Submission 3 — Inclusion Australia — Disability Safeguards Consultation

Disability Safeguards Consultation

Submission to the Department of Health, Disability and Ageing

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Contents

• About Inclusion Australia

• About this submission

• Background

• Case study: learning from the VALID8 model

• How the elimination of restrictive practices applies to safeguarding

• Our responses to Consultation Questions

• Appendix A

• Appendix B

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About Inclusion Australia

Inclusion Australia is the national peak organisation representing the rights of people with an intellectual disability and their families. Founded over 70 years ago in 1954, our mission is to work with people with an intellectual disability, their families and our members to make positive change.

Our strength is in our national representation and our connection to our community. We have a member organisation in every state and territory across Australia:

• ACT Down Syndrome and Intellectual Disability (ACT DSID)
• Council for Intellectual Disability (NSW)
• Developmental Disability WA (DDWA)
• Inclusion Northern Territory (Inclusion NT)
• Parent to Parent (P2P, Queensland)
• South Australian Council on Intellectual Disability (SACID)
• Speak Out Advocacy (Tasmania)
• Victorian Advocacy League for Individuals with Disability (VALID).

To inform our systemic advocacy, we draw upon the decades of collective experience of our members, as the primary advocacy for people with an intellectual disability and families in their jurisdiction. They bring deep expertise in peer support, individual and systemic advocacy, and community engagement, ensuring that the voices of people with an intellectual disability are heard and acted on. Their long-standing, trusted relationships with their communities enable them to provide advocacy that drives meaningful change.

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About this submission

As the national peak organisation representing the rights of people with an intellectual disability and their families, we are grateful to the Department of Health, Disability and Ageing (the Department) for the opportunity to provide input to this important consultation.

In developing our submission, we draw on extensive and long-standing experience and engagement in relation to quality, safeguarding, and person-centred practice within and outside the NDIS.

This includes our participation in the consultative activities run by the NDIS Quality and Safeguards Commission (the Commission) as part of the NDIS Practice Standards reform. Our submission to this consultation can be found here.

A significant part of our recent work in safeguarding is our engagement by the Commission this year to develop practical, evidence-based quality indicators and resources to assist the Commission in clarifying ‘what good looks like’ in Supported Independent Living (SIL) environments.

We used a deliberate codesign approach that prioritised the voices and experiences of people with an intellectual disability with experience in SIL settings. By doing this, we aimed to bridge the gap between regulatory frameworks and lived practice reality and respond to persistent challenges in translating NDIS principles (like choice, control and dignity) into tangible, everyday support practices that are clear for everyone to understand – participants, workers, providers and supporters.

Through the project, we developed a full list of draft quality indicators, along with suggested resources to support people with disability, their supporters, service providers and their workforces, to understand and implement the indicators and the SIL Practice Standards. We understand the quality indicators we provided will be considered and adapted for testing with providers in a pilot in early 2026, and that the Commission is currently consulting developing outcomes statements which will align with them.

In addition, we were actively involved with the NDIS Provider and Worker Registration Taskforce, providing expertise on behalf of our community, particularly people using self-directed supports such as the service-for-one model, who are among those most likely to be significantly impacted by changes to registration.

We have also contributed submissions to the substantial registration reform consultation run by the Commission, informed by feedback from our member organisations and our Complex Needs Family Reference Group.

This submission also draws on the deep expertise and insights gathered through our engagement during the NDIS Review, including multiple focus groups with people with an intellectual disability and their families, background research papers commissioned from external experts, and additional submissions prepared in consultation with our community, including on proposed changes to the NDIS Quality Framework.

This submission responds to the Discussion Questions outlined in the Consultation Paper, drawing on our extensive engagement with our community and systemic insights to provide practical, participant-centred recommendations for the design of the Disability Support Quality and Safeguarding Framework (the Framework) and Disability Support Ecosystem Safeguarding Strategy (the Strategy).

We warmly welcome further conversations about any of our responses to the questions in the Consultation Paper. Please contact us at policy@inclusionaustralia.org.au.

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Background

As the Consultation Paper mentions, both the Disability Royal Commission[1] and NDIS Review[2] made clear that the conditions for an inclusive, safe and dignified life for people with disability depend on strong rights-based safeguards, high-quality supports, and systems that actively prevent violence, abuse, neglect and exploitation. The findings of these two landmark reports repeatedly demonstrate that these protections are most at risk where people have the least power, the least visibility, and the fewest opportunities to influence or meaningfully take part in decisions about the services they rely on.

