Aims: To evaluate the frequency of mechanical restraints and all the variables which can have significantly influenced its use in an acute psychiatric ward during the last 9 years.Methods: This retrospective analysis was conducted in an Italian Service of Psychiatric Diagnosis and Care.Results: A significant reduction of mechanical restraints was observed after the application of more restrictive guidelines on its use in 2015. Concomitantly, an increase of incident reports was reported in 2015 (n= 68) and 2019 (n=71). Successively, a regular 12-hour work shift of hospital guards was implemented inside the ward and, in 2021, mechanical restraints decreased to zero and incident reports reduced by 87%.Conclusions: Our results suggest that alternative procedures in managing aggressive behaviour can be applied after a cultural change, initially imposed by guideline and successively accepted by staff, who can apply safe no-restraint treatment, only delegating to others the task of controlling violence.