OBJECTIVE: To discuss the prevalence of blood-borne viral and sexually transmissible infections among psychiatric populations, as well as current treatment approaches, both locally and internationally. METHOD: In this paper, we outline available epidemiological data, as well as interventions designed to target infectious disease risk among those with serious mental illness. RESULTS: Within Australia, the prevalence of blood-borne viral and sexually transmissible infections among at-risk populations remains unacceptably high despite a number of successful harm reduction and prevention strategies. Although the highest rates of new infections occur among young people aged 15-29 years, recent research suggests that psychiatric populations are also at significant risk. However, despite increased rates, there is currently no coordinated strategy to educate, test and reduce disease risk among people suffering with mental illness within Australia. CONCLUSIONS: Although further epidemiological research at a local level is needed, interventions specifically targeting psychiatric populations and younger cohorts in particular, are essential. This will require multidisciplinary, collaborative service development, incorporating mental health, substance use and infectious disease specialists.