A tool to evaluate proportionality and necessity in the use of restrictive practices in forensic mental health settings: the DRILL tool (Dundrum restriction, intrusion and liberty ladders)

Table 6 Drill Behaviour Ladders and DRILL Intervention Ladders and Scales: Context decision pathways

	Violence	Self-harm	Risk to others	Escape	Non compliance	DRILL Behaviour scale (total)	DASA previous day
De-escalation	0.691	0.386	0.745	0.401	0.653	0.734	0.309
Observation	0.206	0.236	0.507	0.264	0.421	0.595	0.398
Searches	0.415	0.078	0.440	0.394	0.600	0.452	0.314
Extra meds	0.375	0.114	0.319	0.172	0.581	0.334	0.256
Situational coercion	0.427	0.172	0.529	0.528	0.764	0.544	0.356
Manual restraint	0.400	0.026	0.266	0.072	0.414	0.267	0.186
Seclusion	0.459	0.456	0.470	0.265	0.452	0.570	0.270
Mechanical restraint	–	–	–	–	–	–
DRILL Intervention scale (total)	0.409	0.394	0.632	0.253	0.424	0.703	0.351
DASA previous day	0.160	0.000	0.261	0.138	0.380	0.252

Spearman rank correlation coefficients. For DRILL ladders n = 2174, for DASA previous day n = 2166. All p < 0.001 except for some self-harm correlations

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