Restrictive Practice Terms

Disability Royal Commission hearings sometimes use terms that most Australians aren’t very familiar with. We’re keeping a list of these and trying to explain them in plain language. Please feel free to contact us if you have suggestions for words that should be included.

Click here for general DRC terms.

Important note: This Jargon Buster is intended to aid in the understanding of terms used during the Disability Royal Commission hearings. Some of the terms defined here are not the generally preferred terms used by people with disability.

Some are euphemistic, and some frame people with disability as a problem to be solved, rather than focussing on the system which fails to support us.

People with lived experience of psychosocial disability may also have differing preferences about the terms used to describe themselves.

PWDA does not endorse the use of every term on this list.

Terms Used In The “Psychotropic medication, behaviour support and behaviours of concern” hearing.

Psychotropic Medication: Any drug that might affect the mind, emotions and behaviour. Examples of psychotropic medication include antidepressants, antipsychotics, mood stabilisers and stimulants.

Behaviours of Concern: A very broad (and ableist) term used to describe any behaviour considered difficult to understand or manage by a service provider or health worker.It may be used to describe anything from shouting, to refusing to eat, to being naked in public, to self-harm or harming others. We do not like the use of this term, because it centres the experience of the service provider or health worker and their “concern”, while framing the “behaviour” of the person with disability as the problem, rather than identifying problems with the environment they are in.

Environments of Concern: Available research has shown that “behaviours of concern” are very often “adaptive behaviours to maladaptive environments”, and “legitimate responses to difficult environments and situations.”¹ These may include group homes, boarding houses, locked wards, prisons or hospitals.

Challenging Behaviours: An alternative (and equally ableist) term for “Behaviours of Concern”.

Behaviour Support: Supports intended to reduce the occurrence of “behaviours of concern” and minimise the use of mechanical, chemical or physical restrictive practices.

While the behaviour support is intended to be a move away from certain restrictive practices, it is still an essentially ableist idea, as it still frames the person with disability as the problem instead of the systems around that person.

Psychosocial Disability: Societal barriers arising from mental health issues. Not everyone who has a mental health issue or diagnosis will identify themselves a person with psychosocial disability.

Consumers: People who use (or are subject to) the mental healthcare system.

Consumer Advocate: A consumer of the mental healthcare system involved in self-advocacy/systemic advocacy for the rights their community.

Consumer/Survivor Advocate: Another term for consumer advocate, acknowledging that some consumer advocates are also survivors of violence, abuse or neglect at the hands of the system they advocate to change.

Chemical Restraint: The use of a medication or chemical substance for the primary purpose of modifying a person’s behaviour (not for therapeutic or treatment purposes). This may include the use of antipsychotics, antidepressants or sedatives.

Restrictive Practices: Any practice or intervention that has the effect of restricting the rights or freedom of movement of a person with disability. These primarily include restraint (chemical, mechanical, social or physical) and seclusion.

All restrictive practices are a breach of the CRPD (Convention on the Rights of Persons with Disabilities) to which Australia is a signatory.

The National Framework: Commonwealth, State and Territory Disability Ministers endorsed the National Framework for Reducing and Eliminating the Use of Restrictive Practices in the Disability Service Sector at their meeting at the Disability Reform Council meeting on 21 March 2014.

The National Framework focuses on the reduction of the use of restrictive practices in disability services that involves restraint (including physical, mechanical or chemical) or seclusion.

OPCAT: The Optional Protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.

OPCAT is an international agreement aimed at preventing torture and cruel, inhuman or degrading treatment or punishment. OPCAT was adopted in 2002 and entered into force in 2006. 

The Australian Government ratified OPCAT in December, 2017.

‘Impaired Capacity’ or ‘Impaired Decision Making Capacity’:

Someone with capacity is defined as a person who can:

  1. understand the nature and effect of decisions about a matter,
  2. freely and voluntarily make decisions about the matter and
  3. communicate the decisions in some way.

When someone is described as having ‘impaired capacity’, that doesn’t necessarily mean that they can’t make decisions. Many adults with impaired capacity can be supported to make decisions for themselves.

The law states that people with impaired capacity have a right to adequate and appropriate support in decision-making.

Substitute Decision Making: A substitute decision-maker is a person permitted under the law to make decisions on behalf of someone who does not have capacity.

A person can have more than one substitute decision-maker.

The decisions made on behalf of a person by their substitute decision-maker(s) can be about personal (including health) decisions or financial matters.

Interpretive declaration: This is a legal term that means Australia chooses to only acknowledge some parts of the CRPD and chooses to infer or give “in principle” agreement but not full agreement to these Articles. Specifically Articles 12, 17, 18 which are about equality before the law, supported decision making and the right to autonomy.

More information here: https://www.alrc.gov.au/publication/equality-capacity-and-disability-in-commonwealth-laws-ip-44/equality-capacity-and-disability-in-commonwealth-laws/legislative-and-regulatory-framework/

Queensland Specific

Guardianship: Queensland’s guardianship system gives someone the legal authority to make decisions for an adult with ‘impaired capacity’ (most often a person with intellectual or cognitive disability). The appointed guardian can make certain personal and health care decisions on the adult’s behalf.

QCAT: The Queensland Civil and Administrative Tribunal (QCAT) is an independent, tribunal that resolves disputes on a range of matters. QCAT can appoint a guardian on behalf of an adult with impaired decision-making capacity.

Mental Health Act 2016:

Queenland’s Mental Health Act was passed in 2016 with 3 main aims:

  • to improve and maintain the health and wellbeing of persons who have a mental illness who do not have the capacity to consent to be treated
  • to enable persons to be diverted from the criminal justice system if found to have been of unsound mind at the time of committing an unlawful act or to be unfit for trial
  • to protect the community if persons diverted from the criminal justice system may be at risk of harming others.

More about the Mental Health Act can be found here: https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/clinical-staff/mental-health/act/about#explaining

¹(https://trove.nla.gov.au/work/36757107)