The five types
The NDIS (Restrictive Practices and Behaviour Support) Rules 2018 set out five kinds of regulated restrictive practice:
- Seclusion: keeping a person alone in a room or physical space, at any time of day or night, where they are prevented from leaving, not helped to leave, or led to believe they are not allowed to leave
- Chemical restraint: using medication or a chemical substance mainly to influence a person's behaviour. It does not include medication prescribed by a doctor to treat a diagnosed mental disorder, physical illness or physical condition
- Mechanical restraint: using a device to prevent, restrict or subdue a person's movement mainly to influence their behaviour. It does not include devices used for therapeutic or non behavioural purposes, such as a prescribed postural support
- Physical restraint: using physical force to prevent, restrict or subdue movement of a person's body, or part of it, mainly to influence their behaviour. A reflexive hands on move to guide someone away from harm is not physical restraint
- Environmental restraint: restricting a person's free access to parts of their environment, including items or activities, for example locking the fridge, removing a phone, or stopping someone going into the community
The rules for using them
Regulated restrictive practices are not a normal part of support. Under the NDIS they must:
- Be used only as a last resort, in response to a risk of harm to the person or others
- Be the least restrictive option available and proportionate to the risk
- Be used for the shortest possible time
- Be authorised, where the state or territory requires authorisation
- Be clearly set out in a behaviour support plan written by an NDIS behaviour support practitioner, alongside positive strategies that build independence and quality of life
Practices that should never be used
Some practices carry such a high risk of harm that they should never appear in a behaviour support plan. For physical restraint, the NDIS Commission says supine, prone, pin down, takedown techniques and basket holds must never be used, and no restraint may restrict breathing or digestion, inflict pain, hyperextend joints or put pressure on the chest or joints.
Removing someone's communication device may itself be abuse, and seclusion that denies a person's basic needs may be abuse or neglect.
Who can use them
Only registered NDIS providers can use regulated restrictive practices. Unregistered providers must not. The provider implementing the plan must report each month on any authorised use through the NDIS Commission portal.
Any use that is not authorised, or does not follow the behaviour support plan, is an unauthorised restrictive practice and must be reported to the Commission as a reportable incident. If it causes harm, that report is due within 24 hours.
Your rights as a participant or family
You have the right to be involved in developing any behaviour support plan, to understand why a practice is proposed and what is being done to reduce and stop it, and to have the plan reviewed. Ask your behaviour support practitioner how the plan will reduce restrictive practices over time.
If you think a restrictive practice is being used without authorisation, or by an unregistered provider, you can tell the NDIS Commission. If someone is in immediate danger, call 000.
For children and young people
For children, a restriction is not a regulated restrictive practice if it is age appropriate, in line with community standards and the same child safety step any parent would take whether or not the child has a disability, such as a child safety gate for a toddler. The Commission has a separate practice guide on restrictive practices with children and young people.