Is breakaway training effective? An audit of one medium secure unit

Violence to mental health staff is a major problem in the UK. Breakaway training may improve knowledge, attitudes and stress. It is unknown if breakaway training is effective in clinical environments. Aim: To audit the effectiveness of breakaway training in a sample of clinically based mental health nurses in a medium secure forensic mental health unit.

Audit using a cross sectional design with an opportunistic sample of 47 clinically based mental health nursing staff in a forensic medium secure unit. Participants had previously been trained in breakaway techniques. They were approached by the audit team on the ward and randomly selected one of five possible life-threatening assaults that they then had to breakaway from. Measures were blind ratings by breakaway trainers as to the participant's correct use of technique and time. Where participants were unable to breakaway after 10 seconds the scenario was stopped. Descriptive analysis of the sample and inter-rater agreement of breakaway trainers' ratings were conducted.

None of the sample had used a breakaway technique in the preceding 12 months. Forty percent(19/47) were unable to breakaway from a life threatening assault within a ten second period. Sixty percent did not employ the correct breakaway technique.

The effectiveness of breakaway training is questionable given that 40% of the sample were unable to breakaway from a life threatening hold in time. Further replication is required.