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This editorial introduces a two-part Special Issue on the Disability Royal Commission and People with Intellectual Disabilities in Australia. The Commission was established in 2019 to investigate violence, abuse, neglect, and exploitation of people with disabilities. The Commission's Final Report, delivered in 2023, included 222 recommendations, some of which were not unanimous. The report covers a wide range of issues and includes the perspectives of people with disabilities. The Commission's work involved public hearings, private sessions, and community engagements. The report has generated controversy, as it focuses on negative experiences and poor-quality services, without exploring positive experiences and factors contributing to good quality services. The text also discusses the challenges faced by governments in responding to the Commission's recommendations and mentions the release of the Independent Review of the National Disability Insurance Scheme (NDIS), which intersects with the Commission's recommendations. The text provides guidance on accessing the Commission's publications, submissions, public hearings, and other resources. It introduces the articles in Part 1 of a Special Issue that critically analyze the Commission's findings and recommendations on various topics related to people with intellectual disabilities. The text concludes by mentioning that Part 2 of the Special Issue will include additional articles on education, health, and Positive Behaviour Support. [Extracted from the article]

Article 12 of the United Nations Convention on the Rights of Persons with Disabilities has been instrumental in driving the development of the concept and practice of supported decision making. An important feature has been the development of "supported decision making pilots." This paper identifies, describes and analyses pilot programmes providing support for decision making for people with cognitive disabilities in Australia and internationally between 2016 and 2021. It finds that challenges included providing support for socially isolated people and adequately resourcing those programmes. However, most pilots reported positive outcomes for decision makers, adding to the evidence base for claims to be made about the positive impact of supported decision making on the lives of people with disabilities. The pilots demonstrate that, internationally, there is an emerging set of programmes that seek to promote supported decision making incrementally through developing focussed community awareness and practice. While still small‐scale, time‐limited and experimental, with different levels of rigour in practice and evaluation, they provide some foundation and a preliminary evidence base for larger interventions and reforms in the future. [ABSTRACT FROM AUTHOR]

Mental health law reform in recent decades has drawn on the international human rights movement. The entering into force of the Convention on the Rights of Persons with Disabilities (CRPD) on May 3 2008 has been hailed by some as signalling a new era in relation to how domestic mental health laws should be reformed. Both Australia and New Zealand have ratified the CRPD and Australia has acceded to its Optional Protocol. New Zealand and the Australian Capital Territory and Victoria have statutory bills of rights which have an interpretive effect, but are unable to render other statutes invalid. Drawing on the results of interviews conducted with fifty-two representatives of consumer and carer organisations, lawyers, and mental health professionals across Australia and New Zealand, this paper examines the current thinking on human rights and mental health laws in these countries and outlines what changes, if any, may be brought to domestic legislation in light of the Convention. [ABSTRACT FROM PUBLISHER]

Psychiatric Advance Directives (PADs) have been adopted in many jurisdictions around the world and in most Australian states and territories. They are seen as a less restrictive and patient-centered approach to the provision of mental health care. Electroconvulsive therapy (ECT) is a restricted treatment in most jurisdictions in Australia and across the world. This paper explores the history, regulation and use of ECT and PADs and the intersections between them. It provides an overview of the legislative framework in each Australian state and territory and explores some of the issues which have arisen such as complexity of the regulatory framework, making PADs binding for refusing and consenting to ECT, involving treating teams in how PADs are made, using restrictive interventions to implement PADs, and the role of the Tribunal. While PADs are often framed as an important legal tool for allowing patients to refuse psychiatric treatment (especially ECT), the paper emphasizes that they can also be an innovative way for people to consent to psychiatric treatment in advance and an empowering option to access mental health care. It then makes some suggestions for future reform. [ABSTRACT FROM AUTHOR]

Many countries embarked on reforms of mental health law in the wake of the Convention on the Rights of Persons with Disabilities. These reforms have had varying levels of success. This paper considers the experience of consumers in the Victorian mental health system, drawing on an evaluation that asked consumers and clinicians about their knowledge and experience of rights under the Victorian Mental Health Act, 2014. The data show that consumers were not informed of their rights, were not involved in decisions about treatment, were not able to access safeguards, and could not exercise their rights. The explanations for this include limited staff time, unclear delegations of responsibility, a lack of knowledge, training, and support for rights, and a preference for 'best interests' approaches. The paper identifies tangible reforms that would maintain rights for consumers, including competent refusal of treatment, legislative and regulatory reforms, and training and resourcing. Consumers in this study found that the rights-based framework in the Mental Health Act, 2014 had such an insignificant effect on clinical mental health practice in Victoria that their rights appeared to be illusory. [ABSTRACT FROM AUTHOR]