In addition, the Disability Royal Commission showed that violence, abuse, neglect and exploitation are more likely to (though do not solely) take place in segregated settings, separate from the community.[3]

We also know that people with certain disability types are more likely than others to experience life in such settings. That cohort is predominately people with cognitive impairment,[4] including people with an intellectual disability.

A snapshot of evidence drawn from the findings of the Disability Royal Commission demonstrates the ways experiences of violence, abuse, neglect and exploitation significantly impact people with an intellectual disability, as shown in the infographic in Appendix B.

The proposed safeguarding strategy is intended to protect people with disability and drive high-quality, safe, and inclusive services inside and beyond the NDIS. We strongly support government efforts to develop a holistic safeguarding strategy.

In our view, its effectiveness depends on a number of factors addressed in this submission, including the extent to which people with disability are supported to understand, access, and use it to advocate for their rights and participate in decisions about their supports, as well as the extent to which this is supported through workforce capability.

Given this context, it is essential that the development and implementation of the safeguarding strategy include deliberate and targeted engagement with people with an intellectual disability, particularly those who live in group settings. These are environments in which barriers to full inclusion, human rights, and high-quality supports may be most pronounced, and where the safeguarding intended by the strategy must be commensurate with the specific and, at times, increased risks that can arise in these settings.

We also propose that guidance materials be developed in due course to strengthen implementation of the safeguarding strategy. To ensure the strategy is meaningful, accessible, and effective, communications and educational resources should be produced in formats that people with disability can understand and use. This should include an accessible communications strategy to ensure people with an intellectual disability and their families are aware of any changes to the safeguarding approach and associated guidance information. We provide specific examples of how this might look in the following responses to the Discussion Questions.

Ensuring the safeguarding strategy meaningfully reaches, includes, and is shaped by people who experience life in these settings – and their families – is critical to ensuring the strategy actively addresses the structural and cultural conditions that amplify barriers to an inclusive life.

___[1] Disability Royal Commission. 2023. Final Report – Executive Summary: Our Vision for an Inclusive Australia and Recommendations. Retrieved from: https://disability.royalcommission.gov.au/publications/final-report-executive-summary-our-vision-inclusive-australia-and-recommendations

[2] NDIS Review. 2023. Working together to deliver the NDIS. NDIS Review: Final Report. Retrieved from: https://www.ndisreview.gov.au/sites/default/files/resource/download/working-together-ndis-review-final-report.pdf

[3] McVilly, K., Ainsworth, S., Graham, L., Harrison, M., Sojo, V., Spivakovsky, C., Gale, L., Genat, A., Zirnsak, T. (2022). Outcomes associated with ‘inclusive’, ‘segregated’ and ‘integrated’ settings: Accommodation and community living, employment and education. A research report commissioned by the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability. University of Melbourne, Australia.

[4] ‘Cognitive impairment’ is an umbrella term used by the Disability Royal Commission. It describes a range of cognitive disabilities, including intellectual disability._

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Case study: learning from the VALID8 model

The VALID8 tool, developed by our Victorian member organisation VALID, was funded by the Victorian Government as part of the transition from government-run disability services. It started as a self-audit for disability services, particularly group homes, and is designed to help these services learn whether they were doing what they could to empower people with intellectual disability to live their own lives. It was also a way services could define and develop best practice to help empower people they support.

The VALID8 program has demonstrated success in gaining the trust of people with an intellectual disability in services and facilitating meaningful disclosures about service quality and safety concerns. This peer-to-peer approach creates safe spaces for honest feedback that traditional quality review processes often fail to capture.

This approach recognises that people with an intellectual disability bring unique expertise to quality review processes, including by understanding the lived experience of using services, identifying barriers and issues that others might miss, and communicating with service users in ways that build trust and encourages honest feedback. Their involvement as quality reviewers also challenges assumptions about capability and demonstrates the valuable contributions people with an intellectual disability can make to service improvement.

Models like the VALID8 tool should be considered by governments as ways of embedding peer-led and disability-led approaches into safeguarding. These approaches complement formal oversight mechanisms such as Community Visitor Schemes and other formal safeguards by creating culturally safe spaces for people with intellectual disability to share concerns, shaping service improvement by ensuring that lived experience drives quality and accountability. We are heartened to see this model is being explored for national roll-out as ACTIV8, supported through an NDIS Quality and Safeguards Commission grant.

