Aims of the study: To assess the prevalence of metabolic syndrome and implement a framework for screening and management of cardio metabolic risks in women on psychiatric in-patient wards.Background: An estimated 29-48% of psychiatric in-patients have metabolic syndrome. Severe mood disorders and psychotic illnesses are independent risk factors. 20-25% of the world's adult population have metabolic syndrome and they are twice as likely to die from and three times as likely to have a heart attack or stroke compared with people without the syndrome. This study gives an overview of the application of Lester Tool on busy in-patient units and interventional approaches adapted by the team.