Restrictive practices are used across various sectors in New Zealand to manage behaviours or situations where individuals pose a risk to themselves or others. While these practices are sometimes necessary, they carry ethical, legal, and emotional implications, making their use a topic of intense scrutiny.
In New Zealand, restrictive practices are regulated under strict guidelines to ensure they are applied only when absolutely necessary, as a last resort, and in a way that respects the dignity and rights of individuals. Restraint training plays a vital role in equipping professionals with the skills to use restrictive practices appropriately and safely while minimising harm.
What Are Restrictive Practices?
Restrictive practices involve measures that limit a person’s freedom of movement, behaviour, or decision-making. These are typically used in response to behaviours deemed challenging or dangerous. In New Zealand, restrictive practices are classified under five main types:
- Physical Restraint: Using physical force to restrict movement.
- Chemical Restraint: Administering medications to control behavior.
- Mechanical Restraint: Using devices or equipment to limit movement.
- Seclusion: Isolating a person in a space from which they cannot freely exit.
- Environmental Restraint: Restricting access to certain areas, objects, or activities.
Organisations That Use Restrictive Practices in New Zealand
In New Zealand, several organisations use restrictive practices across sectors such as healthcare, disability support, education, aged care, and corrections. Let’s examine how these organisations use such practices and their relevance.
1. Disability Support Services
Under the Enabling Good Lives (EGL) framework, restrictive practices may be employed to manage behaviours of concern among individuals with disabilities, such as self-harm or aggression.
- How They Use Restrictive Practices:
- Physical restraints to prevent self-injury.
- Environmental controls, such as locking cupboards with harmful substances.
- Chemical restraints, such as sedatives, to calm extreme behaviours.
- Regulation: The Ministry of Health oversees the use of restrictive practices, ensuring they are authorised under behaviour support plans developed by trained professionals.
2. Aged Care Facilities
Aged care providers use restrictive practices to manage the safety of residents, particularly those with dementia or other cognitive impairments.
- How They Use Restrictive Practices:
- Physical restraints, such as bed rails or lap belts, to prevent falls.
- Chemical restraints to manage agitation or aggression in residents.
- Seclusion or environmental restrictions, such as locked areas, to prevent wandering.
- Regulation: The Health and Disability Services Standards provide guidelines to ensure restrictive practices are justified and minimise harm.
3. Healthcare and Mental Health Services
Hospitals and mental health facilities use restrictive practices to manage patients during crises, such as psychotic episodes or suicidal behaviours.
- How They Use Restrictive Practices:
- Physical restraints to control aggressive behaviour in emergency situations.
- Chemical restraints to sedate patients posing an immediate threat.
- Seclusion rooms in psychiatric wards to isolate individuals at risk of harming others.
- Regulation: The Mental Health (Compulsory Assessment and Treatment) Act 1992 governs restrictive practices, prioritising the least-restrictive interventions.
4. Educational Institutions
In schools, particularly those catering to students with special needs, restrictive practices may be used as part of behaviour management strategies.
- How They Use Restrictive Practices:
- Physical restraints to prevent harm to staff or students during behavioural outbursts.
- Environmental restrictions, such as seclusion rooms, to manage challenging behaviour.
- Regulation: The Ministry of Education provides guidelines, focusing on the welfare and dignity of students, including the Physical Restraint Framework introduced in 2021.
5. Juvenile Justice and Correctional Facilities
Restrictive practices are used in correctional settings to maintain safety and control.
- How They Use Restrictive Practices:
- Mechanical restraints, such as handcuffs, during transfers or to prevent escape.
- Seclusion in solitary confinement for disciplinary purposes.
- Environmental restrictions, such as controlled access to communal areas.
- Regulation: Practices in these facilities are governed by the Department of Corrections under human rights and safety guidelines.
6. Emergency Services
Emergency responders, such as paramedics and police, may use restrictive practices during crises to manage individuals posing immediate risks.
- How They Use Restrictive Practices:
- Physical restraints to control violent or aggressive individuals.
- Chemical restraints to sedate individuals experiencing extreme agitation.
- Use of tools such as safety belts during transport.
- Regulation: These practices are governed by workplace safety and health guidelines, ensuring they are proportionate and justified.
The Role of Restraint Training in Restrictive Practices
Restrictive practices can have significant physical and psychological impacts if not applied correctly. Restraint training equips professionals with the knowledge and skills to use these practices responsibly, minimising harm and ensuring compliance with regulations.
1. Promoting Safe and Ethical Use
Restraint training emphasises:
- Using restrictive practices only as a last resort.
- Ensuring that actions are proportionate to the risk posed.
- Minimising the duration and impact of restraints.
2. De-escalation Techniques
De-escalation Training includes non-physical methods to prevent or resolve conflicts, such as:
- Verbal communication strategies to calm aggressive individuals.
- Recognising triggers and early signs of escalating behaviour.
- Active listening and empathy to reduce tension.
3. Minimising Risk of Injury
Training ensures that staff know how to:
- Apply physical restraints without causing harm.
- Monitor individuals for signs of distress during restraint.
- Respond to medical emergencies arising from restrictive practices.
4. Compliance with Legal and Ethical Standards
Restraint training provides an understanding of:
- Regulatory frameworks governing restrictive practices in New Zealand.
- Ethical considerations, such as respecting individual rights and dignity.
- Documentation and reporting requirements to ensure transparency.
5. Focus on Alternative Approaches
Training emphasises the importance of alternatives to restrictive practices, such as:
- Positive Behavior Support (PBS): Identifying and addressing the root causes of challenging behaviour.
- Environmental modifications: Creating safe and supportive spaces.
- Individualised care plans: Tailored strategies that reduce the likelihood of behaviours requiring restrictive interventions.
Benefits of Restraint Training
- Enhanced Safety: Reduces the risk of harm to both staff and individuals in care.
- Improved Outcomes: Encourages constructive approaches that address behaviour without unnecessary restrictions.
- Legal Protection: Ensures compliance with regulations, reducing liability for organisations.
- Fostering a Culture of Respect: Reinforces the importance of human rights and dignity in care settings.
In New Zealand, restrictive practices are a contentious but sometimes necessary tool in managing challenging behaviours across sectors like disability care, healthcare, aged care, and education. While their use is heavily regulated, the risk of misuse or harm remains high without proper training and oversight.
Restraint training plays a critical role in ensuring that restrictive practices are used responsibly, ethically, and as a last resort. By equipping professionals with the skills to de-escalate situations and prioritise alternatives, restraint training fosters safer and more compassionate care environments while upholding the dignity and rights of all individuals involved. Contact us for more information on our custom restraint training.
