1st Edition

Restrictive Practices in Health Care and Disability Settings Legal, Policy and Practical Responses

Edited By Bernadette McSherry, Yvette Maker Copyright 2021
    342 Pages
    by Routledge

    342 Pages
    by Routledge

    This volume explores different models of regulating the use of restrictive practices in health care and disability settings.

    The authors examine the legislation, policies, inspection, enforcement and accreditation of the use of practices such as physical, mechanical and chemical restraint. They also explore the importance of factors such as organisational culture and staff training to the effective implementation of regulatory regimes. In doing so, the collection provides a solid evidence base for both the development and implementation of effective approaches to restrictive practices that focus on their reduction and, ultimately, their elimination across health care sectors. Divided into five parts, the volume covers new ground in multiple respects. First, it addresses the use of restrictive practices across mental health, disability and aged care settings, creating opportunities for new insights and interdisciplinary conversations across traditionally siloed sectors. Second, it includes contributions from research academics, clinicians, regulators and mental health consumers, offering a rich and comprehensive picture of existing regulatory regimes and options for designing and implementing regulatory approaches that address the failings of current systems. Finally, it incorporates comparative perspectives from Australia, New Zealand, the Netherlands, Germany and England.

    The book is an invaluable resource for regulators, policymakers, lawyers, clinicians, consumer advocates and academics grappling with the use and regulation of restrictive practices in mental health, disability and aged care contexts.


    Part I: Background: rationales and options for reform

    1. Restrictive practices: options and opportunities
    Bernadette McSherry and Yvette Maker

    2. Ending restraint: an insider view
    Cath Roper, Mary O’Hagan, Hamilton Kennedy and Helena Roennfeldt

    Part II: Designing legislation and policy to support change

    Introduction to Part II

    3. Human rights and rapid tranquillisation
    Peter Bartlett and Stephanie Sampson

    4. The regulation of restrictive practices on people with intellectual impairment: the challenges and opportunities posed by a rights-based approach
    Kim Chandler

    5. Beyond restraint: gender-sensitive regulation of the control of women’s behaviour in Australian mental health and disability services
    Yvette Maker

    6. Attempts to reduce the use of restrictive interventions in England between 2014 and 2019
    Guy Cross

    Part III: Implementing and monitoring reform

    Introduction to Part III

    7. Legal regulation and policy on the use of restraint and coercive measures in health care institutions in the Netherlands
    Lisa Waddington

    8. Queensland’s new physical restraint framework: implementation and lessons since the commencement of the Mental Health Act 2016
    John Allan and Amber Manwaring

    9. Showing restraint: the uses and limitations of data in supporting restraint reduction
    Grant Sara

    10. The Court, the law and German psychiatry’s slow progress towards human rights
    Margret Osterfeld and Martin Zinkler

    Part IV: Changing culture and practice

    Introduction to Part IV

    11. The intractable use of restraint, organisational culture and ‘othering’: lessons from the Oakden scandal
    Bernadette McSherry

    12. Being recovery-oriented and reducing the use of restrictive interventions in mental health care: the challenges in achieving transformation
    Lisa Brophy, Justine Fletcher and Bridget Hamilton

    13. Psychotropic use in Australian aged care homes: what can be done to ensure appropriate use?
    Juanita Breen (previously Westbury)

    14. Engaging doctors to reduce restraint: practice and pragmatics around restraint in clinical care
    Nathan Gibson

    Part V: Conclusions

    15. Regulating restrictive practices: challenges and possibilities
    Bernadette McSherry and Yvette Maker


    Bernadette McSherry is the foundation director of the Melbourne Social Equity Institute and an adjunct professor of law at the University of Melbourne. She has degrees in law, arts and psychology, with a PhD from York University, Canada. She is the Immediate past president of the Australian and New Zealand Association of Psychiatry, Psychology and Law and was a legal member of the Mental Health Tribunal of Victoria from 2001 to 2018. She has written widely in the fields of mental health law and criminal law and is currently a commissioner of the Royal Commission into Victoria’s Mental Health System and a commissioner with the Victorian Law Reform Commission.

    Yvette Maker is a senior research associate in the Melbourne Social Equity Institute at the University of Melbourne. Her work focuses on the disability- and gender-related dimensions of law, policy and practice. She has a special interest in disability human rights law, social security law and policy, and the design and regulation of social care and support systems. She holds bachelor of arts and bachelor of laws (hons) degrees from Murdoch University, and a PhD from the University of Melbourne. Yvette’s sole-authored book, Care and Support Rights After Neoliberalism: Balancing Competing Claims Through Law and Policy, is forthcoming.