Issues Emanating From the Implementation of Policies on Restraint Use With People With Intellectual Disabilities

Abstract
Some service providers use restraints and seclusion with people with an intellectual disability, and policies that permit such practices usually state that their use is primarily to prevent the risk of self‐injury or risk to others. However, the use and effectiveness of restrictive practices have been questioned due to the negative impact on the service user and staff and may also be considered a contravention of the human rights of the service user. Consequently, policies are now trending toward limiting restraint use or on the prevention of or safe elimination of the use of restraint. In Ireland, new legislation has attempted to formalize the definitions of restraint and seclusion, as well as place restrictions on such practices. However, issues have been raised with respect to the implementation of the new policies, particularly in operationalizing a definition of restraint and applying it to widely heterogeneous clinical groups considering the autonomy that service providers have in devising their own service‐level policies. The authors use legislation from Ireland and Victoria, Australia, to illustrate restraint practices and the issues emanating from its use. The authors argue that a gap remains between our understanding of the place of implementing restrictive practices with respect to service provision and their actual applications by providers. They conclude that such discordance between policy and practice needs to be addressed by stronger regulation.

Source: Journal of Policy and Practice in Intellectual Disabilities - September 10, 2013 Category: Disability Authors: Eóin David Rickard, Jeffrey Chan, Brian Merriman Tags: Original Article Source Type: research