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