ABSTRACT

This volume explores different models of regulating the use of restrictive practices in health care and disability settings.

The authors examine the legislation, policies, inspection, enforcement and accreditation of the use of practices such as physical, mechanical and chemical restraint. They also explore the importance of factors such as organisational culture and staff training to the effective implementation of regulatory regimes. In doing so, the collection provides a solid evidence base for both the development and implementation of effective approaches to restrictive practices that focus on their reduction and, ultimately, their elimination across health care sectors. Divided into five parts, the volume covers new ground in multiple respects. First, it addresses the use of restrictive practices across mental health, disability and aged care settings, creating opportunities for new insights and interdisciplinary conversations across traditionally siloed sectors. Second, it includes contributions from research academics, clinicians, regulators and mental health consumers, offering a rich and comprehensive picture of existing regulatory regimes and options for designing and implementing regulatory approaches that address the failings of current systems. Finally, it incorporates comparative perspectives from Australia, New Zealand, the Netherlands, Germany and England.

The book is an invaluable resource for regulators, policymakers, lawyers, clinicians, consumer advocates and academics grappling with the use and regulation of restrictive practices in mental health, disability and aged care contexts.

part I|38 pages

Background

chapter 1|13 pages

Restrictive practices

Options and opportunities

chapter 2|23 pages

Ending restraint

An insider view

part II|100 pages

Designing legislation and policy to support change

chapter 4|23 pages

The regulation of restrictive practices on people with intellectual impairment

The challenges and opportunities posed by a rights-based approach

chapter 5|28 pages

Beyond restraint

Gender-sensitive regulation of the control of women's behaviour in Australian mental health and disability services

part III|77 pages

Implementing and monitoring reform

chapter 8|19 pages

Queensland's new physical restraint framework

Implementation and lessons since the commencement of the Mental Health Act 2016

chapter 9|15 pages

Showing restraint

The uses and limitations of data in supporting restraint reduction

part IV|76 pages

Changing culture and practice

chapter 11|17 pages

The intractable use of restraint, organisational culture and 'othering'

Lessons from the Oakden scandal

chapter 13|18 pages

Psychotropic use in Australian aged care homes

What can be done to ensure appropriate use?

chapter 14|18 pages

Engaging doctors to reduce restraint

Practice and pragmatics around restraint in clinical care

part V|9 pages

Conclusions

chapter 15|7 pages

Regulating restrictive practices

Challenges and possibilities