End unnecessary restraint of people with intellectual disabilities

Thousands of Australians with an intellectual disability, including children and young people, are being unnecessarily restrained in violation of their human rights and contrary to the best practice evidence, according to the Australian Psychological Society which is calling for an overhaul of the system.

At least a quarter of all people with an intellectual disability, including young people and children, are believed to have been subject to restraint in care, including physical restraint (someone holding them down) chemical (via sedatives or other drugs), mechanical (by harnesses or straps) and seclusion ( which can include confinement and withdrawal of special objects).

President of the Australian Psychological Society Professor Bob Montgomery said, "It is unfortunately common practice to use restraint on people with disability as a method to manage what are termed as difficult or challenging behaviours. The misguided belief is that the use of restraint protects people with a disability and those caring for them; however, we now have good evidence to show the opposite - injuries and assaults are more likely to occur in connection with restraint and seclusion.

In contrast, employing psychological interventions is an effective method of managing difficult behaviours and it also significantly reduces the need to use restraint."

The Australian Psychological Society has developed new guidelines - Guidelines on evidence-based psychological interventions that reduce the need for restrictive practices in the disability sector - based on the latest research, and is calling for a review of the legislation and standards in regard to the use of restraint.

Professor Montgomery said it was crucial to educate all those involved in the care of people with an intellectual disability about the causes of difficult or challenging behaviours and to provide training on evidence-based behaviour management alternatives to restraint.

"People exhibit difficult behaviours for a range of reasons," he said. "Most often it is because their needs are not being met or they are unable to clearly communicate their needs. We need to take the time to assess people's needs from a social, emotional and psychological perspective.

Just because someone has a disability doesn't mean that they don't have social needs and a need to be productive, often people with disabilities are sitting around with nothing to do."

Professor Montgomery said that the APS was happy to engage with the disability sector on the issue: however government support was urgently needed to:

  • provided education and training for carers and service providers that promote the use of psychological interventions and so reduce restrictive practices;
  • increase access to psychological interventions for people with intellectual disabilities;
  • provide training and support for carers of people with intellectual disabilities.

"We have a responsibility to offer this vulnerable group in our community the best available care and to treat them with respect," he said.

Professor Bob Montgomery, APS president, and Associate Professor Keith McVilly, Convenor of the APS People with Intellectual and/or Developmental Disability and Psychology Interest Group, are available for interview. A copy of the draft guidelines and the supporting research document are also available.

The APS is the largest professional association for psychologists in Australia, representing more than 19,000 members. The APS is committed to advancing psychology as a discipline and profession. It spreads the message that psychologists make a difference to peoples' lives, through improving psychological knowledge and community wellbeing.

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