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Our study in a psychiatric ward of a general hospital aims to identify acutely ill psychiatric patients who are at high risk of falls. Patient falls were identified by data collectors after they were reported by hospital staff into the Fall Reporting Risk Management System (RMS). From 2007 to 2009, there were a total of 26 patients who fell in the psychiatric ward. Falls are likely to occur while the patient is ambulating beside the bed and is unlikely to be elimination-related. Slipping or tripping was the most common fall mechanism. There were no life-threatening injuries sustained and the most common type of injury was pain, swelling, contusions and abrasions. Two main patient profiles were identified to be at risk of falls, the first being elderly patients with mood disorders and co-morbid medical conditions such as diabetes. These patients are usually deemed high risk in the fall assessment. The second group of patients is young females with eating disorders and who are not on psychotropic medications. Both groups are likely to be alert and oriented, with no muscle weakness or a history of previous falls.