Fourth Progress Report - Disability Royal Commission
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Fourth
Progress
Report
Fourth progress report (1 January – 30 June 2021) 1
Please be aware that the content in this report may be distressing or raise issues of concern for some readers. There are a range of services available if you require support. Contact details for these services are located at the end of this report. Fourth progress report August 2021 Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability GPO Box 1422, Brisbane, Qld 4001. DRCenquiries@royalcommission.gov.au www.disability.royalcommission.gov.au
Contents Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Key updates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Public hearings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Publications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Private sessions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Advisory groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Community engagement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Submissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Issues papers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Our operations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Contact details for support services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Appendix: Publications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Endnotes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Introduction
On 5 April 2019, the Australian Government announced the establishment of the Royal
Commission into Violence, Abuse, Neglect and Exploitation of People with Disability.
The terms of reference for the Royal Commission direct us to inquire into all forms of violence
against, and abuse, neglect and exploitation of, people with disability in all settings and contexts.
The Honourable Ronald Sackville AO QC is the Chair of the Royal Commission. He is supported
by six other Commissioners: the Honourable Roslyn Atkinson AO (who resigned from the Royal
Commission with effect 24 June 2021), Ms Barbara Bennett PSM, Dr Rhonda Galbally AC,
Ms Andrea Mason OAM, Mr Alastair McEwin AM, and the Honourable John Ryan AM.
This is the Fourth progress report of the
Public hearings
Royal Commission into Violence, Abuse,
Neglect and Exploitation of People with The Royal Commission held five public
Disability. It covers the six months from hearings between 1 January and 30 June
1 January to 30 June 2021. 2021. They examined:
The Royal Commission carried out a full • the education and training of health
program of activities during the reporting professionals in relation to people with
period. We held public hearings and
cognitive disability (Public hearing 10)
private sessions, and again expanded our
community engagement. We conducted • the experiences of people with cognitive
and commissioned research; and released disability in the criminal justice system
a number of new publications, including a (Public hearing 11)
public hearing report and research reports.
• the experiences of people with
We continued to receive and process
disability in the context of the Australian
submissions. When necessary due to the
Government’s approach to the COVID-19
COVID-19 pandemic, we changed the way
vaccine roll-out (Public hearing 12)
we worked in order to continue our activities
while ensuring the safety of people engaging • preventing and responding to violence,
with us, and of our Commissioners and staff. abuse, neglect and exploitation in disability
services (Public hearings 13 and 14).
During this period, the Australian Government
granted the Royal Commission’s request for COVID-19 restrictions meant that three of
a 17-month extension. Our final report is now the five public hearings had to be conducted
due by 29 September 2023. The extension remotely without members of the public being
provides the Royal Commission with the present, while the fourth and fifth could not
time to satisfactorily complete the inquiries have all Commissioners physically present
required by our terms of reference. in the hearing room.
Fourth progress report (1 January – 30 June 2021) 1
The Royal Commission also held additional connections with people with disability and
hearing days for the presentation of oral advocacy and representative organisations.
submissions in Public hearing 7 (on barriers
to education) and in Public hearing 9 (on
pathways and barriers to open employment). Community engagements
We conducted a range of community
Private sessions engagement activities over the period,
including meeting with disability
and submissions representative organisations and
collaborating with the Disability Advocacy
The Royal Commission held 282 private
Network Australia to hold six virtual
sessions between 1 January and 30 June
strategic forums. We accepted an invitation
2021, bringing the total held to 410 as at from Multicultural Disability Advocacy
30 June 2021. Commissioners conducted Association in Sydney to engage directly
private sessions by videoconference with a group of people with disability from a
or teleconference for people who preferred range of culturally and linguistically diverse
these formats to a face-to-face session backgrounds. We have begun engaging with
or when COVID-19 restrictions intervened. people with disability in closed environments
such as prisons, youth detention centres,
We received 851 submissions, which and forensic mental health and forensic
was an increase from the 669 received disability facilities. We co-designed and
during the previous six months. This ran four targeted focus groups with people
brings the total submissions received with disability and self-advocates.
as at 30 June 2021 to 2,639.
Advisory groups
The Royal Commission First Nations Peoples
Strategic Advisory Group met twice between
1 January and 30 June 2021. This group
is an expert panel of seven First Nations
people with experience in the disability sector,
and provides guidance on matters specific
to First Nations people.
The Disability Strategic Engagement Group
also met during this period. The group
consists of senior Royal Commission staff
and advisors, and three external members.
It helps the Royal Commission build
2 Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability
Publications For the first time we published a report
in First Nations languages. The report
The Royal Commission released its Report translated was a plain language version
of Public hearing 6: Psychotropic medication, of Dr Scott Avery’s Something stronger:
behaviour support and behaviours of concern Truth-telling on hurt and loss, strength
in this period. Commissioners found there and healing, from First Nations people
was ample evidence to suggest psychotropic with disability.
medication is being over-prescribed to people
with cognitive disability to deal with what are The Royal Commission also published
referred to as ‘behaviours of concern’. our final issues paper, which was on the
experiences of culturally and linguistically
We published two research reports: the diverse people with disability. It was
first by the Centre of Research Excellence translated into nine community languages.
in Disability and Health into the nature We published overviews of responses
and extent of violence, abuse, neglect and to four earlier issues papers.
exploitation against people with disability in
Australia; and the second by the Australian This Fourth progress report provides further
Institute of Criminology into the experiences information on these publications and other
of domestic violence among women with Royal Commission activities during the six
restrictive long-term health conditions. months to 30 June 2021.
Narratives
This report includes de-identified ‘narratives’, which are summaries of the experiences people have
shared with our inquiry through submissions or private sessions and given consent for us to use.
