A disability advocacy group believes the use of restraints against disabled people is still a "daily occurrence" as a former support worker in Canberra came forward to share her horror at being told to tie up a severely intellectually disabled woman with ropes for 30 minutes at a time.
"I am not a monster, but that role turned me into one," the former worker said.
Canberra-based Advocacy for Inclusion chief executive officer Christina Ryan said the use of restraints against disabled people had to be made illegal and a shift made in thinking across society that it was somehow excusable for people with disabilities to be treated in that way.
"It should be illegal to do this and it should be seen for what it is, a form of abuse. It's violence and it's unacceptable," she said.
Ms Ryan has also asked why the federal government has not yet implemented a royal commission into violence, abuse and neglect of people with disability despite a Senate committee calling for just that in November last year.
By contrast, Prime Minister Malcolm Turnbull had implemented a royal commission into abuse of juvenile detainees within 12 hours of a Four Corners expose last week of the Don Dale Youth Detention Centre in the Northern Territory.
The former disability support worker, who did not wish to be named, said she was prompted to come forward and breach client confidentiality after being moved by the Four Corners report and separate revelations of abuse against aged care residents.
"I feel horrible about this, but in light of the abuse happening in juvenile detention centres, I think it is critical that I tell this story on behalf of young people with intellectual disabilities who are abused in this way," the woman said.
The worker said it was the client's mother who directed her to restrain the woman with her hands tied high above her head. The ropes were attached to the roof and "like something you would get in Bunnings".
"I was asked to tie it particularly tightly, while she screamed and cried and exhibited signs of distress. I was then asked to leave her there for around 30 minutes while I cleaned the house. After 30 minutes, I would assist her to shower, and she would cower in the corner crying and screaming. If I assisted her to wash she would, understandably, lash out," the woman said.
The worker believed the mother – "a wonderful woman pushed to the absolute edge of carer stress" – was in an untenable situation, and her agency could offer no real support.
"If I didn't oblige, the client would smear faeces on me, pull my hair, scratch, pull me and knock me to the floor if I didn't tie her up. I would often sit in the car outside the client's house crying – not sure if I should just accept the bruises and faeces, or if I should partake in what felt like a truly horrific violation of this young woman's rights."
The woman said she did approach her agency to ask for help on how to deal with the situation. In an email seen by Fairfax, the worker tells a supervisor she is uneasy about tying up the client and is told in response: "Under no circumstance are we at assist in the tieing [sic] up of [XXXX], if she dose [sic] smear her feacies [sic]then we as support workers clean it up."
The woman said: "They agreed they were uncomfortable with it and they'd try to talk to the carer to try to stop her from encouraging support workers to do it but they were still consistently sending me to that shift with the knowledge that was going to be done.
"They didn't offer me an alternative and I asked for one."
The alleged abuse occurred in mid-2014 around the time the National Disability Insurance Scheme was being introduced in the ACT.
It is unknown if the abuse is still happening as the worker left the sector and the agency involved, Kincare, would not comment on the specific case due to privacy concerns.
"However, as a general matter, Kincare can say that its policy is that physical restraint or confinement of a person is never an appropriate response to any client or situation. Kincare staff are instructed never to restrain a person and Kincare would not condone a staff member doing so in any circumstances," a statement read.
Ms Ryan said the worker was right to come forward and confidentiality provisions should not prevent alleged abuse from being reported.
She said there should always be enough support to prevent a person with disabilities from being restrained.
"Unfortunately, it is still the case that the restraint of people with disabilities is still a daily practice, perhaps not to the level of violence of this case," Ms Ryan said.
"But people are still being restrained, either physically or with excessive medication or unnecessary medication, because family carers and paid support workers do not have the time and/or the skills to do something.
"Despite the NDIS and despite the horrific nature of what's going on and that it wouldn't be acceptable for anyone else, these circumstances are still being viewed as unavoidable in the disability community."
People with Disability Australia human rights adviser Ngila Bevan agreed.
"There are many families and carers across Australia who struggle to support their children or family members with disability and their needs must be recognised. However, restrictive practices such as these are inhumane and degrading treatment and constitute violence," Ms Bevan said.
"People with disability must be able to receive the supports they need in safe environments, and should not have their human rights compromised for the convenience of others whether they are family members, friends or paid staff.
"It's not a person's impairment that makes them vulnerable to abuse and neglect, it's the systemic barriers in their daily lives and the attitudes of the people around them that creates risk and the circumstances where violence can occur."
The Senate committee, meanwhile, was chaired by WA Greens Senator Rachel Siewert. The Australian Greens in June committed $400 million over four years to fund a royal commission into abuse, violence and neglect of people with disability in institutional and residential settings.
The deputy chair of the Senate committee was ACT Liberal Senator Zed Seselja who, with the other Coalition senators, did not agree to support the recommendation for a royal commission but instead recommended a "judicial inquiry" into the abuse be considered.