In the 10 years since Australia has ratified the United Nations Convention on the Rights of Persons with Disabilities (CRPD), the issue of the indefinite detention of persons with cognitive disabilities found unfit to stand trial has received considerable attention. Concerns have been raised by national media, law reform bodies and United Nations human rights agencies. Yet there remain few examples of formal change to unfitness to stand trial laws in Australia. This article focuses on the role of procedural accommodations in meeting CRPD requirements, and other accessibility measures to ensure accused persons with cognitive disabilities are able to take part in criminal proceedings on an equal basis with others. It examines support measures that appear in existing statute and case law within Australia and considers the need to develop new forms of support.