‘De-identified’ means that real names have been replaced with pseudonyms and some details
have been left out to protect people’s identities. De-identification of narratives enables the Royal
Commission to protect both those who have shared their accounts but may not want their identity
disclosed, and people and organisations referred to in those accounts who have not had the
opportunity to respond to any allegations made against them.
The narratives in this report are not representative of any factual findings of the Royal
Commission and any views expressed are those of the person who shared the information
with us, not those of Commissioners.
Fourth progress report (1 January – 30 June 2021) 3
Key updates
Royal Commission Government said it had:
extension already taken action to address and
implement many of the recommendations
The Chair of the Royal Commission, including reform to consultation processes,
the Honourable Ronald Sackville AO QC, improvements to data, governance
requested a 17-month extension to the arrangements and the development of
term of the Royal Commission in a letter further guidance for providers of disability
to the Prime Minister, the Honourable accommodation services.5
Scott Morrison MP, on 30 October 2020.1
The Report on Public hearing 5 was the
On 13 May 2021 the Australian Government first of the Royal Commission’s reports to
granted the extension. The Attorney-General, make both findings and recommendations.
Senator the Honourable Michaelia Cash, and
These dealt with the Australian Government’s
the Minister for Families and Social Services,
planning and implementation of its response
Senator the Honourable Anne Ruston, jointly
to the COVID-19 pandemic, and to any future
announced the decision.2 Our final report is
national emergency. The report is available
now due by 29 September 2023. Before the
on the ‘Public hearing 5’ page of our website.
extension, the deadline was 29 April 2022.
The extension should allow the Royal Amending legislation
Commission to discharge its wide-ranging
responsibilities to a satisfactory standard. On 17 March 2021 the Australian
Government introduced the Royal
Government accepts Commissions Amendment (Protection
of Information) Bill 2021 into the Australian
recommendations in Parliament. The Bill, if passed, will protect
COVID-19 inquiry report confidential information provided to the
Royal Commission outside of a private
The Royal Commission’s Report on Public session beyond the life of our inquiry.6
hearing 5: Experiences of people with
disability during the ongoing COVID-19 Unfortunately, parliament did not debate
pandemic (Report on Public hearing 5) the Bill before rising in June for a five-week
was tabled in the Australian Parliament recess. This means the earliest the Bill could
on 30 November 2020.3 now be passed is parliament’s spring session
which begins in August 2021.
The Australian Government responded to
the report on 27 April 2021, advising that it The Chair requested these amendments
supports, or supports in principle, 21 of the in letters to the Prime Minister, the
report’s 22 recommendations and notes one.4 Honourable Scott Morrison MP, in February
In its response to the report, the Australian 2020 and September 2020. People
Fourth progress report (1 January – 30 June 2021) 5
with disability and disability advocates her invaluable contributions to the Royal
have also requested the changes. Commission.10
Currently, the Royal Commission can
guarantee that information provided on Dr Dinesh Palipana OAM
a confidential basis outside of a private
session will be protected during the term of The Royal Commission has appointed
our inquiry, but not beyond it. This includes Dr Dinesh Palipana OAM as our senior
information provided on a confidential basis in adviser on the experiences of culturally and
submissions. If the Bill is passed in its current linguistically diverse people with disability.
form, the Royal Commission would be able to
guarantee the confidentiality of submissions Dr Palipana was the first medical graduate
and other sensitive information both during and medical intern in Queensland living with
and beyond the term of our inquiry.7 Private quadriplegia. As co-founder of Doctors with
sessions information is already protected Disabilities Australia, he has helped develop
during our inquiry and when it is over. national policies for inclusivity in medical
education and employment. Dr Palipana
As the Royal Commission has previously is now a senior resident at Gold Coast
stated, passage of the amending legislation is University Hospital. He also holds a degree
necessary to remove a significant barrier that in law, and was recently admitted as a legal
has prevented people with disability engaging practitioner in Queensland. He is the current
with the Royal Commission.8 Queensland Australian of the Year and
is a recipient of the Order of Australia.
Commissioner Atkinson AO Prior to his appointment as senior advisor,
Dr Palipana gave evidence in two of our
On 21 May 2021, the Royal Commission public hearings on the challenges people
announced that the Honourable Roslyn with disability face in health settings.
Atkinson AO had decided to step down
from her role as Commissioner, for personal
reasons.9 Commissioner Atkinson’s Kate Eastman SC
appointment ceased on 24 June 2021.
Senior Counsel Assisting the Royal
Commissioner Atkinson was appointed to Commission, Ms Kate Eastman SC, was
the Royal Commission in September 2019 made a Member of the Order of Australia
as its seventh Commissioner. Speaking (AM) in the Queen’s Birthday 2021 Honours
on behalf of all Commissioners, the Chair List, announced on 14 June. The award
said the Royal Commission had benefited recognises her ‘significant service to the
enormously from Commissioner Atkinson’s law, to human rights and to professional
work, and expressed deep appreciation for organisations’.11
6 Royal Commission into Violence, Abuse, Neglect and Exploitation of People with DisabilityEzekiel*
I just wanted to have a job, toe the line and not make
any waves so I put up with her bullying.
Ezekiel has a condition that causes his muscles to contract uncontrollably and affects his
speech and motor skills. He is in his 60s and identifies as a person from a culturally and
linguistically diverse background.
In his 30 years working in his sector he’d never experienced workplace bullying.
However, this changed during his employment by a government agency.
He wasn’t sure if his supervisor didn’t like his personality or whether she didn’t like him
‘full stop’.
