Foss_whole_thesis.pdf (3.49 MB)
The Screams aren't going to be heard‚ÄövÑvp : restrictive intervention legislation in Tasmania
thesisposted on 2023-05-27, 10:18 authored by Foss, KA
People living with disability worldwide are still subjected to the use of restrictive interventions. This is in spite of overwhelming evidence regarding the risks of the use of those interventions coupled with an increased rights based approach when supporting people living with disability. Increasingly around the world, policy and legislation is being implemented with the aim of reducing the rates of restrictive intervention in this population. On 1st January 2012 such legislation (Disability Services Act 2011 (TAS)) was proclaimed in Tasmania. Drawing on the views of differing members of the Tasmanian disability sector, this thesis sought to determine the success of the implementation of the aspects of the legislation relating to the regulation of restrictive interventions, any perceived barriers to this implementation, and how these might be overcome. I utilised an exploratory research methodology, which included a mixed method of focus groups, interviews and surveys with organisational management, support workers, clinical workers, families and advocates. I conducted a thematic analysis of the data and comparison of results indicated that there are several barriers to the implementation of such legislation in Tasmania. I compared this data with data available regarding the implementation of similar legislation in other jurisdictions. I found that restrictive interventions are still used within the Tasmanian disability sector. The reasons for this are several-fold. Workers within the sector do not have the skills and training to be able to comply with the legislative requirement to reduce the amount of restrictive interventions used in services. In addition, the attitudes and cultures existing within the sector are not conducive to a reduction in the use of these interventions. The results also revealed that systems of governance are not sufficient to enforce this legislation. This study provides evidence of the need for cultural change to be addressed, alongside and irrespective of the implementation of the National Disability Insurance Scheme (NDIS). This should include the culture of the support staff, leaders and managers of organisations, board members, as well as clinicians. It is further recommended that a greater emphasis is given to systems of governance, both departmental and organisational. For example, the department should develop a process for penalising non-compliance, and organisational boards should expect greater accountability and reporting around the use of restrictive interventions. This thesis indicates a strong need for additional skill development and training in the areas of positive behaviour support and alternatives to the use of restrictive interventions. Again, this training needs to be directed to organisation and clinical staff. A final recommendation is made in light of the current findings, which is that the Act is operationalised further so that all are definitions, philosophies and roles are clear to all stakeholders. This thesis provides a platform for considering the national approach to the regulation and monitoring of restrictive interventions in the Tasmanian context, which will be implemented as a result of the introduction of the National Disability Insurance Scheme (NDIS).
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