Disability practice resources for restrictive interventions.
Any intervention that is used to restrict the rights or freedom of movement of a person with a disability, and includes chemical restraint, mechanical restraint, physical restraint and seclusion.
A disability service provider must follow rules to use restrictive interventions. These rules are in the Disability Act 2006.
Recognising and reducing mechanical restraint - practice guide
The Recognising and reducing mechanical restraint - practice guide provides a framework and evidence-based recommendations for identifying, assessing, planning and implementing mechanical restraint reduction plans.
This guide will make reference to positive behaviour support frameworks for reducing behaviours of concern and behaviour support plans as well as previous publications about reducing specific types of mechanical restraint such as the Department of Health and Human Services’ Reducing the use of restrictive clothing as mechanical restraint practice guide (2010). Case studies and frequently asked questions are also presented throughout the guide.
This document has been developed following a series of four projects conducted by the Senior Practitioner – Disability about using mechanical restraint within Victorian disability services. The findings of these projects have influenced the recommendations within this practice guide.
Reducing the use of restrictive clothing as mechanical restraint
This practice guide has been developed to assist in the assessment of behaviours of concern associated with the use of restrictive clothing. It offers a guide to safely reduce the use of restrictive clothing through addressing why the behaviour is occuring in the first place.
Restrictive Intervention Data System (RIDS)
The Restrictive Intervention Data System (RIDS) has been developed to report events of routine, Pro Re Nata (PRN) or emergency restrictive interventions such as chemical restraint, mechanical restraint or seclusion.
Electronic Behaviour Support Plan (eBSP)
The electronic Behaviour Support Plan (eBSP) online reporting function has been developed within RIDS to help reduce the burden of reporting to the senior practitioner. It enables disability service providers to develop quality behaviour support plans online as an alternative to the current paper version. Once developed, the plans can be submitted directly to the senior practitioner.
The RIDS eBehaviour Support Planning toolkit supports staff who work in the disability sector to provide high quality support to clients at risk of restraint and seclusion.
The senior practitioner’s team has combined several guides and support documents to produce the RIDS eBSP toolkit. The toolkit was designed in collaboration and with feedback from our stakeholders. It will help disability staff to design high quality support plans for the people they support. We know from our recent research that high quality behaviour support plans are more likely to result in reductions in restrictive interventions. The new toolkit is a practice guide on how to develop high quality, legislatively compliant behaviour support plans.
RIDS – eBSP frequently asked questions
To facilitate the implementation of RIDS – eBSP and to support users of the system, the Office of the Senior Practitioner regularly sends out frequently asked questions (FAQs), addressing key issues arising from its work with services using the system.
Medications and the restrictive intervention data system guide
This information sheet includes a guide and medication list and is designed to answer most frequently asked questions about reporting chemical restraint on RIDS. The reporting of chemical restraint on RIDS is a requirement of the Disability Act 2006.
Restrictive Intervention Self-Assessment Tool (RISET)
The Restrictive Intervention Self-Assessment Tool (RISET) is an educational tool that's designed to help you understand restrictive practices and how their use can be reduced. RISET does not record any identifying information about you, the house you're working at, or the person with a disability you work with.
Learn more about RISET
For assistance phone the Office of Professional Practice (OPP) on 9096 8427 or email: RIquestions@dhhs.vic.gov.au
Physical restraint - a direction paper
Physical restraint is the use of physical force to prevent, restrict or subdue movement of a person’s body or part of their body for the primary purpose of the behavioural control of a person with a disability. Physical restraint does not include physical guidance or physical assistance.
The Senior practitioner physical restraint direction paper applies to all disability service providers defined in the Disability Act 2006 when a disability service is provided to a person, including children and young people.
The Senior Practitioner - Disability (Office of Professional Practice) consulted broadly with the disability sector and commissioned work by leading academics in the field to develop the direction paper, which consists of three main components:
- Prohibiting specific types of physical restraints
- Prohibiting other types of physical restraints except as provided for under the direction
- Specifying the process for obtaining the Senior Practitioner’s approval for using physical restraint.
The obligation to report the use of physical restraint on restrictive intervention data system RIDS came into force on 1 July 2011. The prohibition on using physical restraint except as permitted under the direction came into force on 1 January 2012.
The direction paper strengthens the Office’s role in protecting the rights of people with disabilities, subject to restrictive interventions and compulsory treatment. This is as well as providing a foundation for minimising risk to disability support professionals.
For more information, see Related resources.
Independent person toolkit
An independent person is involved when a disability service provider plans to use a restrictive intervention with a person with a disability. The Independent person toolkit, aims to provide plain English information and guidance around the independent person process.
The toolkit is divided into 3 parts:
- Advice to independent person
- Advice to people with a disability
- Advice to disability service provider.
Chemical restraint - what disability support workers need to know
The majority of people who show behaviours of concern will be administered some form of chemical restraint, which is the most commonly used form of restraint. According to the Disability Act (2006) any medication that is prescribed in Victoria for behavioural control is a form of chemical restraint.
There are positives and negatives about the use of chemical restraint. On the positive side, chemical restraint may be effective in calming a person who is highly agitated. On the negative side, chemical restraint may result in adverse side effects (e.g. dry mouth, restless legs, headache, constipation, weight gain, sexual dysfunction and low blood pressure).
The Chemical restraint - what disability support workers need to know document provides information about chemical restraint and further recommended readings.
Disability, mental health and medication - Implications for practice and policy
People with a disability who are prescribed medication and people with dual disability (intellectual disability and mental illness) are a vulnerable group of people. Many of them are subject to restrictive interventions, particularly chemical restraint.
While many are receiving adequate and regular medical care, there are many health and medication matters we do not yet understand. This is in relation to people with a disability who are subject psychotropic medication and those with dual disability in Victoria.
This study aims to provide a further understanding of the current practice being provided and add to the evidence for the need to improve practice. For some practitioners it affirms what they already know.
The findings of this research also build on previous audits and other projects undertaken by the Office of the Senior Practitioner in the area of medication, mental health and people with a disability.
Intellectual disability and mental illness – too many people on mental illness tablets
Intellectual disability and mental illness are different conditions.
This report is a plain language version of Disability, mental health and medication: Implications for practice and policy.
Experiences of restrictive practices report
This report provides discussion points and recommendations that promote and encourage:
- Policy makers
- Support staff
- Family carers
- People with disabilities
- Other organisations and advocates
to think about what can promote and lead to positive supports along a rights based approach.
For more information, see Related resources.
Other restrictive interventions
This practice guide provides a reflection and examination of current practices that may constitute 'other restrictive practices' identified in S.150. It helps service providers to think about possible alternatives and creative opportunities that optimise autonomy and wellbeing.