Psychotropic medicines and restrictive practice
What the 2026 progress report means for NDIS and aged care providers
Providers should be able to explain why a psychotropic medicine is being used, how the person is involved in decisions and who checks whether the treatment remains appropriate. Those answers need to be visible in day-to-day records and practice.
The September 2026 joint progress report from Australia’s health, aged care and NDIS quality commissions makes this a useful time to review those systems. It describes work on education, behaviour support, medicines safety and regulatory data across all three sectors. It is a progress report, rather than a new standalone set of provider obligations. [1]
For boards, executives and quality managers, the practical next step is a targeted review of medication and restrictive-practice governance. Start with the person’s experience and follow the evidence through to management oversight.
Understand the purpose of the medicine (psychotropic medicines and restrictive practice)
Psychotropic medicines can be an appropriate treatment. The medicine’s name alone does not determine whether its use is chemical restraint. The purpose and circumstances of use matter. [7]psychotropic medicines and restrictive practice.
In the NDIS framework, chemical restraint involves medication used primarily to influence behaviour. The definition excludes medication prescribed by a medical practitioner to treat, or enable the treatment of
a diagnosed mental disorder, physical illness, or physical condition. If the purpose is unclear, the provider should seek clarification from the prescriber. The NDIS Commission’s Medication Purpose Form is one way to record this; providers can use their own suitable records. [2]
A useful file review, therefore, asks whether the current prescription, documented purpose, and actual administration tell a consistent story. Any uncertainty needs a clear escalation route to the appropriate clinician.
Check consent and supported decision making
The Clinical Care Standard calls for information about the reason for treatment, expected duration, benefits and harms, with informed consent documented before use. Capacity and emergency situations must be handled under the relevant law. Communication support should help the person participate as fully as possible. [3]
Check who gave consent, what decision it covers and whether the record explains their authority where substitute decision-making is involved. In residential aged care, the applicable restrictive-practices consent pathway depends on the person’s capacity and the relevant state or territory arrangements. A family contact entry should not be treated as proof of legal authority. [5]
Connect behaviour support with everyday care
For people with cognitive disability or impairment, the Clinical Care Standard places individualised non-medication strategies at the centre of responses to behaviours of concern. Existing behaviour support plans should inform care, and observations should feed back into their review. [3]
Test this with a real example. Can a worker find the current plan, explain the person’s preferred strategies and describe what to record when support is ineffective? Compare the answer with progress notes and handover information. A training attendance record alone will not answer those questions.
Make review and follow through visible
The Clinical Care Standard expects regular monitoring and review of benefits, harms and the continuing need for treatment. Review outcomes and the next review timing should be documented and communicated. [3]
Give responsibility for arranging follow-up to a named role. Check that concerns reach the prescriber and that agreed changes reach the medication record, care plan and relevant workers. Include pharmacists and behaviour support practitioners where appropriate to their roles. Medication changes or cessation require clinical oversight; a governance review should never prompt workers to change treatment independently.
Use the correct regulatory pathway
NDIS implementing providers using regulated restrictive practices must meet the relevant registration, behaviour support, authorisation, and reporting requirements. Check the state or territory authorisation pathway, lodge the required evidence and reconcile usage reports, including where a listed practice was not used. Reporting is generally monthly, but section 14 of the NDIS Rules requires reports every two weeks while a short-term state or territory approval is in force. Unauthorised restrictive practices also require incident reporting; usage reporting does not replace that process. [4] [8]
For residential aged care, the Department’s current guidance calls for restrictive practices to be a last resort to prevent harm, with alternatives documented, informed consent obtained, a behaviour support plan in place, and ongoing monitoring and review. The Aged Care Rules contain additional chemical-restraint requirements addressing practitioner assessment, prescribing, consent, and records. [5] [6]
Keep these pathways distinct. Residential aged care requirements should not be copied wholesale into home care, disability support or hospital procedures. Map obligations to the actual setting, service and jurisdiction, including the applicable emergency provisions. Seek specific clinical or legal advice when the position is unclear.
Bring meaningful evidence to leadership
The progress report describes the regulators’ growing use of data to understand risk, including psychotropic use and inappropriate restraint. It also identifies further collaboration on medication reviews, behaviour support and information sharing. [1]
DHD recommends a small assurance sample that follows cases from the prescribing purpose through consent, care delivery, review, and reporting. Ask for exceptions and actions, as well as completion rates. Useful questions include:
Which files have an unclear medication purpose, an overdue review, or an unresolved consent question?
Do worker accounts and administration records match the current plan?
Have identified gaps been assigned an owner, corrected and checked again?
Choose a sample that reflects service risk, including changes in treatment, transitions between services and as-needed use. Report patterns to the appropriate clinical and governance leads without assuming that every psychotropic prescription is inappropriate.
Strengthen your evidence before the next review
DHD Consultancy supports NDIS and aged care providers with governance reviews, evidence sampling, workforce capability and practical corrective actions. If your medication and restrictive-practice controls need a closer look, we can help you identify the gaps and build a proportionate improvement plan.
This article provides general governance information. It does not replace individual clinical advice or legal advice about your service’s obligations.
Sources and useful links
Official sources reviewed on 12 October 2026 Brisbane time. Numbers correspond to the links in the article.
The clinical standard was published in 2024. The joint progress report is dated September 2026. The Department’s residential aged care guidance was last updated on 3 August 2026.
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