How the elimination of restrictive practices applies to safeguarding

Any contemporary safeguarding framework must not only prevent violence, abuse, neglect and exploitation - it must actively create the conditions in which people with an intellectual disability can live safely, autonomously and free from coercion. The use of restrictive practices is one of the clearest indicators of system failure and a fundamental breach of people’s rights. As governments design a new national safeguarding framework and strategy, it is essential that the reduction and elimination of restrictive practices is treated as a core safeguarding priority, and that the framework is informed by evidence-based, rights-focused models such as the one developed by Inclusion Australia (included on the next page).

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People with an intellectual disability are disproportionately subjected to restrictive practices, particularly chemical restraint, across disability, education, health, justice and community settings. Restrictive practices are widely recognised as incompatible with human rights obligations, including Australia’s responsibilities under the UN Convention on the Rights of Persons with Disabilities, which requires states to prevent violence, abuse, neglect and exploitation and ensure people’s freedom, safety and legal capacity. Evidence from the Disability Royal Commission shows that restrictive practices are most commonly used in segregated and congregate environments – such as group homes, day programs and detention settings – here people often have limited autonomy, rely heavily on providers for daily supports, and lack meaningful access to safeguards and informal supports. For many people with an intellectual disability, restrictive practices cause trauma, fear, humiliation, long-term harm, and significant breaches of dignity.

Inclusion Australia has developed a holistic model for the reduction and eventual elimination of restrictive practices to guide governments, providers and systems towards approaches that uphold people’s rights, prevent harm, and promote autonomy. The model recognises that so-called “behaviours of concern” are rarely about the person alone but are shaped by context—including unmet communication needs, lack of choice and control, trauma histories, unsafe or chaotic environments, and the person’s social world. These behaviours are often valid expressions of distress or dysregulation. They must be understood within the person’s life circumstances rather than pathologised or managed through coercive or harmful responses.

Our model brings together four essential enablers that must be present for restrictive practices to be meaningfully reduced:

• Supported decision-making – People must have access to the supports they need to make and express their own decisions, with autonomy actively promoted rather than substituted. Supported decision-making is a core safeguard and a prerequisite for reducing restrictive practices.
• Early and ongoing communication support – Many adults with intellectual disability never received timely communication support, limiting their ability to express needs and preferences. Ensuring access to communication support, including AAC, is critical to preventing escalation and maintaining rights.
• A trauma-informed lens – People with an intellectual disability experience very high rates of violence, abuse and neglect. A trauma-informed approach recognises these impacts, avoids triggering harm, and shifts practice from “fixing behaviour” to supporting safety, connection and wellbeing.
• Belonging in ordinary community life – Strong informal supports, relationships, visibility and inclusion are powerful natural safeguards. People are safer when they belong, are known, and have people in their lives outside service systems.

The model demonstrates how these enablers strengthen one another and foster holistic understanding of behavioural drivers, enabling practitioners and systems to respond in ways that uphold dignity, autonomy and safety.

For a safeguarding framework to be effective, it must embed these principles across all settings – disability and mainstream, formal and informal. Incorporating this model into the national safeguarding strategy will help shift practice from risk management through restriction to building environments and cultures where people with an intellectual disability receive high quality, fit-for-purpose supports and safeguards.

For the full model, evidence base and detailed evidence review, please visit: https://www.inclusionaustralia.org.au/resource/a-model-for-the-elimination-of-restrictive-practices/.

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Our responses to Consultation Questions

1. When you hear the words “safeguards” and “quality” in this context, what does it mean to you?

For Inclusion Australia, safeguards and quality are fundamentally rights-based concepts, grounded in the lived experience of people with an intellectual disability and their families. Safeguards are not only mechanisms designed to prevent harm - they also include the systems, relationships and conditions that enable people to live free from violence, abuse, neglect and exploitation and exercise full autonomy, dignity, and participation. They include formal oversight, but equally rely on informal safeguards: trusted relationships, peer networks, advocacy, and the social inclusion that reduces isolation and risk.

Quality is not the absence of mistreatment. Quality is also the presence of ordinary, connected, meaningful lives: belonging, relationships, cultural identity, communication access, self-determination, and supported decision-making.

