The purpose of this study was to develop a fall risk assessment instrument for the inpatient psychiatric population. Nine risk factors were identified through a review of the literature. The instrument was applied retrospectively to patient records, and the percentage of those who fell who triggered each of the items in each domain was calculated. The expected value of the population and weighting system were established. The Morse Fall Scale and Edmonson Psychiatric Fall Risk Assessment Tool (EPFRAT) were administered simultaneously to inpatient psychiatric patients. Sensitivity of the EPFRAT was 0.63, compared with 0.49 for the Morse Fall Scale; specificity of the EPFRAT was 0.86, compared with 0.85 for the Morse Fall Scale. Initial psychometric testing of the EPFRAT indicates the instrument is more sensitive in assessing fall risk in the acutely ill psychiatric population than those currently available. Additional psychometric testing is needed to determine the reliability and validity of the EPFRAT.