Aim To evaluate the effectiveness and safety of restraint and breakaway in a 16-bed psychiatric intensive care unit.

Method Analysis of specifically designed incident forms was undertaken to identify the effectiveness and safety of take-downs and holds, in relation to staff numbers and gender composition of the restraint team; and identify the use, effectiveness and safety of breakaway techniques.

Findings There was no evidence to suggest that having a greater than average number of staff involved in the restraint or the avoidance of female staff in limb management had a detrimental effect on effectiveness or safety of the restraint. Breakaway was used in 13% of attacks on staff and in 70% of these the intended purpose of the breakaway was achieved.

Conclusion Restraint procedures, as taught in Control and Restraint training, appear to be an effective and reasonably safe means of manually controlling a violent client in psychiatric intensive care settings.