An effective national safeguarding system must be shaped by what people actually experience in everyday life, particularly those with the least visibility, such as people experiencing life in settings in which there is likely to be a high level of social, economic and political isolation: for example group homes, boarding houses, Australian Disability Enterprises (ADEs) and justice settings.

It is also crucial to consider people with an intellectual disability who may not be NDIS participants but who may have significant support needs and experiencing high levels of social and economic isolation. This may include people who live in government housing or boarding houses.

2. What do you like or dislike about the definition of safeguards? Is anything missing or confusing?

The definitions are drawn from the 2016 NDIS Quality and Safeguarding Framework, which we understand is concurrently being reformed by the NDIS Commission. We have heard from our community over the years that one of the shortcomings of this definition is that safeguarding is framed mainly as the absence of violence, abuse, neglect and exploitation. While preventing harm is essential, this definition does not reflect contemporary understandings of what genuine safeguarding requires – particularly for people with an intellectual disability.

We support the emphasis on rights, safety and wellbeing, but believe the definition needs to be strengthened in several key ways:

• Supported decision-making must be explicitly recognised as a core safeguard. The right for an individual to make their own decisions about their life to the maximum extent possible, and to have access to the support needed to exercise that right, is fundamental to preventing harm and promoting autonomy.
• Safeguards must address structural conditions that enable abuse, including congregate living, block-funded supports and environments where people have little control over who provides their support.
• Safeguards must explicitly include accessible communication, without which people with communication and decision support needs cannot understand their rights, make informed choices or raise concerns.
• The definition must recognise that safeguarding extends beyond the NDIS, applying equally to health, education, justice, aged care and housing systems—settings where the Disability Royal Commission found significant harm occurs.
• Safeguarding must acknowledge and directly address the power imbalance between providers and participants, rather than assuming people can always advocate for themselves or use complaints processes.
• Effective safeguarding relies on both formal and informal mechanisms, including independent advocacy, peer networks, community visitors, family involvement and long-term unpaid relationships such as citizen advocacy.

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A contemporary definition must therefore recognise that safeguarding is both about preventing harm and creating the conditions for people with disability to live self-determined, ordinary and inclusive lives.

3. What do you like or dislike about the definition of quality? Is anything missing or confusing?

The current definition of quality is too narrow and overly service-centred. It risks reducing “quality” to basic compliance rather than focusing on outcomes that genuinely matter to people in their everyday lives. A meaningful definition must set clear expectations for inclusion, autonomy, dignity, identity, communication access, relationships and participation – not just minimum service requirements.

Quality should set a mandate for continuous improvement and make it clear that people with disability have the right to expect the highest standards of support. This requires a balanced approach: while participants should be supported to understand and exercise their rights, this cannot translate into an expectation that they alone drive quality.

A complaints-driven approach is particularly unsafe and inequitable for people with an intellectual disability, especially for non-speaking people or those with complex communication needs. Relying on individuals to identify and report concerns ignores the power imbalance between participants and providers and risks further disempowering those already at greatest risk.

To avoid this, definitions must:

• Explicitly recognise the power imbalance between providers and participants
• Reduce reliance on participant-led complaints by placing a stronger responsibility on providers, systems and the regulator to drive and monitor quality
• Strengthen provider and workforce accountability through clearer expectations, better training, and active oversight
• Invest in independent, disability-led capacity building, including self-advocacy supports and accessible information, so people can meaningfully understand their rights without being expected to individually enforce them.

4. Do you have anything to add?

Quality and safeguarding must be experienced in practice, not only defined in policy. A system that relies on complaints or audits alone will miss people with the least voice, least support, and highest risk. Safeguarding must be proactive, embedded into everyday practice, and continuously informed by lived experience – including of family members of people with the highest support needs.

5. Who would you tell if you did not feel safe?

Our community consistently tells us that people with an intellectual disability first disclose concerns to those with whom they have genuine trust:

• A family member or friend
• An independent advocate
• A peer supporter or self-advocacy group
• A trusted support worker
• In some cases, a systemic advocacy organisation.

In segregated or congregate environments, disclosure often happens only when a safe, informal relationship exists outside the provider’s influence. This is why informal safeguards – long-term, trusted social connections – are essential.

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When people are not listened to, or their concerns are dismissed, they are far less likely to speak up again. In some cases, unresolved worries or expressions of distress can be misunderstood as “behaviours of concern”, leading to behaviour support plans that may include restrictive practices.