His supervisor was never satisfied with his work and would repeatedly ask him to resubmit
it for approval. She would complain about his time management ability and his failure to meet
key performance indicators.
The agency supplied speech recognition software to improve his efficiency but the software
wasn’t compatible with the agency’s IT system. It ended up being ‘more of a hindrance than
a help’. Ezekiel had to complete tasks manually, which put him ‘behind the eight ball’.
Then things ‘got quite nasty’.
Ezekiel’s desk was near a corridor and when people walked past they would say hello and
‘have a bit of a chitchat’.
The supervisor stacked boxes on and around Ezekiel’s work station so people couldn’t see him.
He likened it to ‘the Great Wall of China’.
7It became a safety issue because when doors opened creating a gush of wind, the boxes
would fall down.
The boxes were there for several months until they were replaced by a partition.
At weekly supervision meetings his supervisor would belittle Ezekiel, telling him ‘you’re
not good enough to work here’, and she would never recommend him for another job.
‘Their behaviour towards me was quite appalling.’
When Ezekiel’s supervisor took annual leave the acting supervisor accepted his work
without complaint.
Ezekiel spoke to the group manager and told him he was ‘being bullied out of a job’.
He asked to be placed in another team or different role.
But his requests were denied.
Ultimately his contract was terminated 12 months before it was due to end.
Ezekiel decided he ‘wasn’t going to stand for this’. He successfully appealed to the state
industrial commission and received a small payout.
He signed what he thought was a standard confidentiality agreement but discovered it excluded him
from being employed by the government agency or any organisation it provided funding to. As this
covered most employers in his sector, it has made it almost impossible for Ezekiel to find work.
In hindsight it’s probably the worst career move I ever made …
Finding employment when you’re 61, with a disability, is bloody hard.
* Name changed and some details removed to protect people’s identities. Narrative based on a private session
with the Royal Commission.
8Public hearings
Public hearings held in Sydney. The Royal Commission received
evidence from 49 witnesses. They included
1 January – 30 June 2021 people with disability and their families, health
professionals, and representatives from
During the first half of 2021, the Royal universities, peak bodies, medical colleges,
Commission held five public hearings. accreditation and professional authorities and
In addition, oral submissions in Public professional associations.
hearing 7 (Barriers to accessing a safe,
quality and inclusive education and life The hearing directly related to issues identified
course impacts) and Public hearing 9 in Public hearing 4, which examined the
(Pathways and barriers to open employment health care and services provided to people
for people with disability) were presented, with cognitive disability. Issues included the
respectively, at hearings held on 7 May 2021 education and training of health professionals
and 24 March 2021. (Information on those providing health care and services to people
earlier hearings is available in our Third with cognitive disability. The first two days
progress report12 and in the ‘public hearings’ of Public hearing 10 focused on medical
section of our website.) practitioners and nurses. The final day focused
on dentists, pharmacists and allied health
Education and training professionals, particularly psychologists and
of health professionals speech pathologists.
Public hearing 10 Propositions developed
to improve health care
Public hearing 10: Education and training
of health professionals in relation to people Having considered the evidence in Public
with cognitive disability, took place on hearing 4 and Public hearing 6, Counsel
15–16 December 2020 and on 2 March 2021 Assisting and Royal Commission staff
Fourth progress report (1 January – 30 June 2021) 9developed a series of propositions. People with cognitive
They related to health professionals’
disability’s experiences
education and training and are aimed
at improving the health care and health
in the criminal justice system
outcomes for people with cognitive
disability. The propositions were Public hearing 11
grouped into three main categories: Public hearing 11: The experiences of people
with cognitive disability in the criminal justice
• Framework – directed to the system, took place from 16–25 February
development of a standardised 2021 in Brisbane. Witnesses gave evidence
competency framework to guide the in the Brisbane and Sydney hearing rooms,
development of all reforms to education as well as by audio-visual link.
and training
The Royal Commission heard from
• Fundamentals – directed to key 33 witnesses, including five people with
content and procedural elements disability who had direct experience with
that should guide and inform Australia’s criminal justice system. We also
all training and education heard evidence from research experts,
advocates who work within the criminal
• Training phases – directed to specific
justice system, and representatives from
stages of education and training.
both forensic disability units and government.
The propositions were discussed, tested
The hearing explored how people with
and refined with panels of witnesses at the
cognitive disability are ‘managed’ within
hearing. Each panel examined particular the criminal justice system, including:
propositions and ways of improving the
education and training of health practitioners • people with cognitive disability spending
who treat and care for people with cognitive lengthy periods in custodial and forensic
disability. The panel structure facilitated settings due to the limited availability
discussion between witnesses, Counsel of alternative services (both within
Assisting and the Commissioners. and outside custody) or accommodation
to meet their needs
Following the hearing, Counsel Assisting
prepared written submissions for parties • people with cognitive disability being
subject to restrictive practices such as
with leave to appear and witnesses.
seclusion or chemical restraint, to manage
The submissions set out the evidence
risks of self-harm or harm to others
relating to the propositions and proposed
recommendations for the Royal Commission. • processes for transitioning people
The Commissioners are considering Counsel with cognitive disability out of custodial
Assisting’s submissions and the submissions and forensic settings when restrictive
in response. interventions have exacerbated mental
10 Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disabilityhealth or behaviours of concern, thereby The CIDP case study illustrated the
creating barriers for people moving into importance of support, advocacy and case
the community management to facilitate access to the NDIS,
and of mainstream supports for people with
• the role of government-funded support
cognitive disability at risk of enmeshment
services and the rationale for these
services being discontinued. in the criminal justice system.
