The five regulated restrictive practices
The NDIS Commission's rules name five types. Each is defined by its purpose: it counts as a restrictive practice when its main purpose is to influence a person's behaviour.
- Seclusion: keeping a person alone in a room or space they can't leave, or aren't helped to leave
- Chemical restraint: medication used mainly to change behaviour, rather than to treat a diagnosed mental illness or physical condition
- Mechanical restraint: a device used to stop or limit movement to influence behaviour, as opposed to something used for therapy or safety such as a seatbelt or splint used as prescribed
- Physical restraint: using physical force to stop or limit a person's movement to influence behaviour
- Environmental restraint: restricting free access to parts of the person's environment, or to items or activities, such as locked fridges, cupboards or rooms
When can a restrictive practice be used?
Only when there is a real risk of harm to the person or others, and only as a last resort after positive, less restrictive approaches have been tried or considered. The practice has to be the least restrictive option that keeps people safe, proportionate to the risk, and used for the shortest time possible.
It also has to be part of a behaviour support plan written by an NDIS behaviour support practitioner, authorised under state rules, and reported to the NDIS Commission by the provider using it. A practice used without those safeguards is unauthorised, and providers must report it as a reportable incident.
The behaviour support plan comes first
Under the NDIS rules, a behaviour support practitioner has one month from being engaged to write an interim plan where a regulated restrictive practice is in use, and six months to complete a comprehensive plan based on a functional behaviour assessment. Plans that include a regulated restrictive practice are lodged with the NDIS Commission and reviewed at least every 12 months, or sooner if things change.
A plan does not authorise a practice on its own. It describes what the practice is, exactly when it can be used, and, most importantly, the positive strategies that should make it unnecessary. Our guide to positive behaviour support explains that approach.
How authorisation works in NSW
In New South Wales, regulated restrictive practices are authorised through a Restrictive Practices Authorisation (RPA) panel, using the Department of Communities and Justice's RPA portal. The provider that will use the practice submits the behaviour support plan, consent and supporting information.
The panel includes a senior manager of that provider with experience in behaviour support and restrictive practices, and an independent behaviour support specialist. The practitioner who wrote the plan can't sit on the panel. Decisions must be unanimous, and an authorisation lasts for no more than 12 months, or until the behaviour support plan expires if that is sooner. If the panel doesn't agree, the practice is not authorised.
Reducing and eliminating them
Every plan that includes a restrictive practice must also set out how it will be reduced and, where possible, stopped. That is the test of a good plan: over time, as the person's needs are better understood and met and their skills grow, the restriction should be needed less.
If a plan has carried the same restriction, unchanged, for years, it is fair to ask why.
Questions worth asking
If someone you support has a restrictive practice in their plan, you are entitled to understand it:
- What risk is this practice responding to, and what was tried first?
- Exactly when may it be used, and who decides at the time?
- Has it been authorised, and when does the authorisation end?
- How is each use recorded and reported?
- What is the plan to reduce it, and how will we know it's working?
- Who do I contact if I'm worried it's being used outside the plan?
Restrictive practices at Care Alliance
Care Alliance is a psychologist-led, NDIS-registered provider. Our behaviour support practitioners write behaviour support plans that include regulated restrictive practices, and we are registered under Module 2a to implement them, including in our Supported Independent Living homes and high intensity supports. Our approach starts from the least restrictive option and from the person's rights and dignity, and no practitioner decides alone about a restrictive practice or a plan that isn't working.
We work across Newcastle, Lake Macquarie, Maitland, Cessnock, Port Stephens and the Central Coast. If you'd like to talk about a plan, make a referral or call 1300 206 309.
Common questions
What are the five regulated restrictive practices in the NDIS?
Seclusion, chemical restraint, mechanical restraint, physical restraint and environmental restraint. Each is a restrictive practice when its main purpose is to influence a person's behaviour.
Who authorises restrictive practices in NSW?
A Restrictive Practices Authorisation (RPA) panel, through the NSW Department of Communities and Justice's RPA portal. The panel includes a senior manager of the provider using the practice and an independent behaviour support specialist, its decision must be unanimous, and authorisation lasts no more than 12 months.
Is a locked fridge or cupboard a restrictive practice?
Usually, yes. Restricting someone's free access to parts of their home, or to items or activities, is environmental restraint when the main purpose is to influence their behaviour. It needs a behaviour support plan and authorisation, just like other regulated restrictive practices.
Is medication a restrictive practice?
Medication is chemical restraint when it's used mainly to influence behaviour. Medication prescribed to treat a diagnosed mental illness or physical condition is not. The difference matters, so it is worth asking the prescriber what each medication is for.
What happens if a restrictive practice is used without authorisation?
It is a reportable incident: the provider must report it to the NDIS Commission. It should also prompt a review of the person's behaviour support plan, because an unplanned restriction usually means a need isn't being met.
This guide is general information about the NDIS, not advice about your individual situation, and scheme rules change over time. For decisions about your plan, check the current guidance at ndis.gov.au or talk to your support coordinator, planner — or call us on 1300 206 309.
