Getting ready to live tweet the last day of the #DisabilityRC hearing into the use of psychotropic medication and chemical restraints.
It's been a tough week, so if you need to mute this thread of the hashtag, we do understand.
It's been a tough week, so if you need to mute this thread of the hashtag, we do understand.
If you feel impacted by anything you read here today, remember you can always call Lifeline on 13 11 14.
You can also call the National Counselling and Referral Service (specifically set up to support people impacted by anything related to the #DisabilityRC) on 1800 421 468.
You can also call the National Counselling and Referral Service (specifically set up to support people impacted by anything related to the #DisabilityRC) on 1800 421 468.
We have been very disappointed so far with the lack of people with disability giving evidence at this hearing, and we'd like to start this thread today by sharing three blogs written for us by people with lived experience of the mental health system. #DisabilityRC
"Bad Medication" - Ashley Waite talks about how being overmedicated as a child led to trauma and medication avoidance later in life. #DisabilityRC pwd.org.au/bad-medication/
"Visits to the hospital" - Pippin Latham shares their experiences with ableism and restrictive practices in the hospital system. #DisabilityRC pwd.org.au/visits-to-the-…
"I used to Know and Love my Mind" - Heidi Everett speaks (and sings) on the relationship between her mind, psychotropic medications and the mental health system. #DisabilityRC pwd.org.au/i-used-to-know…
Keep an eye on @bluntshovels today who is also doing a bit of tweeting on her day off. #DisabilityRC
https://twitter.com/bluntshovels/status/1309270320319049729
And we're off. Our first witness is Professor Karen Nankervis, School of Education, University of Queensland.
Prof Nankervis teaches and does research on disability, eliminating the use of restrictive practice and positive behaviour support. #DisabilityRC
Prof Nankervis teaches and does research on disability, eliminating the use of restrictive practice and positive behaviour support. #DisabilityRC
We're talking about the quality of positive behaviour support plans. One issue is that planners are often writing in language that is quite technical and inaccessible for many of the family/support workers expected to implement them. #Disability
(@VMIAC has also started their thread for today. Follow them here:
https://twitter.com/VMIAC/status/1309275003364413440)
Some discussion of QL's "robust safeguarding framework" around the use of restrictive practices. Monitoring and mandatory reporting. The information has/is being collated with the intention to "improve or identify where effectiveness is being achieved". #DisabilityRC
They found that use use of restrictive practices peaked around Christmas time 2 years in a row. This is useful for addressing the underlying causes around these times. #DisabilityRC
Eastman is asking if research/monitoring led to a reduction or elimination of restrictive practices. Nankervis says we are seeing trends toward decreasing seclusion, she isn't sure what the changes were around chemical restraint. Anecdotally it reduced. #DisabilityRC
Eastman raises the issue of high numbers of unauthorised uses of chemical restraint based on NDIS rules. Nankervis says the research identified many thousands of instances of use of chemical restraint but the NDIS rules on authorisation weren't incorporated. #DisabilityRC
Prof Nankervis acknowledges that there may have been instances of chemical restraint that weren't reported in the research. #DisabilityRC
We're now talking about corrective measures when chemical restraints were being used outside of regulations. Centre of Excellence staff would work with support services, providing training and support with a focus on best practice. #DisabilityRC
Prof Nankervis: The "behaviour of concern" is often a "behaviour of protest". YES.
While the collection of data and work of academics in the area of eliminating restrictive practices is vital and important, the sanitising of the abuse being described here, and the centring of carers and support services over PWD perspectives is wearing very thin. #DisabilityRC
The next witness is Shayna Smith (Queensland Office of the Public Guardian). We're going to be talking about the role of the Office of the Public Guardian in protecting the human rights of PWD. #DisabilityRC
The Public Guardian seems to be approving restrictive practices far more often than they are refusing. 113 cases approved with 5 (?!?!?!?!?!) disapproved in the same period of time. #DisabilityRC
Smith is using the word "consent" a lot. What *they* consent to on behalf of PWD whose personal consent is apparently irrelevant. Disconcerting. #DisabilityRC
Applications for chemical restraint are looked at on a case by case basis. The history of the provider making the application is not a factor. No process in place for identifying repeat offenders of abusive practices apparently. #DisabilityRC
We're now on to the Community Visitor Scheme. Community visitors are supposed to provide oversight of restrictive practices with surprise visits. They can inspect a range of documents and make enquiries. They report any concerns. #DisabilityRC
They make sure chemical restraint are not being used beyond what has been "consented" to by the OPG. (Ultimately though, they are still approving the use of ongoing chemical restraint in some situations.) #DisabilityRC
Discussion on the qualifications of community visitors. They are not extensive. They seem to be developing skills on the job. The focus is an holistic approach. #DisabilityRC
Was any compliance action taken from any community visitors reports?
Smith doesn't know. Apparently they don't get follow up information after they forward reports.
There is no real accountability in this system.
#DisabilityRC
Smith doesn't know. Apparently they don't get follow up information after they forward reports.
There is no real accountability in this system.
#DisabilityRC
Main takeaways: The OPG are approving the use of chemical restraint more often than not - a breach of human rights and the CRPD - and we don't know if the community visitor program results in any actual compliance action when already inadequate regulations are not being followed.
We are now hearing from Janice Rushworth (Queensland Department of Child Safety, Youth and Women). We're going to be talking about the child protection regime. #DisabilityRC
FYI @CydaAu are also tweeting today's proceedings.
https://twitter.com/CydaAu/status/1309301970910375938
Commissioners are asking about data kept on use of chemical restraints. Rushworth says there is no central database. Information is kept in individual files.