Three case studies During her opening address to Public
hearing 11, Counsel Assisting noted:
The Royal Commission explored these
issues through three detailed case studies. Some of the evidence in this hearing
Two of these involved the experiences of speaks of people’s experiences in trying
‘Melanie’13 and ‘Winmartie’,14 First Nations to access services from States or through
people with disability, who have both been the NDIS, and the sense by some of
held in indefinite detention having been found responsibility being shuffled between the
unfit to plead to charges of manslaughter. two. We note that there will be a second
The case studies of Melanie and Winmartie part of this hearing, at a later time, which
are extreme examples of the experiences will enable the States and the NDIA to be
of people with cognitive disability within heard on these issues.15
the criminal justice system. Both remained
in restrictive environments because of Public hearing 15
inadequate alternatives. It was not clear who
had responsibility for funding their supports. These issues will be explored further in Public
hearing 15: Criminal justice and the NDIS.
The third case study addressed the Cognitive This hearing had been scheduled to take
Impairment Diversion Program (CIDP). The place from 23–24 June 2021 in Brisbane
CIDP was run by the Intellectual Disability but was postponed to August 2021 due to
Rights Service between 2017 and 2020, and COVID-19 restrictions.
funded by the NSW Government. Its objective
was to divert from the criminal justice system
people with cognitive impairment who were
charged with low level offences. The CIDP
provided dedicated support people who would
arrange expert reports to support applications
for diversion orders, assist in securing legal
advice or representation, and co-ordinate
services, including applying for additional
National Disability Insurance Scheme (NDIS)
funding. The NSW Government decided
to terminate funding for the CIDP beyond
30 June 2020.
Fourth progress report (1 January – 30 June 2021) 11The COVID-19 vaccine roll-out with disability about the roll-out, particularly
those in residential care.
Public hearing 12
The hearing
The Royal Commission held Public hearing 12:
The experiences of people with disability in the The Royal Commission heard from
context of the Australian Government’s approach 13 witnesses in Public hearing 12. Eight
to the COVID-19 vaccine roll-out, on 17 May were either people with a disability or the
2021 in Sydney. Witnesses gave evidence family member of a person with disability.
by audio visual-link or pre-recorded video. Each of these witnesses told the hearing of
their individual experience both in trying to
Background to Public hearing 12 obtain information about the vaccine and
then trying to access it. A disability support
Public hearing 12 built on the Royal
worker, disability advocates, an expert and
Commission’s examination of the experiences
a senior representative from the Australian
of people with disability during the ongoing
Government’s Department of Health also
COVID-19 pandemic in Public hearing 5. At
gave evidence.
that hearing, we heard that many people with
disability were experiencing hardship during During the hearing, it became apparent
the early stages of the pandemic. We were through the voices of people with disability,
also told that the Australian Government’s family members of a person with disability
response during that period may not have and the evidence of advocates and an expert
been adequate. that the concerns expressed to the Royal
Commission were well-founded.
The Royal Commission held Public hearing 12
following widespread reports about the slow A senior representative of the Department
pace of the vaccine roll-out for people with of Health was questioned about the slow
disability. The Australian Government had pace of the vaccine roll-out for phase 1a for
announced Australia’s COVID-19 vaccine people with disability and disability workers.
national roll-out strategy on 7 January 2021. Witnesses were also asked to explain how
The strategy included disability care staff and the Australian Government proposed to
disability care residents in phase 1a – the complete the roll-out of phase 1a and phase
highest priority and the same as aged care 1b to people with disability, including people
staff and aged care residents. with intellectual disability.
By mid-April, however, disability sector At the conclusion of the hearing, Counsel
representatives expressed serious concern Assisting was directed to prepare written
to the Royal Commission at the slow pace submissions for parties with leave to appear
of the vaccine roll-out for people with and witnesses. Commissioners will consider
disability and disability care workers. They the submissions of Counsel Assisting and of
also expressed concern about the lack of parties with leave to appear before preparing
accessible information available to people a report on this hearing.
12 Royal Commission into Violence, Abuse, Neglect and Exploitation of People with DisabilityHearings related The evidence focused on the experiences
of two people with disability, referred to as
to disability services
‘Melissa’17 and ‘Carl’.18 Melissa’s sister and
Carl’s mother both appeared as witnesses,
Public hearing 13 – Disability
as did the chief executive officer of Sunnyfield.
services case study #1
Melissa, Carl and a third resident, referred
Public hearing 13: Preventing and responding
to as ‘Chen’,19 had been subjected to violence
to violence, abuse, neglect and exploitation
and abuse in their home. The hearing
in disability services (a Case study), took
examined whether Sunnyfield should have
place from 24–28 May 2021 at Homebush
prevented violence and abuse and whether
in Sydney. This was the Royal Commission’s
it should have responded differently once
first hearing open to the public since the
it became aware of the violence and abuse.
COVID-19 pandemic began. It was also the
The hearing also examined the role and
first of several case studies examining the
responsibilities of external oversight bodies
role of disability service providers.
including the NSW Ombudsman and the
The Chair noted in his opening remarks that: NDIS Quality and Safeguards Commission
(NDIS Commission).
The significance of the case studies
goes beyond consideration of the At the end of the hearing, the Chair directed
actions of particular service providers or Counsel Assisting to prepare written
regulatory bodies in specific situations. submissions analysing the evidence
The case studies are intended to and setting out proposed factual findings.
illuminate the practices and policies There will be a short public hearing for
of NDIS service providers and of the the presentation of oral submissions on
regulators insofar as they affect the 10 September 2021. Commissioners will
wellbeing and human rights of people consider Counsel Assisting’s submissions
with disability who are participants in and any submissions in response from
the NDIS.16 the parties represented at the hearing.
