restrictive practices across different service settings.
The Queensland Government will consider recommendation 6.36 as part of its broader consideration of restrictive practices reforms.
QLD government response
The Queensland Government remains committed to implementing the recommendations of the Disability Royal Commission. The Queensland Government has updated its responses to a range of Disability Royal Commission recommendations to reflect contemporary Queensland Government policy and commitments.
2025 response
The Queensland Government is committed to reform of Queensland’s restrictive practices authorisation framework.
South Australia
Response: Accept in principle
Status: In progress
What has been achieved to date
In South Australia, prohibited physical restraints are prescribed in the Disability Inclusion (RP-NDIS) Regulations 2021.
The South Australian government has been analysing seclusion data to understand the impact of prohibiting seclusion for children across jurisdictions. The Disability inclusion Act 2018 (SA) Restrictive Practices Guidelines do not permit authorisation of restrictive practices used as punishments or in the absence of risk of harm.
Broader prohibition of practices in other sectors will be considered in the context of cross sectoral restrictive practices regulation.
SA government response July 2024
The use of certain unsafe physical restraints and punitive practices by NDIS providers of NDIS supports to NDIS participants has already been prohibited in South Australia under legislative amendments to the Disability Inclusion Act 2018 and its subordinate legislation.
Guidance also exists in health and mental health settings regarding the use of unsafe physical restraints, punitive practices and seclusion of children. This recommendation must be considered in the context of Recommendation 6.35 regarding the establishment of legislative framework for the regulation of restrictive practices as well any intersection with the recommendations of the NDIS Review.
Tasmania
Response: Accept in principle
Status: In progress
What has been achieved to date
The Tasmanian Disability Rights, Inclusion and Safeguarding Act 2024 (the Act) received Royal Assent in November 2024 and is expected to commence in mid 2025.
The Act provides for certain practices to be prescribed as prohibited. Regulations are drafted to commence with the commencement of the Act. This is anticipated in mid 2025.
Further work is required to apply this or similar legal frameworks to other settings.
TAS government response July 2024
The Tasmanian Government accepts this recommendation in principle.
The Tasmanian Government is currently working on a Disability Inclusion and Safeguarding Bill 2023 that will strengthen the role of the Senior Practitioner in providing oversight to the use of Restrictive Practices in disability service provision.
The Tasmanian Government needs to undertake more work to understand how the legal framework for restrictive practices would apply in other settings.
Victoria
Response: Accept in principle
Status: In progress
What has been achieved to date
Victoria has completed the first component of this recommendation.
In 2019, the Victorian Senior Practitioner issued a Direction prohibiting disability service providers and registered NDIS providers from using those restrictive practices in Victoria. In 2024, that Direction was updated to also prohibit the use of seclusion on person under the age of 18 years in Victoria.
Victoria is progressing preliminary work with health, mental health and education to progress the implementation of the recommended reforms related to the other areas of this recommendation.
VIC government response July 2024
We accept this recommendation in principle.
We are committed to reducing and eliminating restrictive practices to the greatest extent possible in all settings for people with disability.
We support the prohibition on the use of physical restraints.
We will not permit the use of punitive approaches outlined in this recommendation in disability settings. This includes seclusion of children and young people in disability settings.
The Victorian Senior Practitioner has issued a prohibition to disability service providers and registered NDIS providers.
This prohibits the forms of physical restraint outlined in this recommendation, in accordance with the Disability Act.
The Victorian Senior Practitioner has not issued a similar prohibition for punitive approaches.
However, in practice, the Victorian Senior Practitioner does not approve any proposals by service providers to use punitive approaches as part of a behaviour support plan under the Disability Act.
The Department of Education’s Restraint and Seclusion Policy has all the provisions needed to support this part of the recommendation. It also prohibits designated seclusion rooms and areas that are primarily used for the purpose of seclusion.
The Department of Education seeks to reduce and eliminate seclusion to the greatest extent possible. Victorian government schools are not allowed to use mechanical restraint or chemical restraint.
We will work collaboratively across government and with states and territories to consider approaches. We will give a full response to this recommendation later.
Western Australia
Response: Accept in principle
Status: In progress
What has been achieved to date
The WA Government is working to design a legislative framework for the authorisation, review and oversight of restrictive practices in disability service settings. The framework is expected to prohibit certain restrictive practices, in line with this recommendation as it relates to disability service settings. The WA Department of Communities has led numerous rounds of research and consultation, including public consultation.
The WA Department of Education’s Student Behaviour in Public Schools Policy, procedures and requirements were reviewed in 2023. The revised policy minimises the use of restrictive practices and prohibits the use of protective isolation in confined spaces.
WA government response July 2024
The WA Government is committed to the reduction of the use of restrictive practices in services for people with disability. WA accepts in principle this recommendation and will undertake new work as it relates to people with disability in disability and education service settings. Further consideration will be undertaken as to how certain and prohibited restrictive practices are mitigated in existing arrangements within health and mental health settings to meet the principles of this recommendation.
What the Disability Royal Commission said in the final report
State and territory governments should immediately:
- Adopt the list of prohibited forms of restrictive practices agreed by the former Disability Reform Council in 2019 and provide that the use of seclusion on children and young people is not permitted in disability service settings.
- Provide that the following are not permitted in health and mental health settings:
- using seclusion and restraint as a means to reduce behaviours not associated with immediate risk of harm
- using seclusion and restraint as a form of discipline, punishment or threat
- restrictive practices that involve or include deliberate infliction of pain to secure compliance
- using prone or supine holds, using any restraint intended to restrict or affect respiratory or digestive function, or forcing a person’s head down to their chest
- secluding a person who is also mechanically restrained
- secluding a person who is actively self-harming or suicidal
- using metal handcuffs or hard manacles as a form of mechanical restraint (unless under police or other custodial supervision while in the health facility)
- vest restraints for older people
- neck holds
- drugs, or higher doses of drugs, that create continuous sedation to manage behaviour
- seclusion of children and young people.
- Provide that the following are not permitted in education settings:
- the use of restrictive practices:
- as a form of discipline, punishment or threat
- as a means of coercion or retaliation
- in response to property destruction
- for reasons of convenience
- life threatening physical restraints, including physical restraints that restrict a student’s breathing or harm the student by:
- covering the student’s mouth or nose, or in any way restricting breathing
- taking the student to the ground into the prone or supine position
- causing hyperextension or hyperflexion of joints
- applying pressure to the neck, back, chest or joints
- deliberately applying pain to gain compliance
- causing the student to fall
- having a person sit or kneel on the student
- chemical restraints
- mechanical restraints
- clinical holding:
- as a behaviour support strategy
- to enforce the compliance of a student in undertaking personal care that is non-urgent and does not present a risk to the student
- to punish a student
- denial of key needs, such as food and water.
- the use of restrictive practices:
More recommendations
View progress on other recommendations made by the Royal Commission.