Rushworth does not have the information on how many children in care are being prescribed psychotropic medication or subject to chemical restraint. She acknowledges the lack of a central database in a problem #DisabilityRC
Eastman appears to be gobsmacked by the lack of forthcoming information. Did Rushworth prepare for this hearing at all? #DisabilityRC
It seems there is some contradiction between Ms Rushworth's statement that chemical restraint is not to be used, and the contemplation of using chemical restraint in the manual.
There is some discussion over the departments policy on the use of chemical restraint. Eastman say the wording is confusing. "What's in and what's out?" Rushworth clarifies it is a "prohibited practice". #DisabilityRC
Rushworth talking about the difficulty of working with both Federal (NDIS) and State laws around restrictive practices. Conflicting rules and definitions. #DisabilityRC
Next witness: Donna Lockyer (Queensland Department of Communities, Disability Services and
Seniors). We are going to be talking about the short-term approval process and what it means for NDIS participants. #DisabilityRC
Seniors). We are going to be talking about the short-term approval process and what it means for NDIS participants. #DisabilityRC
Bringing up the department policy document on chemical restraint. This policy only applies to adults. Latest updates include addition of regular assessments, beyond that Lockyer does not recall specifics. #DisabilityRC
Department received 250 short-term applications for chemical restraint. 184 approved, 22 withdrawn, 36 not approved. Another high approval rate for apparent breaches of human rights. #DisabilityRC
We're now discussing the details of how a person's capacity to make their own medical decisions is worked out. It's a complicated consultation process involving medical specialists, family, legal teams ... #DisabilityRC
Appeals on decision making around short-term applications for chemical restraint must be made to QCAT. There has been no appealing of a decision since Lockyer has been in this role. #DisabilityRC
Wait ... Sackville is confirming that almost all (all but 2!!!!) short-term approvals are for medication that is *already* being administered. This is *retrospective* approval. No consequences for providers who used psychotropic medication pre-STA #DisabilityRC
Next witness: Professor Julian Trollor. We're talking about issues involving Autistic people and people with intellectual disability who have difficulty communicating in decisions about medication. #DisabilityRC
Is there any training aimed at addressing these communication gaps?
There is no substantial difference (improvement) in training for medical professionals in the last 20 years. #DisabilityRC
There is no substantial difference (improvement) in training for medical professionals in the last 20 years. #DisabilityRC
Prof Troller advocates the introduction of training prioritising communication with PWD and families. STOMP (UK program talked about earlier this week) could be a good template for an Australian training toolkit. #DisabilityRC
We're onto the different conceptualisations of disability and health conditions. If you define Autism or intellectual disability as something that can be "treated" then psychotropic drugs can be defined as a treatment rather than a restriction. Hugely problematic!!! #DisabilityRC
"Some people find the labelling of chemical restraint distressing".
This is not our problem! If calling it what it is upsets you, then you should be upset by the *practice*, not the label. #DisabilityRC
This is not our problem! If calling it what it is upsets you, then you should be upset by the *practice*, not the label. #DisabilityRC
Talking about lack of data and the impact of that on both safeguarding and research. Troller emphasises that we need data for *all* PWD, not just those receiving particular services. We don't have a real idea of the risks and benefits of psychotropic medications. #DisabilityRC
That concludes Prof Troller's evidence. We are adjourning until 2pm. #DisabilityRC
Now hearing from Graeme Head AO (National Disability Insurance Scheme Quality and Safeguards Commissioner) #DisabilityRC
Talking specialist behaviour support providers, and registration. Orgs need to be registered to provide specialist behaviour support rather than individuals. #DisabilityRC
There have been a lot of restrictive practises used in Australia that until recently went unnoticed. The commission is bringing it to light with new regulations on reporting. #DisabilityRC
We're now talking about measures taken to reduce restrictive practices. #DisabilityRC
Clarification: "Unauthorised restraint" by the NDIS rules. #DisabilityRC
One PWD experienced 2112 unauthorised chemical restraints in a year. (5.9per day!!!!!!!) They had a behaviour support plan in place previously that lapsed. 12 or 13 different medications, 2 as needed and the rest regularly administered. #DisabilityRC
Not every report like this triggers a compliance review straight away. This case came to light because the plan lapsed. The Commission has no power to override the decisions of doctors. They work through the support services. Who is holding the doctors to account??! #DisabilityRC
Talking about awareness among medical practitioners about disability. Not clear what is being done about lack of awareness, other than a general acknowledgement that more is needed, and the Commission alone doesn't have the expertise to advise medical practitioners. #DisabilityRC
We're now getting into how effectively the Commission is moving toward the goal of "reduction and elimination". Does the NDIS give them the powers required to achieve this. In relation to providers Head says yes. #DisabilityRC
Not so much when it comes to getting medical professionals on board though. Head is talking about a potential lockstep approach with various other orgs and bodies that doesn't really exist yet. @DisabilityRC
Does the Commission have the powers to enforce compliance with "frontline workers" (support workers generally)? Head is saying yes, but is seems very much like a work in progress from the description. #DisabilityRC
Sackville points out that 468 people experienced more than 100 unauthorised restrictive practices in one year. #DisabilityRC
The issue of federal vs state definitions is coming up again. #DisabilityRC
Should the Commission have its own community visitor program? Apparently this is a question for Parliament. As it stands the Commission has been directed to work with the states. Head accepts there may be an advantage to a Commission community visitor program. #Disability
Handing over now to @gdevera who is live tweeting until the end of the hearing.
https://twitter.com/gdevera/status/1309353319379341312
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