Please also refer to page 6 of this submission in relation to the VALID8 model.

6. How could it be made easier for you to tell someone you don’t feel safe?

Over the years, our community has cited the following factors as protective and accessible mechanisms for disclosure:

• Accessible, multi-format information (Easy Read, pictorial, plain language, Auslan, audio, translated material) provided proactively
• Safe, independent, retaliation-free reporting pathways, including private opportunities to speak with someone outside the service
• Regular, private check-ins by advocates, peer workers, or visitors – particularly in group homes, supported accommodation, day programs and other closed settings (for example, justice settings)
• Independent advocacy being made available at the earliest sign of risk
• Adoption of peer-led models (such as VALID8/ACTIV8, as explained on page 6 of this submission) that have proven effective in building trust and enabling disclosure.

Crucially, service providers must not, and must not be seen to, control or mediate access to these pathways.

7. What makes it difficult for people to access, understand and use information to make decisions?

Common barriers we hear include:

• Information being unavailable in accessible formats or delivered too late to be useful
• Workers lacking skills in communication support, including Easy Read, and non-verbal communication tools
• Lack of supported decision-making, where people are told what will happen rather than supported to understand options, risks and to make choices according to their own will and preferences
• Power imbalances that make people fearful of questioning staff or saying “no”
• Limited opportunities to build decision-making capability over time
• High staff turnover that removes the trust necessary for meaningful conversations
• Complex and bureaucratic organisations that are difficult for people with an intellectual disability and their families to navigate – and can be equally difficult for support workers to navigate.

8. Do you have anything to add?

Accessible information and supported decision-making are fundamental safeguards and must be mandated as part of any safeguarding framework or strategy.

9. What are ways we can support people with disability to shape their own support system?

This requires cultural and structural change. Effective strategies include:

• Embedding supported decision-making at every stage of service delivery, not only for major decisions

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• Providing information in accessible formats from the outset – not after decisions have already been made
• Funding and sustaining independent advocacy, self-advocacy, and peer-led organisations, which are essential for capacity-building – and service providers supporting and encouraging access to these supports
• Employing people with disability – including people with intellectual disability – in co-design, governance, training, monitoring and evaluation roles
• Integrating peer-led quality mechanisms like VALID8/ACTIV8 into the safeguarding strategy and framework
• Strengthening informal networks through citizen advocacy and community programs that build trusted relationships.

10. Do you have anything to add?

Systems must be designed to counteract the power imbalances that make co-design difficult in practice. People cannot meaningfully shape services if they fear retaliation, lack accessible information, or are not supported to participate fully.

11. What does person-centred support look like to you?

Person-centred support includes:

• Upholding dignity of risk and supporting risk-taking in the context of supported decision-making
• Enabling people to express identity, culture, preferences and relationships
• Providing communication access across all interactions
• Ensuring supports build autonomy, capability, and community inclusion
• Considering the person’s strengths, goals, rhythms of life, and wider social connections
• Supporting access to healthcare, education, employment and community settings with appropriate adjustments.

Person-centred support must be demonstrable in day-to-day interactions – not only in plans or policy documents.

12. How can services get better at putting the person first?

Putting the person first requires genuine structural and cultural change across services, not just new policies. Services must shift from a compliance-driven model to an approach grounded in rights, autonomy and the lived experience of people with disability – particularly people with an intellectual disability.

Services need sustained investment in training and supervision so workers can confidently and consistently support people’s autonomy and rights. This includes:

• Supported decision-making capability: workers must understand decision support principles, how to scaffold choices, and how to avoid substituting their own judgements
• Communication access: including how to use tools, adapt information and engage with people with complex communication needs
• Trauma-informed, rights-based and culturally safe practice: ensuring workers understand the impacts of past trauma, power imbalances and coercive environments, and are responsive to cultural differences

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• Ongoing active support and practice leadership: especially in group homes and day programs, to model good practice, coach staff, and prevent harmful cultures from developing.

Putting people first means involving people with disability in shaping the service from the beginning through including people with an intellectual disability and families into governance, training, policy development and quality monitoring. This may also include embedding peer-led models (e.g., VALID8 as discussed on page 6) to gather feedback, surface concerns, and inform continuous improvement.

