When the words “restrictive practice” appears in an NDIS conversation, families may understandably feel confused or concerned. What does it actually mean? When can it be used? Who can authorise it? And what rights does a person with disability have?
Restrictive practices are an important part of the NDIS behaviour support framework because they can limit a person’s human rights or freedom of movement. The NDIS Quality and Safeguards Commission states that they should only be used as a last resort to prevent harm, with safeguards focused on reducing and eventually eliminating their use.
Understanding restrictive practices can help families ask the right questions, recognise their loved one’s rights, and participate more confidently in behaviour support planning.
What is a restrictive practice?
A restrictive practice is an action or intervention that limits a person’s human rights or freedom of movement. Under the NDIS framework, there are five regulated restrictive practices: seclusion, chemical restraint, mechanical restraint, physical restraint and environmental restraint. These terms can sound technical, so it is useful to understand what they mean in everyday situations.
Seclusion involves leaving a person alone in a room or space where they are not allowed to leave, including situations where the person believes they cannot leave.
Chemical restraint involves using medication primarily to influence or reduce a person’s behaviour.
Mechanical restraint involves using equipment or a device to prevent or restrict a person’s movement or access to part of their body.
Physical restraint involves holding a person, or part of their body, so they cannot move freely in order to stop or reduce behaviour.
Environmental restraint involves restricting a person’s access to certain things, activities or places in their home or community.
Not every form of support or assistance is automatically a restrictive practice. The circumstances and purpose of the intervention matter, which is why families should seek clarification when they are unsure.
Why are restrictive practices used?
Restrictive practices may sometimes be considered when there is a significant risk of harm to the person or another person. However, the NDIS Commission emphasises that restrictive practices can have serious human rights impacts and should be used only as a last resort, with a focus on reducing and eliminating their use over time. This is where positive behaviour support (PBS) becomes important.
Positive behaviour support focuses on understanding why a person may be experiencing or displaying behaviour of concern and identifying ways to meet their individual needs. Strategies can include teaching new skills, change the person’s environment and provide guidance to their support team. The focus should therefore be more than simply stopping a behaviour. It should be about understanding the person, improving quality of life and addressing the reasons behind the behaviour.
When can a regulated restrictive practice be used?
A regulated restrictive practice must meet specific requirements. The NDIS Commission states that it must be clearly written in the behaviour support plan, authorised by the relevant state or territory body, used as a last resort, used for the shortest time possible, proportionate to the risk of harm and be the least restrictive option available.
This means that restrictive practices should not simply be introduced because they are convenient or because a support team finds a particular behaviour difficult to manage. There should be a clear framework around why the practice is being considered, how it will be used, what safeguards apply and how its use will be reduced over time.
Where should families look for information?
If restrictive practices are part of a person’s support arrangements, the behaviour support plan is one of the key documents families should understand. A behaviour support plan can outline when, if and how a restrictive practice may be used, as well as strategies designed to reduce and eventually eliminate its use.
Families can ask:
- What behaviour is the support plan addressing?
- What is the purpose of the intervention?
- Is a regulated restrictive practice involved?
- Is it clearly documented in the behaviour support plan?
- Has the required authorisation been obtained?
- What positive behaviour support strategies are being used?
- What is being done to reduce or eliminate the restrictive practice?
- How is the person’s quality of life being supported?
- How will the family and participant be involved in reviewing the plan?
These questions are not about challenging support for the sake of challenging it. They are about understanding what is happening and ensuring the person’s rights remain central.
Who is responsible for implementing restrictive practices?
Different providers can have different roles. A specialist behaviour support provider and behaviour support practitioner may develop the behaviour support plan, while an implementing provider may be responsible for putting the plan into practice. Providers who use regulated restrictive practices must meet additional NDIS requirements, including registration requirements.
Implementing providers also have responsibilities around authorisation, activating behaviour support plans and reporting the use of regulated restrictive practices. Monthly reporting is required, including when an authorised practice has not been used.
What if a restrictive practice is used without authorisation?
This is particularly important for families to understand. A restrictive practice is unauthorised if, for example, it is not included in the behaviour support plan, has not been appropriately authorised, or is not being used in accordance with the behaviour support plan. The NDIS Commission treats unauthorised restrictive practices as reportable incidents.
The Commission states that unauthorised restrictive practices must be reported as a reportable incident within 5 business days of the provider becoming aware of the incident. If a registered provider uses an unauthorised or high-risk practice, or something occurs that places a participant at risk of harm or injury, the NDIS Commission advises that it should be reported.
What can families do?
Families don’t need to be experts in NDIS legislation to be involved. Start by asking questions and making sure you understand the person’s behaviour support plan. Ask the behaviour support practitioner or provider to explain any restrictive practice in plain language.
Most importantly, keep the person’s dignity, rights, preferences and quality of life at the centre of the conversation. A restrictive practice should never become simply “what we always do.” The NDIS Commission’s current approach places emphasis on reducing and eliminating regulated restrictive practices through evidence-based positive behaviour support.
The bigger picture
Restrictive practices are not simply another item on an NDIS checklist. They involve a person’s rights, freedom, dignity and safety. For families, understanding the difference between supporting someone and restricting someone can be an important part of advocating for quality support.
The goal of positive behaviour support is not simply to control behaviour. It is to understand the person, identify what they need, improve their quality of life and build strategies that can reduce the need for restrictive practices over time.
The more families understand, the better equipped they are to ask questions, participate in planning and advocate for support that respects the person, not just the behaviour.
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