Exclusive: Carers use of methods such as sedating or strapping a person down more than doubles in a year
National disability insurance scheme providers used unauthorised restraints on clients – such as sedating or strapping down a person, or depriving them of their personal belongings – more than one million times in 2020-21.
The new figures, reported to federal parliament by the NDIS quality and safeguards commission, show a 240% increase on the previous 12-months and have prompted calls for an investigation.
The federal government last year said the commonwealth and states had agreed to “work to reduce, and ultimately eliminate, the use of restrictive practices on people with disability”.
But Guardian Australia can reveal the NDIS quality and safeguards commission received 1,032,064 reports of unauthorised restrictive practices in 2020-21, a 240% increase on the 302,690 reports from the previous 12 months.
In 2020-21, there were 585,847 (56%) reports of unauthorised “chemical” restraint, such as the use of sedatives to manage client behaviour, a 229% increase on the 2020-21 figure.
The NDIS commission’s own guidelines note “an over-reliance for the use of medication to address behaviours of concern in people with disability” and warns of the possibility of long-term negative side-effects.
The commission said there were also 376,575 reports of the unauthorised use of “environmental” restraints, which can refer to restricting a client’s access to part of their own home or denying access to personal possessions like a mobile phone or television.
It was notified of 63,795 instances where an unauthorised “mechanical” restraint was used (for example strapping a person down, or forcing them to wear splints, gloves, a helmet or other equipment) and 4,794 instances of unauthorised physical restraint. This might include physically holding a person down while they display “behaviours of concern”.
Providers also reported 789 instances of unauthorised seclusion, which refers to locking an NDIS client in a room which they can’t leave.
In all these cases, a total of 788 NDIS providers failed to gain the proper authorisation to employ these restraints on 7,826 NDIS participants.
Numbers of Unauthorised Restrictive Practices (URPs) Sorted by location and type. Note: WA, which represents 9% of all participants, came under commission oversight in December 2020 Chemical Environmental Mechanical Physical Seclusion 0 100k 200k 300k NSW Victoria Queensland WA SA Tasmania NT ACT Guardian graphic | Source: NDIS Quality and Safeguards Commission
The watchdog’s compliance register shows it has issued only eight compliance notices and two fines to providers that have failed to comply with restrictive practice rules.
The commission’s annual report also shows there were a marked increase in the number of “reportable incidents” logged during 2020-21, including alleged abuse and alleged unlawful physical/sexual contact.
Restrictive practice is a broad term and its use is subject to a patchwork of federal and state laws and regulations.
Under NDIS rules, a provider must lodge a behaviour support plan with the watchdog. However, they may also need to gain permission from a state oversight body, normally known as the senior practitioner.
The aim of these rules is to ensure any use of restraints is subject to oversight and legal challenge. Behaviour support plans are also intended to reduce the future need for restraints, which already should be employed as a last resort.
An NDIS Commission spokesperson said the figures were “completely unacceptable”.
“This volume of reports demonstrate the shocking prevalence of these practices in the disability sector in Australia and is one of our highest priorities,” the spokesperson said.
“Targeted compliance action with providers who preside over significant numbers of these arrangements is under way now.”
Providers must report to the NDIS commission every time they use a restricted practice without authorisation. A person being sedated three times a day for an entire year without authorisation would count as 1,095 reportable incidents over 12 months, the commission says.
The disability royal commission says restrictive practices are mostly likely to be used in group homes, though they can also be employed in public settings.
Children and Young People with Disability Australia has reported students experiencing restraints including seclusion and being restrained with belts, while a high-profile 2015 case involved an autistic student being placed in a specially made cage.
More recently, the Age reported last week that a young disabled man was shackled by a hospital for five months because there was no alternative treatment or supported accommodation available.
The opposition’s NDIS spokesperson, Bill Shorten, told Guardian Australia: “There must be an independent investigation into this.”
“I appreciate it’s not as simple as it should never happen, but the number seems way too high,” he said. “The Morrison government should not walk past this confronting and disturbing evidence.”
“Where are the behavioural plans to stop unauthorised restrictive practice that should be in place?”
Jordon Steele-John, the Greens disability rights spokesperson, called for a national plan to address the problem, saying “elimination of unauthorised restrictive practice must be the goal and it must be achieved urgently”.
He said the practices particularly affected “people with intellectual disability and those who are neuro-diverse”.
The increase in the figures likely reflecting increased use and reporting from providers, Steele-John said.
“The use of these practices, authorised or unauthorised, is a violation of someone’s human rights,” he said. “The critical difference is without authorisation you are simply using them with no plan to stop using them.”
The NDIS minister, Linda Reynolds, said it was a “complex issue” and she was working with the commission to “gain a greater understanding of the nature and scale of these practices across Australia”.
She said the commission had done important work by shining a light on the increasing use of unauthorised restrictive practices and noted it was stepping up its compliance.
“The commission commenced reporting on these practices at a national level as this did not occur under the previous fragmented state based approach,” she said.
Senior manager of policy at People with Disability Australia, Giancarlo De Vera, also called for a national plan to address the issue, saying he had “grave concerns about the data”. It suggested people with disability were “not receiving adequate supports”.
A National Disability Services spokesperson said the peak body for providers also supported uniform legislation across Australia to “reduce the compliance complexity”.
“The use of restrictive practices is a serious infringement of a person’s rights, nonetheless there are limited circumstances where there may be no other way to ensure the safety of the person or another,” the spokesperson said.