Purpose: Assessment, documentation, and prevention of risk are central to mental health services. However, there is a paucity of research examining how risk is perceived by key stakeholders including managers and clinicians. Design and Methods: Qualitative, exploratory design. In-depth interviews were held with 22 senior managers and 21 clinicians. Findings: Communicating risk was a major theme to emerge. For managers, accountability was a primary consideration in communicating risk and therefore influential over nursing practice. Clinicians were more likely to view the organizational processes of communicating risk as a bureaucratic exercise. Practice Implications: The significant difference between managers and clinicians is problematic for achieving consumer-focused mental health service delivery, a more critical approach to risk is essential in preserving the therapeutic relationship.