Restrictive practices: fact or myth: Who is really protected?

This paper critically examined the use of Restrictive Practices (RPs) in adult disability services in Ireland, focusing on the prevalence, of types and reasons they are applied. Using quantitative methods, a dataset of mandated reports (NF39A notifications) submitted by disability residential service providers to the regulator, the Health Information and Quality Authority (HIQA) in Ireland were analysed. NF39A notifications report the use of RPs in registered designated centres (RDCs) every three months. The international literature indicates that RPs are commonly used in disability services to ensure the safety of people living there. This research explores the broader implications of these practices, particularly their impact on the rights of People with Disabilities (PWDs) who are subject to these restraints. Through an analysis of 11,344 reported incidences, this research identified trends using content analysis for the categories, types and reasons RPs were applied. While previous studies have primarily concentrated on more stringent forms of restraint, such as physical and chemical restraints, this research examined the significance of environmental restraints and their underexplored impact on PWDs. Environmental restraints result in significant restrictions being placed on PWDs that limit their independence and autonomy. They can include locked doors, restricted access to personal belongings, food and drink and social media. The findings are significant and can inform legislative and policy reform to protect PWDs human rights. The highest reason RPs were applied was blanket rules (n=2,709) 23.9% whereas challenging behaviour only accounted for (n= 1,109) 9.8 % of the reasons despite its strong association with RPs in legislation and policies. Peer related and safeguarding reasons was the fifth highest reason (n=810) 7.1% for applying RPs. Environmental restraints (n= 7,058) 62.2% were the highest category of restraint reported. The highest types reported were locked or restricted internal communal areas (n=2,594) 22.9% and locked exits (n=2044) 18%. In total 156 different types of RPs were identified under environmental restraints. These findings suggest that policies and legislation must be reformed to reflect all the reasons and types of RPs applied in disability settings. Further research is also needed to examine the lived experience of PWDs, given the prevalence of environmental restraints found in this study.

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University of Galway

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CC BY-NC-ND

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University of Galway Theses (PhD Theses)