Last updated February 2024

Some adults with intellectual or cognitive impairment may have behaviours that place themselves or others at risk of harm. To manage these risks in a way that ensures people are safe, restrictions are sometimes necessary. These are known as restrictive practices.

Queensland’s restrictive practices scheme is established under pt 6 of the Disability Services Act 2006 (Qld) (Disability Services Act) and ch 5B of the Guardianship and Administration Act 2000 (Qld). This regime seeks to ensure that restrictive practices used by service providers take account of the adult’s human rights and are the least restrictive ways of safeguarding them and others. The legislation applies only to adults 18 years or over, who have an intellectual or cognitive disability and are at risk of harming themselves or others and who receive services from government-provided and/or government-funded disability service providers.

It does not apply to families, or private or non-funded organisations.

The introduction of the National Disability Insurance Scheme (NDIS) saw the Commonwealth Government play a major role in providing funding for people with disability. The National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 (Cth) is the instrument for the implementation and oversight of restrictive practices used with adults who are participants of the scheme.

The Rules are intended to support participants to be informed purchasers and consumers of NDIS supports and services. The main function of the NDIS Quality and Safeguards Commission (NDIS Commission) is to work with participants and providers to improve the quality and safety of NDIS services and to assist people with disability to live free from abuse, neglect, violence and exploitation.

The Rules provide compatible requirements with state legislation and require the lodgement of behaviour support plans with the NDIS Commission.

What is a restrictive practice?

Containment

Containment means to physically prevent an adult with an intellectual or cognitive disability from freely leaving the place where they receive disability services, other than by seclusion, in response to the adult’s behaviours that may cause harm to themselves or others. However, the adult is not contained if the adult has a skills deficit and cannot safely leave without supervision, and them leaving is prevented by the locking of gates, doors or windows.

Seclusion

Seclusion means to physically confine an adult with intellectual or cognitive disability alone, at any time of the day or night, in a room or area, from where they are prevented from freely leaving in response to the adult’s behaviours that may cause harm to themselves or others.

Chemical restraint

Chemical restraint means using medication for the primary purpose of controlling the behaviour of an adult with an intellectual or cognitive disability. Using medication to treat a diagnosed mental illness or medical condition is not chemical restraint.

Physical restraint

Physical restraint means using any part of another person’s body to restrict the movement of an adult with an intellectual or cognitive disability for the primary purpose of controlling their behaviour that may cause harm to themselves or others.

Mechanical restraint

Mechanical restraint means using a device to restrict movement of an adult with an intellectual or cognitive disability or preventing or reducing the adult injuring themselves, for the primary purpose of controlling the adult’s behaviour.

Restricting access to objects

Restricting access to objects means restricting the access by an adult with an intellectual or cognitive disability to an object to prevent the adult using the object to cause themselves or others harm.

Approvals

Before gaining general approval to use restrictive practices, disability service providers must complete an assessment of the adult with an intellectual or cognitive disability and develop a ‘positive behaviour support plan’, which is designed to encourage positive behaviour. Family members, guardians, advocates and healthcare professionals should be consulted as part of this process.

Section 150 of the Disability Services Act provides that positive behaviour support plans must specify for each restrictive practice:

  • the circumstances when the restrictive practice is to be used
  • how it is the least restrictive arrangement
  • the procedure for using the restrictive practice, such as any observation and monitoring required during the restrictive practice’s use
  • the measures to ensure the adult is receiving proper care and treatment and is protected
  • the positive and negative effects of using the restrictive practice
  • how often the use of restrictive practice will be reviewed.

General approvals

Generally, the use of restrictive practices must be approved by the Queensland Civil and Administrative Tribunal (QCAT), which can authorise the use of:

  • containment
  • seclusion
  • chemical, physical and mechanical restraint
  • restricting access to objects.

The decision maker must be satisfied that the restrictive practice is necessary and that it is the least restrictive way to keep the adult with an intellectual or cognitive disability or others safe. The tribunal’s authorisation to the use of restrictive practices can be made up to a maximum of 12 months, after which time the decision is reviewed to determine whether they are still necessary. However, QCAT can review the arrangements at any time. The tribunal’s approval will automatically end if the adult with an intellectual or cognitive disability stops receiving disability support services from the particular service provider.

The tribunal may also appoint a guardian to make restrictive-practice decisions for an adult only if it is satisfied:

  • the adult has impaired capacity
  • the adult’s behaviour has previously caused harm to themselves or others
  • there is a need for restrictive-practice decisions
  • without the appointment of a guardian for restrictive practices, the adult’s behaviour is likely to cause themselves or others harm and the adult’s interests will not be adequately protected.

An order for the appointment of a restrictive-practice guardian cannot be made for more than two years. If there is no restrictive-practice guardian, an informal decision maker can only approve restricting access to objects. For a full discussion on the law on guardianship, see the chapter Laws Relating to Individual Decision Making.

Short-term approvals

Where there is immediate and serious risk of the person harming themselves or others, short-term approvals for the use of restrictive practices can be made for periods of up to six months.

The Public Guardian approves the short-term use of containment and seclusion. Approvals for short-term use of chemical, mechanical or physical restraints and restrictions to access are made by the person’s restrictive-practice guardian or, in their absence, the Chief Executive of the Disability Services.

The legislation grants immunity to relevant disability service providers and individuals acting on their behalf in relation to restrictive practices, provided they have complied with the statutory requirements set out in pt 6 of the Disability Services Act.