Restrictive practices in the NDIS: what families need to know
A restrictive practice is anything that limits a person's rights or freedom of movement. Under the National Disability Insurance Scheme (NDIS), five types are regulated: seclusion, and chemical, mechanical, physical and environmental restraint. They can only be used as a last resort to prevent harm. They must be in a behaviour support plan, authorised under state or territory rules, and reduced over time.
What is a restrictive practice?
The NDIS Quality and Safeguards Commission (NDIS Commission) defines it as any action that limits a person's human rights or freedom of movement. Examples include some medication, locked doors or cupboards, or a helmet.
Restrictive practices are sometimes used to keep a person or others safe. The Commission is clear about their limits. They don't meet the person's needs or create lasting positive change, and they can make behaviour worse.
Every NDIS participant subject to a restrictive practice must have a behaviour support plan (BSP).
What are the five regulated restrictive practices?
The NDIS (Restrictive Practices and Behaviour Support) Rules 2018 regulate five types. The table uses the NDIS Commission's plain descriptions.
| Type | What it means |
|---|---|
| Seclusion | Being left alone in a room or place and not allowed to leave. This includes when the person is told, or believes, they can't leave, even if the door is open. |
| Chemical restraint | Being given medicine to stop or reduce a behaviour. |
| Mechanical restraint | Using equipment or a device to stop or reduce a behaviour. It may limit how the person moves or uses part of their body. |
| Physical restraint | Holding a person, or part of their body, so they can't move freely, to stop or reduce a behaviour. |
| Environmental restraint | Stopping a person from having or doing certain things, or from going to certain places in their home or community. |
The Rules also say what doesn't count:
- Medication a doctor prescribes to treat a diagnosed mental disorder, a physical illness or a physical condition isn't chemical restraint.
- Devices used for therapy or other non-behavioural reasons aren't mechanical restraint.
- A reflex hands-on move to guide or redirect someone away from harm, as a reasonable act of care, isn't physical restraint.
Some practices are never allowed
The NDIS Commission says practices that put participants at high risk of harm must never be used. Some are against the law in some states and territories.
Need a practitioner?
We'll connect you with a registered provider near you who has space.
When can a restrictive practice be used?
Only as a last resort to respond to a risk of harm, after positive strategies have been tried. It must be the least restrictive option and used for the shortest possible time.
For a regulated restrictive practice in a behaviour support plan, the Rules say it must:
- be clearly identified in the plan
- be authorised under the state or territory process, where there is one
- be used only as a last resort in response to a risk of harm
- be the least restrictive response possible
- reduce the risk of harm to the person or others
- be in proportion to the risk of harm
- be used for the shortest possible time
Only registered NDIS providers can use regulated restrictive practices. It's a breach of the NDIS Rules for an unregistered provider to use them.
Who authorises restrictive practices?
Each state and territory has its own authorisation process. The provider using the practice, called the implementing provider, must get authorisation in the state or territory where the person lives.
The implementing provider lodges evidence of the authorisation with the NDIS Commission. It then reports to the Commission every month on its use of regulated restrictive practices, including months when none were used. Monthly reports should be done within 5 business days of the end of the month.
How does authorisation work in South Australia?
South Australia's Restrictive Practices Authorisation scheme started on 30 May 2022. It's run by the Restrictive Practices Unit in the Department of Human Services (DHS), led by the Senior Authorising Officer.
- The scheme sits under South Australia's Disability Inclusion Act 2018, as amended in 2021 to cover restrictive practices for NDIS participants.
- Only two roles can make authorisation decisions: authorised program officers (APOs) and the Senior Authorising Officer. APOs work for registered NDIS providers and are approved by the Senior Authorising Officer.
- APOs can authorise some practices. Others they endorse and send to the Senior Authorising Officer to decide.
- A guardian or family member can't authorise a restrictive practice or tell a provider to use one. They do have a say in decisions.
- Seclusion has extra limits in South Australia. It can't last longer than two hours. It can only be used in an emergency to prevent serious harm, and only to help the person de-escalate or self-regulate.
- Some practices are banned outright, including using a restrictive practice as punishment and withholding basic needs like food or water.
Families can contact the Restrictive Practices Unit on 1800 862 004 or at DHSRestrictivePracticesUnit@sa.gov.au with questions or worries about a restrictive practice.
How are restrictive practices reduced and stopped?
Reducing and stopping them is a legal aim of every plan that includes them. The practitioner must look for changes to the person's environment and new skills that could remove the need.
The Rules require the specialist behaviour support provider to take all reasonable steps to reduce and eliminate the need for regulated restrictive practices. The person must also get chances to join community activities and learn new skills.
Comprehensive plans with restrictive practices must be reviewed at least every 12 months, or sooner if circumstances change. At each review the practitioner checks progress on the plan to fade them out. If progress has stalled, the Commission expects the review to record why and set clear actions, who is responsible and by when. For chemical restraint, that means working closely with the prescribing doctor.
If you'd like a practitioner to review a plan that includes restrictive practices, we can connect you with a registered one.
What can I do if I'm worried about a restrictive practice?
Talk to the provider and the behaviour support practitioner first. You can also contact the NDIS Commission, and in South Australia the Restrictive Practices Unit.
- If someone's life is at risk or there's an immediate risk of harm, call 000.
- Ask the practitioner to explain the practice, why it's needed and how it will be reduced. They must explain it in a way the person and family can understand.
- Registered providers must report unauthorised restrictive practices to the NDIS Commission within 5 business days.
- Email behavioursupport@ndiscommission.gov.au if an unregistered provider is using restrictive practices.
- You can also make a complaint about a provider to the NDIS Commission.
Questions people ask
Is medication always a restrictive practice?
No. Medication a doctor prescribes to treat a diagnosed mental disorder, a physical illness or a physical condition isn't chemical restraint. It's chemical restraint when the main purpose is to influence behaviour.
Can a family member agree to a restrictive practice?
In South Australia, no. A guardian or family member can't authorise a regulated restrictive practice or direct a provider to use one, though their views are part of the decision. Other states and territories have their own processes.
Does the NDIS fund seclusion rooms?
No. The National Disability Insurance Agency (NDIA) says it can't fund seclusion rooms, or supports that include restrictive practices not allowed in your state or territory.
What is an implementing provider?
Any NDIS provider who puts a behaviour support plan into practice or uses a regulated restrictive practice while supporting someone. If they use regulated restrictive practices, they must be registered and audited against Module 2A of the NDIS Practice Standards.
Do restrictive practices have to be reported?
Yes. Authorised practices are reported to the NDIS Commission every month. Unauthorised practices are reportable incidents and must be reported within 5 business days.
Keep reading
- Behaviour support plansWhat goes in an NDIS behaviour support plan, how interim and comprehensive plans differ, the 1 and 6 month timeframes, who writes it and when it gets reviewed.
- Interim behaviour support plansWhat an interim behaviour support plan is, when one is needed, the 1 month rule when restrictive practices are used, and what happens next under the NDIS.
- Behaviour support practitionersWhat an NDIS behaviour support practitioner does, how the NDIS Commission approves them, how to check one and find one near you, and how to become one.
Find a practitioner