A policy norm enshrined in the United Nations Convention on the Rights of Persons with Disabilities 2006 reflected in Australia's National Disability Insurance Scheme is for people with psychosocial and other disabilities to have choice and control over their lives and not to live in institutional settings. In Australia, private congregate care settings remain in most states and territories, yet are not recognised as institutional settings in policy or academic literature. This recognition is long overdue and is the focus of this article. The article reports on findings from an ethnographic study in a type of private congregate care setting in Victoria—supported residential services (SRS). Adopting criteria adopted by Davies (1989) from Goffman's notion of "total institution," observations and interviews with 12 residents with psychosocial disability are analysed. These settings are found to meet many of the criteria for total institution. This finding has two critical implications for policy and practice. First, the extent to which institutionalisation in SRS impacts on the choices residents are able to make. Second, the extent to which independent support and advocacy are needed to ensure residents can exercise choice and control over their lives to find pathways out of SRS. [ABSTRACT FROM AUTHOR]

The adoption of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in 2006 and, in particular, Article 24 was a landmark in the struggle of people with disability for recognition of their fundamental human rights, including their right to education. As a legally binding treaty under international law, imposing obligations on States Parties that signed and ratified it (including Australia), it required those States Parties to bring their domestic legislation into conformity with their CRPD obligations. The Disability Discrimination Act 1992 (DDA), and the Disability Standards for Education 2005 (Standards) made under it, remain the principal Australian statutory protection of the rights of students with disability to access education on the basis of equality and non-discrimination even though the DDA and the Standards preceded the CRPD. This article explores the proposition that the DDA and the Standards do not adequately implement Australia's international legal obligations in relation to the education of students with disability. Note: This article makes use of agreed or legally defined terms. These terms are presented in italics throughout. [ABSTRACT FROM AUTHOR]

The Commonwealth of Australia (2016) inquiry into access to learning for students with disability received several submissions on gatekeeping practices in Australian schools, resulting in minimised school enrolment and reduced participation in classrooms. The inquiry also received reports of the use of restrictive practices such as restraint and seclusion. As Australia has ratified the United Nations Convention on the Rights of Persons with Disabilities (2006), which stipulates the requirement to provide inclusive, safe and effective learning environments and educational experiences for every person (Article 24), these practices warrant further investigation. As part of an Australia–wide survey of families and staff around the Disability Standards for Education 2005 (Com Law. 2015. Retrieved from ), data were collected on a range of gatekeeping and restrictive practices from more than 900 respondents, of whom 745 were family members of a student with disability. Over 70% of the families who participated in this study reported having experienced gatekeeping or restrictive practices. This study identifies that the practices were reported to be widespread over all levels and types of schools and for all types of disability, causing concern as to how Australia can meet its obligations as a signatory to the UN convention. [ABSTRACT FROM AUTHOR]

Background: The right to the highest attainable standard of mental health remains a distant goal worldwide. The Report of the UN Special Rapporteur on the right of all people to enjoyment of the highest attainable standard of physical and mental health pleaded the urgent need for governments to act through appropriate laws and policies. We argue that Australia is in breach of international obligations, with inadequate access to mental health services, inconsistent mental health legislation across jurisdictions and ongoing structural (systematic) and individual discrimination. Discussion: Inadequate access to mental health services is a worldwide phenomenon. Australia has committed to international law obligations under the Convention on the Rights of Persons with Disabilities (CRPD) to 'promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disability, with respect to their inherent dignity'. This includes people with mental health impairment and this convention includes the right to 'the highest attainable standard of mental health'. Under the Australian Constitution, ratification of this convention enables the national government to pass laws to implement the convention obligations, and such national laws would prevail over any inconsistent state (or territory) laws governing mental health service provision. Summary: The authors argue that enabling positive rights through legislation and legally binding mental health service standards may facilitate enhanced accountability and enforcement of such rights. These steps may support critical key stakeholders to improve the standards of mental health service provision supported by the implementation of international obligations, thereby accelerating mental health system reform. Improved legislation would encourage better governance and the evolution of better services, making mental health care more accessible, without structural or individual discrimination, enabling all people to enjoy the highest attainable standard of health. [ABSTRACT FROM AUTHOR]