Public hearing 13 focused on a case study Public hearing 14 – Disability
about the experiences of a small group of services case study #2
people with disability living in supported
accommodation at a house in western Public hearing 14: Preventing and responding
Sydney operated by Sunnyfield Disability to violence, abuse, neglect and exploitation in
Services (Sunnyfield). The case study disability services (South Australia), was held
examined Sunnyfield’s role and responsibility from 7–11 June 2021 in Adelaide. This was
in preventing and responding to violence and the second public hearing examining the role
abuse directed at residents by two staff. of disability service providers.
Fourth progress report (1 January – 30 June 2021) 13‘Mitchell’, and Daniel Rogers The Royal Commission received
evidence about:
The first part of the hearing focused on the
experiences of two people with disability, • DHS’s internal reporting and complaints
‘Mitchell’20 and Daniel Rogers, each of handling processes
whom has lived in supported accommodation
• the nature of ‘in kind’ services within
provided by the South Australian Department
the context of the NDIS Quality and
of Human Services (DHS). Safeguarding Framework
Mitchell’s aunt and uncle, ‘Victoria’21 and • DHS’s role in providing disability
services and safeguarding for people
‘James’,22 gave evidence about events
with disability before, during and after
surrounding receipt of an anonymous letter
the roll-out of the NDIS.
threatening violence against, and abuse and
neglect of Mitchell. The hearing examined why Responses to the death
there was a delay in investigating the threatening of Anne-Marie Smith
letter and the actions Victoria and James took to
see something done. Actions included making The second part of the hearing examined
complaints to the South Australian Ombudsman responses to the tragic death of Ann-Marie
and the NDIS Commission. Smith on 6 April 2020 by DHS, the National
Disability Insurance Agency (NDIA) and
The hearing examined the experience of Daniel the NDIS Commission. Ms Smith’s friend,
Rogers during his time living in a house known ‘Brooke’,23 described Ann-Marie’s death
as ‘N Street’. Daniel’s mother, Karen Rogers, as ‘incomprehensible’.24
a disability advocate herself, felt she often
The Royal Commission’s terms of reference
had cause to complain about Daniel’s care.
constrain the scope of the investigation that
Particular events caused her great concern,
could be undertaken into Ms Smith’s death.
including Daniel’s admission to hospital in
Accordingly, the hearing primarily focused
February 2019 with extensive bruising around
on the measures taken in response to
his waist. Ms Rogers gave evidence that she
investigations already conducted, in particular
believed support staff at N Street had not been
the reports of two inquiries that followed
truthful with her about this and other incidents.
Ms Smith’s death:
The hearing examined DHS’s practices • the reports of the Safeguarding Task
and policies around spending and accounting Force, commissioned by the South
for Daniel’s money, its communication with Australian Government
his family (including about health matters)
• the Honourable Alan Robertson SC’s
and the standards of care it provided to Daniel. report, Independent review of the
The hearing also examined the adequacy adequacy of the regulation of supports
of the steps taken by the South Australian and services provided to Ann-Marie
Police and DHS to investigate the circumstances Smith, an NDIS participant, who died
of the physical injuries to Daniel. on 6 April 2020.
14 Royal Commission into Violence, Abuse, Neglect and Exploitation of People with DisabilityThe hearing examined: Following the hearing, Counsel Assisting and
parties with leave to appear provided detailed
• how the NDIA and the NDIS Commission written submissions.
identify vulnerable NDIS participants
Counsel Assisting’s oral submissions
• the NDIS Commission’s regulation
on 7 May 2021 drew together key themes
of ‘sole carers’
from the evidence and made submissions
• the responsibility of local area coordinators to the Royal Commission on proposed
and support coordinators for vulnerable findings, recommendations and areas for
NDIS participants’ safety and wellbeing further investigation. Parties who were
granted leave to appear at Public hearing
• the South Australian Government’s
7 had the opportunity to present
decision to reduce the scope of the
oral submissions in response.
state’s community visitor scheme
• information-sharing arrangements between The detailed written submissions of Counsel
the NDIA and the NDIS Commission Assisting and parties granted leave to appear
at Public hearing 7 have been published
• information-sharing arrangements between
on the ‘Public hearing 7’ page of our website.
state and Australian Government agencies.
The Commissioners are considering the
submissions and will release a report
Barriers to education on the hearing in due course.
Oral submissions Pathways and barriers
On 7 May 2021, the Royal Commission to open employment
held an additional hearing day for Public
hearing 7: Barriers to accessing a safe, Oral submissions
quality and inclusive education and life
course impacts. The additional hearing day As outlined in the Third progress report,
was for Counsel Assisting to present oral the Royal Commission held Public hearing 9:
submissions, which was by audio-video link. Pathways and barriers to open employment
for people with disability, from 7–11 December
The Royal Commission took evidence in 2020.25 Witnesses gave evidence from the
Public hearing 7 from 12–16 October 2020. hearing rooms in Sydney and Brisbane,
Seven young people with disability told the Royal and by audio-visual link.
Commission about their school experiences.
Commissioners also heard evidence from The hearing focused on people with
parents of students with disability, disability disability’s experiences in finding, obtaining,
advocates, health professionals, academic maintaining and progressing in open
education experts, and representatives from the employment; transitions into and out of the
Departments of Education in Queensland and workforce; and experiences of safe and
New South Wales. inclusive work environments.
