Patients with severe mental illness are at an increased risk for developing cardiovascular disease and diabetes. Obesity, genetics, tobacco use, poor diet, and minimal physical activity further increase the risk of developing chronic metabolic and cardiovascular disease this patient population. People with major mental illness lose, on average, more than 25 years of potential life primarily as a result of developing chronic medical illnesses. It has been established that many atypical antipsychotics negatively affect weight, lipid profiles, and glucose tolerance in as little as ten days. In 2004, the American Diabetes Association (ADA), American Psychiatric Association (APA), and American Association of Clinical Endocrinologists (AACE) developed and published consensus guidelines for the use of antipsychotics. Because diagnosis of diabetes, hypertension, and hyperlipidemia remains underestimated and risperidone remains a first-line agents prescribed at James A. Lovell Federal Health Care Center (FHCC) we feel is important to evaluate our monitoring practices.