Multi-agency public protection arrangements (MAPPA) were introduced in England and Wales in 2000 with the aim of minimizing the risk of sexual and violent offences to the general public posed by identified high risk individuals living in the community. This chapter reviews the legislative changes that led to the formation and subsequent development of MAPPA. It summarizes the structure and functioning of the MAPPA framework and examines MAPPA's relationship with mental health services, illustrating this with clinical vignettes. The relationship of MAPPA with mental health is an area of intense controversy, raising questions about whether to prioritize the protection of the public, or the rights of the individual's privacy and confidentiality. Public protection from danger and the wish to eliminate risk appear to be major preoccupations of contemporary society, so that MAPPA could be seen as an inevitable outcome.