Although international research has accumulated significant evidence on inclusive practices and their benefits for children, how this translates into early childhood settings is often unsatisfactory within and across countries. Against the background of general acceptance of the principles incorporated in the Convention on the Rights of Persons With Disabilities, we examine how 3 countries who are signatories to this convention, Australia, Greece, and Malaysia, are making progress towards inclusion in early childhood. Using an implementation science framework, the key components of enabling contexts, research-based practices, and effective implementation supports are explored. In this framework, each of these components is essential for achieving the desired outcomes of inclusion. The country profiles of Australia, Greece, and Malaysia are examined (including similarities and differences in legislation, policies, early childhood services, and practices) in an effort to support understanding of factors facilitating and challenging early childhood inclusion. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has uncovered the ways in which disabled people are made more vulnerable due to structural inequalities. These vulnerabilities are the result of the interaction between individual and structural factors that shape how risk is experienced by disabled people. In Australia, these vulnerabilities are influenced by the way disability services and care for disabled people are delivered through a consumer-directed approach. We analysed the policies and documentation made by the Australian Government and state and territory governments during the pandemic to explore whether these were disability-inclusive. We aimed to unpack how these policies shaped disabled people as vulnerable citizens. Methods: Guided by documentary research, we used framework analysis to examine the policies of the Australian Government and state and territory governments. We analysed legislation that was given royal assent by the federal, state and territory governments, and documents (reports, fact sheets, guidance documents, etc.) published by the federal government and the state of Victoria (given that this state experienced the brunt of the epidemic in Australia) between February 2020 to August of 2020. Results: We found that most of the resources were not aimed at disabled people, but at carers and workers within disability services. In addition, most policies formulated by the Australian Government were related to the expansion of welfare services and the creation of economic stimulus schemes. However, while the stimulus included unemployed people, the expansion of benefits explicitly excluded disabled people who were not employed. Most of the legislation and documents offered accessibility options, though most of these options were only available in English. Disability oriented agencies offered more extensive accessibility options. Conclusions: The findings indicate a large number of documents addressing the needs of disabled people. However, disability-inclusiveness appeared to be inconsistent and not fully considered, leaving disabled people exposed to greater risk of COVID-19. Neoliberal policies in the health and welfare sector in Australia have led to an individualisation of the responsibility to remain healthy and a reliance on people as independent consumers. Governments need to take a clear stance towards the emergence of such a discourse that actively disvalues disabled people. [ABSTRACT FROM AUTHOR]

People with intellectual disability and complex support needs challenge human rights in the current disability policy and practice framework in Australia. With the implementation of the National Disability Insurance Scheme (NDIS) in Australia, it is pivotal to understand how human rights can offer a framework for understanding these challenges. There are complex issues and challenges in operationalising support for the human rights of people with intellectual disability. Their experience is characterised by overlapping and compounding forms of discrimination, abuse and vulnerability in their social and systemic interactions. This article uses qualitative content analysis to describe and articulate disadvantages and challenges of this group, and maps this onto the United Nations Convention on the Rights of Persons with Disabilities and current policies and practices in Australia. The article concludes that utilising human rights instruments helps to recognise the multiple disadvantages faced by people with intellectual disability and complex support needs and focus on the specific areas that need to be addressed in policy and practice. [ABSTRACT FROM AUTHOR]

It has been a significant period of time since Australia ratified the United Nations'Convention on the Rights of Persons with Disabilities 2006(CRPD). While the CRPD brings significant positive changes in legislation, public policy, and service delivery (for example, in the National Disability Insurance Scheme), there are still a number of challenges in implementing the CRPD in Australia, particularly for people with intellectual disability who exhibit behaviours of concern. Some of the challenges include a negative perception of disability, the misrepresentation of occupational health and safety frameworks, and a revival of the call for congregate care living. Given these barriers to full CRPD realization, some of the solutions may include a closer engagement with families, other legislative frameworks, and industrial relations, and a stronger monitoring role for the CRPD implementation in Australia. [ABSTRACT FROM AUTHOR]

People with a mental health or cognitive disability are vastly over-represented in the Australian prison system. Investigatory reports by Ombudsmen and similar organisations reveal that there is considerable scope for improving the treatment of this cohort. One avenue for doing so is using a human rights framework, given that Australia's international human rights law obligations require (among other things) that imprisoned people be treated with respect for their human dignity and, furthermore, recent international research demonstrating that fair and respectful treatment in prison may improve psychological well-being. However, there are considerable challenges involved in implementing this requirement in overcrowded and hierarchical prison settings. It is even more difficult to comply with the legal requirements given the web of provisions at the international, national and State/Territory levels, causing complexity and a lack of clarity as to their interrelationship. This article condenses the requirements into four principles and discusses how these have been applied by courts in relevant international and domestic cases. This analysis aims to assist correctional managers and policy makers seeking to comply with these legal requirements. Such compliance should form part of a multifaceted approach to protecting these vulnerable individuals from further harm. [ABSTRACT FROM AUTHOR]

The recent United Nations Convention on the Rights of Persons with Disabilities (CRPD) reframes how policy responds to disability, difference, interdependence and rights. We examine how Australian disability activists used the CRPD to advocate for the intersectional rights of women with disability. We applied a framework from Zwingel's conceptualisation of mutually constituting global norms to analyse the intersectionality of rights represented in three stages of the CRPD process - during the drafting, the wording in the Convention, and the periodic review. We found that disability activists were able to shape the gendering of disability through their targeted representation as people with lived experience. This expertise filled a knowledge gap in the policy process valued by the actors at other policy levels. Extending Zwingel's concept of global discourse translation, it also suggests that the dynamic contribution continues in the international interpretation of the CRPD itself. [ABSTRACT FROM AUTHOR]