The pharmacokinetic profile of risperidone long‐acting injection (RLAI) has lead to specific recommendations for its treatment initiation. A team of Mental Health Nurse Advisers conducted this audit in a cohort of 1647 patients from 32 centres in the UK to assess to what extent treatment with RLAI is initiated according to these recommendations and how this affects treatment adherence. Copyright © 2009 Wiley Interface Ltd