The efficacy of the Historical, Clinical, and Risk Management Scales (HCR-20; C. D. Webster, D. Eaves, K. S. Douglas, & A. Wintrup, 1995), Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991), Beck Hopelessness Scale (BHS; A. T. Beck, A. Weissman, D. Lester, & L. Trexler, 1974), and Brief Psychiatric Rating Scale (BPRS) to predict violence and self-harm in 34 institutionalized mentally disordered offenders was assessed. Both the HCR-20 and BPRS were strong predictors of violence whereas the PCL-R had moderate predictive ability. BHS was the only variable predictive of self-harm. Although risk assessment measures were successful at predicting in-patient violence, a clinical measure of mental state was at least as effective in these mentally disordered offenders.