Fourth progress report (1 January – 30 June 2021) 15Counsel Assisting presented oral opportunity to address the findings about
submissions in Public hearing 9 on 24 March systemic barriers. This should include how
2021. The submissions identified key themes these systemic barriers should be addressed
emerging from the evidence and proposed and eliminated.
findings and areas for further inquiry by the
Royal Commission. Parties granted leave Public hearing 19
to appear at Public hearing 9 presented
The Royal Commission will continue
submissions in response.
its investigation into the systemic barriers
to open employment for people with disability
Counsel Assisting submitted that the
at Public hearing 19, which is scheduled
evidence supports the Royal Commission
to take place later in 2021.
finding that people with disability experience
systemic barriers in obtaining and retaining It will examine the measures employers,
employment in the open labour market. The regulators and others have taken to respond
systemic barriers are attitudinal, physical and to the systemic barriers to open employment
environmental, organisational and structural. for people with disability identified in Public
hearing 9. It will also explore measures to
Building on the evidence from Public hearing 9, eliminate the barriers to open employment
Counsel Assisting submitted that the that cause or contribute to violence against,
Royal Commission should provide private and abuse, neglect and exploitation of,
and public sector employers with an people with disability.
16 Royal Commission into Violence, Abuse, Neglect and Exploitation of People with DisabilityUpcoming public hearings
The Royal Commission has released a schedule of public hearings planned for the second half
of 2021. Table 1 shows the topics for the seven public hearings we expect to conduct or continue
in the period 1 July to 31 December 2021, along with the expected dates and locations. The schedule
(also published on the ‘about the Royal Commission’ section of our website) is subject to change
for reasons including, but not limited to, recurring COVID-19 restrictions.
Table 1: Public hearings proposed for the second half of 2021
Date No. Hearing topic Location
12–13 August 15 Satellite hearing: Criminal justice and the NDIS Brisbane
2021
10 September 13 Preventing and responding to violence, Sydney
2021 abuse, neglect and exploitation in disability (virtual
services (a Case study) – Oral submissions hearing)
17–24 September 16 First Nations children with disability Alice
2021 in out-of-home care Springs
30 September 14 Preventing and responding to violence, abuse, Sydney
2021 neglect and exploitation in disability services (virtual
(South Australia) – Oral submissions hearing)
13–19 October 17 The health and safety of women Hobart
2021 and girls with disability
8–12 November 18 Disability service provider (TBC) TBC
2021
22–26 November 19 Measures taken by employers and regulators Melbourne
2021 to respond to the systemic barriers to open
employment for people with disability
Fourth progress report (1 January – 30 June 2021) 17Simone*
The medications that I was given, I wasn’t able to think clearly.
I was given everything from antidepressants to anti-anxiety …
which eventually turned into antipsychotics and sedatives.
So between the age of 15 through to 25 it’s a blur.
Simone is in her early 30s. She talked to the Royal Commission about her experiences in the
mental health system for more than half of her life. Over that period she was given multiple
diagnoses including depression, anxiety, attention deficit hyperactive disorder, schizophrenia,
psychosis and bipolar disorder, and each diagnosis came with a new medication.
Simone’s interactions with the mental health system began at the age of 15 when she went to see a
GP about the way she was feeling – sad, anxious, tired, devoid of energy and with what she described
as ‘extreme symptoms … but mostly a deep disturbance in myself’. By the end of a 15-minute
appointment the GP had diagnosed depression and sent Simone away with antidepressants.
Simone’s symptoms got worse. She went back to the GP who this time diagnosed anxiety, and
sent her away with more medication. Simone’s symptoms continued to escalate. She was now
hearing voices and experiencing other ‘very distressing symptoms’. She went to a new doctor,
who consulted with her first doctor. ‘Suddenly’, Simone said, ‘I’d been diagnosed with everything’.
‘Of course the core problem wasn’t being treated and so my conditions were worsening …
At the early age of 22 I shut down, I stopped talking for a long time, probably about two years.’
The core problem Simone is referring to is that she had been subjected to psychological and
sexual abuse since she was a child. The escalation of her symptoms at the age of 15, which
had prompted her to see the GP, corresponded with her being raped by a family friend.
But none of the doctors who diagnosed Simone and prescribed medications ever looked
further than her symptoms to understand that they may have been, as Simone now believes,
‘an appropriate response to trauma’.
18Simone went to see the doctor about how she was feeling, only to be told there was ‘something
wrong’ in her head. ‘In many ways the mental health system helped my abuse,’ she said. ‘They tell
you you’re crazy.’ It reinforced the gaslighting being carried out by her abuser.
‘It makes me wonder how many people are wrongfully diagnosed when they have a legitimate
reason to be feeling what they are feeling.’
Following school, Simone started university but she had become ‘phobic’ of her
surroundings and ‘it just wasn’t working’. She was diagnosed with psychosis, given more
medication, and then ‘just sort of collapsed’. ‘I was put in a program for people with
disabilities … the bin of society,’ Simone said. She was in the program for a couple of years.
She spent most of her 20s in a ‘blurred reality’ due to all her medications. But in the last couple
of years she has begun to gain clarity around what happened to her. She has been able to reveal
the fact of her abuse and begun to understand her abuser had targeted her. ‘Everything happened
very fast, almost like my whole brain just started to re-wire. And I was able to call out that person
and shut down the whole abuse cycle. I immediately started to feel all of my symptoms disappear.’
Simone stopped her medications and found her own therapies, including dance, stand-up
comedy and other creative outlets. ‘I am still piecing a lot of this together … still dealing with
what I think you call “arrested development”.’
‘Coming out of this by myself has been a lot of work,’ Simone told us. But while she now
finds herself in ‘a brutal game of catch-up’, she is also for the first time able to contemplate
the possibility of a brighter future with ‘a loving home of my own, a career, a loving partner …
the anchors, the things that can help connect us to the world’.
‘It’s been a hell of a journey!’