Services must be supported and required to use evidence and data to understand people’s experiences and to improve practice:

• Implementing best-practice data collection on quality of life, safeguarding concerns, communication access, workforce capability and service culture
• Analysing trends in complaints, restrictive practices, incident reports, advocacy referrals and peer-review findings to identify systemic risks
  • This must include a holistic understand of what constitutes a “complaint”, so that any definition of complaints can be flexible enough to encompass the different ways people express their dissatisfaction with a situation or person. For example, a person may display self-injurious behaviour in certain situations such as when a particular staff member is on shift. Complaints mechanisms should be able to holistically consider such expressions of complaint.
• Using validated tools, evidence-informed practice guides and quality indicators tailored to people with intellectual disability
• Ensuring data is used not only for compliance but for learning, reflection and cultural change.

14. Do you think the services you receive are held accountable to deliver quality and safe services?

Our community reports that accountability is inconsistent and too often ineffective. People with an intellectual disability, particularly people who live in group homes or with limited informal support, frequently do not experience services as accountable or responsive. The Disability Royal Commission heard considerable evidence of this from across the disability service system.

15. Are there other forms of accountability you think would increase quality and safety?

Yes. Effective accountability must be proactive, independent, and grounded in lived experience. Key approaches include:

• Unannounced visits (such as through a nationally consistent Community Visitors Scheme – please view our submission to the Department’s recent consultation here) especially in group homes and other segregated settings
• Public reporting of provider performance in accessible formats
• Routine triangulation of data – including complaints, incident reports, advocacy data and peer-review findings
• Clear consequences when providers breach rights, including sanctions and escalation pathways.

16. What could be changed to keep services accountable?

Safeguarding must be embedded at every level. This means:

• Stronger independent oversight across disability and mainstream systems
• Clear standards for cultural safety, supported decision-making, and communication access
• Mechanisms for early intervention – including advocates, peer workers and trained visitors

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• Improved data sharing and coordination between oversight bodies
• Mandatory follow-up where patterns or trends suggest systemic risks
• Ensuring accountability mechanisms do not rely on provider self-reporting alone.

18. Do you have any examples of when services have worked well together?

We hear isolated examples of effective collaboration – often when disability providers, families, health services and advocates work together to address complex needs. However, these examples are not systematic and typically rely on individual relationships and internal ‘champions’ rather than coordinated systems. We are confident there are examples of good practice that could be studied and replicated, but more consultation with our community is needed to gather comprehensive evidence.

19. Are there things that stop services working well together in your experience?

Persistent barriers include:

• Fragmented systems with unclear responsibilities
• Poor information sharing across disability and mainstream services
• Lack of coordination roles or bridging positions, particularly at key transition points, such as from school to work.

21. How else can we make safeguarding better?

Safeguarding must be understood as a whole-of-life, whole-of-system responsibility. Key priorities include:

• Embedding supported decision-making as a core safeguard across all settings
• Ensuring safeguards apply equally outside the NDIS, particularly in health, education, justice, housing and employment
• Targeted safeguards for group homes, segregated environments and closed settings, where risks are highest
• Sustainable funding for independent advocacy, peer networks, citizen advocacy, community visitors and self-advocacy groups
• National roll-out and embedding of peer-led quality review models such as VALID8/ACTIV8
• Ensuring all safeguarding information is available in accessible formats from the outset
• Developing a national ecosystem that includes formal oversight and informal supports, recognising they are mutually reinforcing
• Recognising that effective safeguarding must include ways of actively reducing social isolation, as isolation is one of the greatest risk factors for abuse
• Recognising that some services may prioritise financial considerations, limiting their willingness to engage in genuine collaboration due to fears of losing participants
• Ensuring that new research, emerging evidence and important findings about safeguarding are shared widely and accessibly. The Commission should take clear responsibility for disseminating this research, and providers should be incentivised – through accreditation, quality standards or funding levers – to understand the evidence and adopt good practice.

A robust national safeguarding approach must be comprehensive, rights-based, culturally safe, and informed at every stage by the lived experience of people with an intellectual disability and their families.

