Thursday, 1 December 2011
New Laws Needed to Better Protect Vulnerable South Australians
South Australia is out of step with modern thinking on disability care and needs to completely review its laws, according to the State’s Public Advocate.
In his annual report (tabled in Parliament late last week) Dr John Brayley says while South Australia was once recognised as progressive, the key Acts that serve vulnerable people have become dated.
“In each of the major areas we reviewed this year, our laws and practices were found wanting when compared to some other States and countries such as the United Kingdom and Canada,” he said.
“A major rewrite is needed to bring us in line with recent advancements in disability rights, social policy and service delivery. New laws can keep people safe and set obligations on government to provide care for those in need.”
Dr Brayley – the State’s former Director of Mental Health, and Chief Advisor in Psychiatry – is particularly concerned about laws covering the use of restrictive practices, including mechanical restraint and the administering of psychotropic drugs, to people with disabilities. He said there were “more crosses than ticks” for South Australia when compared with Queensland and Victoria.
“Modern laws require detailed assessment, and proper behaviour support plans,” he said. “The aim is to avoid the need for restraint and seclusion, and set tough approval requirements that describe when they can be used and how the use is publicly reported.
“However our observation is that the use of chemical restraint is often poorly recognised and that people here do not automatically get access to detailed psychology assessments and behavioural plans.
“There is no doubt that needless restraint could be avoided if we had tougher laws regulating its use.”
More broadly, the report says there are gaps in the provision of disability services that warrant development of a new Disability Services Act.
“We need to ensure people are properly assessed, have a support plan, and receive the services described in that plan,” Dr Brayley said. “Such a system needs access to a right of appeal if a person is considered ineligible or has services denied. Such a system can be affordable and made to work.”
The report expresses concern about the living conditions of some of the more than 800 people with psychiatric, intellectual or other disabilities who live in supported residential facilities (SRFs). It notes the existence of some high-quality facilities, but says many others operate from old buildings that are too small, are poorly heated and cooled and lack adequate privacy.
“A problem we continually encounter is the enforced doubling up in rooms,” Dr Brayley said. It is a person’s home yet they have to share a room with a stranger, often of a very different age. Privacy, security and safety are all compromised and people can live most of their adult lives in these conditions.”
Dr Brayley said the Supported Residential Facilities Act could be updated to improve the quality of physical accommodation, make the delivery of health care and support services a legal requirement, and permit regular visits by independent community visitors to check for abuse or neglect and the adequacy of services.
The report also calls for more support to be provided to assist people with disabilities to make their own decisions before a guardian is appointed.
“We are proud of the guardian work we do but we also know the system is unbalanced,” Dr Brayley said. “We do not have well developed systems to help people make decisions, and without this people can fall into guardianship when it could have been avoided.”
This year the Office of the Public Advocate (OPA) will work with the Julia Farr Association MS McLeod Benevolent Fund to trial a new system of supported decision making based on models that have worked effectively in Canada.
The OPA’s full annual report can be downloaded from its website at www.opa.sa.gov.au
The OPA reviews programs, analyse unmet need, and promotes rights for vulnerable people who have an intellectual disability, brain injury, mental illness, dementia, or neurological disease that affects decision making. It also has a direct service role for vulnerable people, and acted as guardian of last resort for 705 adults in 2009-2010.