* Name changed and some details removed to protect people’s identities. Narrative based on a private session
with the Royal Commission.
1920 Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability 20
Publications
Commissioners’ Report psychotropic medication being administered.
Over time, relatives and carers witnessed
of Public hearing 6 the overall health and wellbeing of the
person with disability, the person they love,
On 2 June 2021, the Royal Commission deteriorate markedly.
released its Report of Public hearing 6:
Psychotropic medication, behaviour The Royal Commission found that it is critical
support and behaviours of concern, to the safety and wellbeing of people with
which summarises and analyses the cognitive disability that they are assigned
evidence presented during the hearing.26 a multidisciplinary support team who are
aware of best practice alternatives to
While widely used and commonly psychotropic medication. ‘Positive behaviour
understood, the use of the phrase support’ is an alternative to psychotropic
‘behaviours of concern’ is controversial. medication that can significantly reduce
Commissioners acknowledged that such the incidence of behaviours of concern and
behaviours are a form of communication the perceived need to use psychotropic
for some people with cognitive disability. medication as a chemical restraint.
The Royal Commission found there is To fully understand the impact psychotropic
limited evidence to support the efficacy medication has on the lives of people with
of psychotropic medication as a way to disability, gathering data and conducting quality
address behaviour escalation. The evidence research into its use is critical. Yet the overall
highlighted that people with cognitive funding for such research has been reduced.
disability often experience serious negative
consequences from the use of psychotropic Commissioners found that:
medication. Side effects can be exacerbated
with longer term use, and if the psychotropic • psychotropic medication is over-
medication interacts adversely with other prescribed to people with cognitive
drugs. In the very worst cases the results disability in response to behaviours
can be fatal. of concern
• the distinction drawn in legislation
A theme that emerged at the hearing was between medication used as a chemical
how escalating crises led to increasing and restraint and medication prescribed
more severe behaviours of concern, which as a treatment for people with cognitive
in turn can lead to a greater likelihood of disability is problematic.
Fourth progress report (1 January – 30 June 2021) 21Research under state and territory mental health
legislation, and the authorisation and
use of restrictive practices in relation
Key legislation affecting to people with disability.
people with disability
(This report was published after we
On 22 December 2020, we published finalised our Third progress report,
Report on the key elements of the legislative which covered our activities in the
framework affecting people with disability six months to 31 December 2020.)28
by the Australian Government Solicitor.27
Nature and extent
This report is a detailed analysis of
Commonwealth, state and territory laws On 16 March 2021, the Royal Commission
of particular significance to people with published Nature and extent of violence,
disability. The analysis considers legislation abuse, neglect and exploitation against
governing the NDIS, anti-discrimination people with disability in Australia by the
regimes, income support programs for people Centre of Research Excellence in Disability
with disability, housing, employment, health, and Health (CRE-DH).29
criminal justice and the accessibility of the
physical environment. This research reveals that people with
disability experience violence and abuse at
While it is not feasible to summarise the significantly higher rates than people without
whole report, some examples illustrate the disability and that the maltreatment of people
topics it addresses:
with disability in Australia is a serious and
widespread problem.
• The chapter on discrimination deals with
laws that make it unlawful to discriminate
The report shows, for example, that in
on the ground of disability or impairment.
the previous 12 months, women with
The report provides details of the
disability were more than twice as likely
Disability Discrimination Act 1992 (Cth),
to report sexual violence as women without
as well as anti-discrimination laws
disability. One-quarter of young people with
in state and territory regimes,
disability reported experiencing violence
which are not necessarily uniform.
in the previous 12 months, compared with
11 per cent of those in older age groups.
• Its review of health laws focuses on
key areas governing the medical And people with cognitive and psychological
treatment of people with disability, impairments reported higher rates of all
including the provision of medical types of violence compared with people
treatment to those who are assessed with other types of impairments.
as not having the capacity to consent
to such treatment. The report also looks The report also shows that over the
at the provision of compulsory treatment course of their lifetime, about two-thirds
22 Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disabilityof people with disability have reported experienced by women without such conditions.
some kind of violence. ‘Violence’ includes They also experienced coercive control at
physical, sexual or intimate partner violence three-and-a-half times the rate experienced
and emotional abuse or stalking by any by women without restrictive conditions.
perpetrator. That compares with just under
half of people without disability having First Nations women or women from culturally
similar experiences. and linguistically diverse backgrounds with
long term health conditions were shown to be
Experiences at even greater risk of experiencing physical
or sexual violence or coercive control during
of domestic violence the COVID-19 pandemic.
On 11 May 2021, we published Experiences
of domestic violence among women with Issues papers
restrictive long-term health conditions:
Report for the Royal Commission into The Royal Commission published The
Violence, Abuse, Neglect and Exploitation experiences of culturally and linguistically
of People with Disability by the Australian diverse people with disability issues paper
Institute of Criminology (AIC).30 The study was on 9 March 2021.31 It was translated into nine
based on a large online survey of women. languages and produced in Auslan and Easy
Read versions. The paper asks the public
Women with disability who responded to the to share their views about the experiences
survey recorded high levels of physical and of culturally and linguistically diverse people
non-physical violence during the early stages with disability.
of the COVID-19 pandemic. The report found:
During the period 1 January to 30 June 2021,
• one in eight had experienced physical we also published overviews of responses
violence by a current partner to four earlier issues papers. They are the
Emergency planning and response issues
• one in 10 had experienced sexual paper,32 the Employment issues paper,33 the
violence by a current partner Rights and attitudes issues paper34 and the
• one in five had experienced emotionally Restrictive practices issues paper.35
abusive, harassing or controlling
These publications are discussed in more
behaviour by a current partner
detail in ‘Issues papers’.
