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Objective: This paper describes the risk assessment (RA) approach in a maximum security forensic psychiatric unit in New South Wales, Australia. The literature in relation to violence and mental illness is briefly reviewed and discussed and the process of RA is described. Emphasis is placed on the importance of combining clinical and actuarial methods to engage in comprehensive RA. Conclusion: It is concluded that a combination of actuarial and clinical assessment completed by a multidisciplinary team of mental health professionals with clinical knowledge of the patient being assessed is proving to be an efficient and effective method. Further directions are highlighted and a cautionary note in relation to the potential for unintended outcomes is made. [ABSTRACT FROM AUTHOR]