Risk assessment remains fundamental to all mental health practice. Use of a framework of assessment, structured clinical judgement, clinical formulation, risk formulation and a management plan is an efficient method of estimating and managing risk in the mental health population. A framework led by judgements informed by complete history-taking, well-made risk formulation and evidence-based practice, aligned with robust management plans and national guidelines, is effective in avoiding or minimising serious untoward incidents. These, however, do occur because prediction cannot be entirely accurate and contexts are dynamic. Therefore regular monitoring, review, documentation, adaptation and communication with all other agencies involved, including clients and carers, are necessary for positive and responsive risk taking. Adequate training of the multidisciplinary team should be mandatory.