• one in seven had experienced coercive
control by a current partner.
Multiple forms of physical and non-physical
violence and abuse were common. Women
with restrictive health conditions experienced
physical or sexual abuse at four times the rate
23
2324
Private sessions
Between 1 January and 30 June 2021, six-month period. Subject to the constraints
the Royal Commission held 282 private imposed as a result of COVID-19,
sessions in eight locations: Brisbane, we anticipate holding around 200 private
Sydney, Canberra, Melbourne, Adelaide, sessions with residents in group homes over
Perth, Hobart and Launceston. the life of the Royal Commission and across
every state and territory, roughly in line with
Private sessions allow people to share population data.
experiences with a Commissioner in a
confidential setting. Participants’ identities,
and anything they tell us during or in Private sessions snapshot
connection with a private session, are as at 30 June 2021
protected from disclosure by law, including
after the Royal Commission ends. The 282 private sessions the Royal
Commission held between 1 January and 30
The Royal Commission introduced private June 2021 brought the total number of private
sessions by videoconference or teleconference sessions held to 410 as at 30 June 2021.
during the COVID-19 pandemic and has
continued to offer these formats during the In the same period, the Royal Commission
six-month reporting period for people who received 371 private session registrations.
preferred them to a face-to-face session, Around one in three (36 per cent) of those
or when COVID-19 restrictions intervened. who registered for a private session are
people with disability.
Until this year, we held private sessions only
with people who registered with us, either The highest number of registrations were
personally or through an intermediary such from people in the more populous states of
as an advocate, a funded support service New South Wales (22 per cent), Queensland
or a family member. This approach had the (22 per cent) and Victoria (19 per cent).
potential to result in under-representation of
people who were uncertain about engaging Of all the people who attended a private session:
with us or lacked the necessary support to do
so. Accordingly, we recently trialled partnering • 11 per cent identify as First Nations people
with advocacy organisations to facilitate • 13 per cent identify as being from a culturally
private sessions for people with disability, and linguistically diverse background
mainly living in segregated settings such
• 6 per cent identify as LGBTIQ+
as group homes. These individuals almost
certainly would not have participated in the • fewer than 10 people are under 18 years old
Royal Commission without this initiative, due • 72 per cent are female and 25 per cent
to their high and multi-layered support needs. are male; 2 per cent did not say, or did
not wish to nominate a gender; and fewer
This initiative produced 26 private sessions than 10 people identify as transgender,
with residents in group homes over the non-binary or gender diverse.
Fourth progress report (1 January – 30 June 2021) 25Table 2 shows the proportion of people across a range of categories who have attended a private session.
Table 2: Demographic information for people who have attended a private session
Person attending private session Proportion of all
attendees (%)
Person with disability requesting on behalf of themselves 44
First Nations person 7
Culturally and linguistically diverse person 6
LGBTIQ+ person 4
Paid or unpaid support person requesting on behalf of person with 69
disability
Parent of adult with disability 27
Parent of child with disability 21
Othera 15
Sibling of person with disability 6
Legal guardian 3
Support person (paid) 2
Health professional 2
a
In addition to those listed, includes advocate (paid), advocate (unpaid), spouse, other family member,
medical professional, support person (unpaid), friend and teacher.
Note: In some instances, two or more categories may apply. For example, if a person with disability also
identifies as a First Nations person and is a parent of a child or adult with disability.
26 Royal Commission into Violence, Abuse, Neglect and Exploitation of People with DisabilityEmerging themes abuse, 35 per cent described systemic
abuse or neglect, and 6 per cent were of
The Royal Commission analyses the exploitation. These numbers exceed 100
information provided in private sessions per cent because many accounts were of
to identify common themes. Key areas multiple forms of violence, abuse, neglect
we look at include the settings in which and exploitation.
violence, abuse, neglect and exploitation
• We also heard about the people who
occur; the positions held by the people
allegedly perpetrate violence against,
allegedly responsible; and the experiences
and abuse, neglect and exploitation of,
of people with disability or their supporters
people with disability. Eighty-two per
in making complaints.
cent of accounts described a known
relationship to the person allegedly
We use ‘account’ in this section (and later
responsible. Most frequently, we were
in ‘Submissions’) to refer to an individual’s
told they were paid support workers,
experience of violence, abuse, neglect
teachers and medical professionals.
or exploitation in a particular context.
For example, an account of family violence • People with disability told us it can
may encompass multiple incidents of family be difficult to report violence, abuse,
violence over a lifetime. We may hear neglect or exploitation because they
more than one account from one person. feel their complaints are often unheard
For example, a person may give an account or do not receive appropriate action.
of family violence and an account of abuse Making a complaint was discussed
at a place of employment. in 58 per cent of the private sessions
that included one or more accounts
In this reporting period: of violence, abuse, neglect or exploitation.
Of these, the vast majority said they did
• The accounts of violence, abuse,
not receive a satisfactory outcome and
neglect or exploitation analysed occurred
approximately one in two told us no action
in settings including schools (26 per cent
was taken.
of accounts), state and federal services
(21 per cent), the workplace (15 per cent), • Many private sessions participants
medical environments (15 per cent), described problems relating to the ‘siloing’
group homes (7 per cent), and family of each of the services they needed to
and domestic relationships (12 per cent). access and the geographical barriers
inhibiting access to services. People with
• Almost half (49 per cent) of the accounts disability have had difficulties accessing
analysed described incidents of neglect, the NDIS and in interacting with
46 per cent involved violence and Centrelink and the health system.
Fourth progress report (1 January – 30 June 2021) 27You can also read
