The violence, neglect and mistreatment of Australian people with disability bleeds into every facet of their lives and must be blunted, the disability royal commission has found.
The royal commission's was on Friday tabled in federal parliament after being handed earlier in the day to Governor-General David Hurley.
The report, taking in the commission's public hearings between November 2019 and July 2020, found barriers exist on every level - from environmental and institutional challenges to community attitudes - that prevent full societal inclusion of people with disability.
While the 561-page report did not issue recommendations for policy change, it outlined the experiences of people with disability and the underlying drivers of their mistreatment.
There are almost 4.4 million people with disability in Australia and 365,000 participants in the National Disability Insurance Scheme. Yet the report found that in 2016 some 2.4 million people with disability aged between 18 and 64 had experienced violence in their lifetime.
Commission chair Ronald Sackville QC said key themes were recurrent across various settings including Australian institutions, workplaces, schools, homes and communities.
They included the limited choice people with disability hold over their lives, the segregation of people with disability in settings such as workplaces and group homes, the use of physical and chemical restraints, and limited access to support services.
He also said significant gaps were found in the quality of healthcare for people with disability, such as in caring for women with cognitive disabilities and through "diagnostic overshadowing", or wrongly attributing symptoms of illness to a person's disability.
The stories of the 36 people with disability referenced in the interim report entail school bullying, neglect and misdiagnosis in the healthcare system, physical and sexual abuse by staff in supported accommodation, and workplace discrimination.
The intersection of disability and factors such as gender, race and sexuality was also apparent, Mr Sackville said, creating "multi-layered experiences of discrimination and disadvantage".
This was particularly the case for Indigenous people with disability.
"The royal commission should be seen as a mosaic and the pieces will come together as the royal commission proceeds, and will culminate in the final report," Mr Sackville told reporters.
Mr Sackville acknowledged the scope of the royal commission had been significantly underestimated and said he would write to Prime Minister Scott Morrison later on Friday requesting a 17-month extension for the commission's final report.
The final report for the $528 million commission is due in April 2022, but Mr Sackville said he would seek an extension for its completion to September 2023.
He would not request additional funding.
"The terms of reference are extraordinary broad, much broader than any royal commission appointed in this country since well before the turn of the 21st century. That means the commission is not a sprint, it's a marathon," Mr Sackville said.
"There's no quick fix for the endemic and deep-rooted issues we've identified and explored."
However, Mr Sackville said the commission would next month issue findings and recommendations on its hearings into the experiences of people with disability amid the COVID-19 pandemic. Eight NDIS participants had died from COVID-19 as of August.
The commission also acknowledged the pandemic had caused major delays for its work.
Lacking data
The report acknowledged that good data on the extent of abuse and neglect of people living with disabilities was lacking.
"Multiple previous reports and inquiries have noted the absence of this data, and governments and others have been told many times to improve their data collections. Data, however, remains limited," the report read.
"This is especially the case for data about groups of people who may be more vulnerable to violence, abuse, neglect and exploitation, such as children, people with communication disability, First Nations people, culturally and linguistically diverse people, and LGBTIQ+ people with disability".
The report also highlighted the impact of violence on First Nations people living with disability.
"First Nations people with disability experience high rates of violence. In a 12-month period, around 6 per cent of First Nations adults with disability experience physical violence. First Nations people with disability comprise 52 per cent of all First Nations victims of recent physical violence," it read.
First hand accounts
The report also detailed first hand accounts of abuse and neglect people living with disabilities had suffered.
In one account of life at a group home a resident describes being kicked by the group home manager and locked in a room for hours on end.
The case study described a lack of fresh food in the home causing him to lose more than 20 kilograms in weight, and having money stolen from their bank accounts by the group home manager.
The report said the commission would until its conclusion explore the requirements for a more inclusive society for people with disability, continue to investigate the intersection of disability with other factors, and hear more stories from people with disability.