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Appendix A

References for our model for the elimination of restrictive practices

Ali A, Blickwedel J, Hassiotis A. Interventions for challenging behaviour in intellectual disability. Advances in Psychiatric Treatment. 2014;20(3):184-192. doi:10.1192/apt.bp.113.011577

Blue Knot Foundation. N.d. Becoming Trauma Informed Services. Retrieved from: https://professionals.blueknot.org.au/wp-content/uploads/2023/12/45_BK_FS_PRF_BecomingTraumaInformed_Services_DEC23.pdf

Claire Spivakovsky. 2017. ‘Governing Freedom through Risk: Locating the Group Home in the Archipelago of Confinement and Control’. Punishment and Society 19 (3). https://doi.org/10.1177/1462474517703968.

Claire Spivakovsky, Linda Steele and Dinesh Wadiwel. 2023. Restrictive practices: a pathway to elimination. A research report commissioned by the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability. University of Melbourne, Australia.

Daniel Lawrence, Ruth Bagshaw, Daniel Stubbings & Andrew Watt, ‘Restrictive practices in adult secure mental health services: A scoping review’, vol 21 (1), International Journal of Forensic Mental Health, p 81; Laura Higgins, ‘Secure unit: Positive behavioural support and restraint reduction in a unit for offenders with an intellectual disability and/or autism: practice paper’, vol 11 (1), International Journal of Positive Behavioural Support, pp 42-54.

García JC, Díez E, Wojcik DZ, Santamaría M. Communication Support Needs in Adults with Intellectual Disabilities and Its Relation to Quality of Life. Int J Environ Res Public Health. 2020 Oct 9;17(20):7370. doi: 10.3390/ijerph17207370. PMID: 33050216; PMCID: PMC7601275.

Karl Nunkoosing & Mark Haydon-Laurelut, ’Intellectual disability trouble: Foucault and Goffman on ‘challenging behaviour’’ in Dan Goodley, Bill Hughes & Lennard Davis (eds) Disability and Social Theory, Palgrave Macmillan, 2012.

Keith McVilly and Jeffry Chan. 2011. ‘Restrictive Interventions for People with Intellectual Disability Exhibiting Challenging Behaviours: Analyses of a Population Database’, 24(6), Journal of Applied Research in Intellectual Disabilities, pp. 495-507.

Keith McVilly, et al. 2022. Outcomes associated with ‘inclusive’, ‘segregated’ and ‘integrated’ settings: Accommodation and community living, employment and education. A research report commissioned by the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability. University of Melbourne, Australia.

Louise Denne, Nick Gore, Carl Hughes, Sandy Toogood, Edwin Jones & Freddy Jackson Brown, ‘Implementing evidence-based practice: The challenge of delivering what works for people with learning disabilities at risk of behaviours that challenge’, (2020), vol 25 (3), Tizard Learning Disability Review.

Lynne Weber, Keith McVilly and Jeffry Chan, ‘Restrictive Interventions for People with Intellectual Disability Exhibiting Challenging Behaviours: Analyses of a Population Database’ (2011) 24(6) Journal of Applied Research in Intellectual Disabilities.

Martin Stevens, ‘Moral positioning: Service user experiences of challenging behaviour in learning disability services’, (2006), vol 36 (6), British Journal of Social Work, pp. 955-978.

Paul Harpur and Heather Douglas ‘Disability and domestic violence: protecting survivors’ human rights’ (2014), 23(3), Griffith Law Review, pp. 405-433.

Paul Ramcharan, Karen Nankervis, Maria Strong & Alan Robertson, ‘Experiences of restrictive practices: A view from people with disabilities and family carers: A final research report to the Office of the Senior Practitioner’, Research report for Office of the Senior Practitioner, Victorian Government, May 2009.

Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability. 2020. Report on Public hearing 6: Psychotropic medication, behaviour support and behaviours of concern. Retrieved from: https://disability.royalcommission.gov.au/publications/report-public-hearing-6-psychotropic-medication-behaviour-support-and-behaviours-concern

Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability. 2020 Submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability in response to Group homes issues paper, ISS.001.00060, p 10.

Stella Koritsas & Teresa Iacono, ‘Predictors of challenging behaviour in adults with intellectual disability’, (2015), vol 9 (6), Advances in Mental Health and Intellectual Disabilities, pp 312-326.

Webber, Mcvilly, and Chan, ‘Restrictive Interventions for People with a Disability Exhibiting Challenging Behaviours: Analysis of a Population Database’, Lynne S. Webber et al., ‘Factors Associated with the Use of Mechanical Restraint in Disability Services’, Journal of Intellectual & Developmental Disability, 44/1 (2019), 116-20.

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Appendix B

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