Changed legislation and the new playing area in the care sector require another view on real estate by institutions in the mental healthcare sector, since they have become responsible for their own real estate portfolios. Healthcare institutions no longer receive compensation for the actual costs for housing, but integral performance funding including an integral housing component. Combined with the change from a central supply-driven sector to a regulated market-driven sector, that causes fluctuations in volume and thus in revenues. Therefore, these institutions must get a grip on their properties, whereby understanding the risks is necessary for success. This paper presents a model that visualises the risks in the current real estate portfolio in order to advise the mental healthcare institutions on risk management in their real estate portfolio and to provide a handle for strategic real estate management. The risk management tool is developed based on the steps of the risk management process according to COSO. Risk-identification and determination of the factors of the risk attitude is being done by analyzing the Political, Economical, Social and demographical and Technological developments combined with an analysis of the market developments in the mental healthcare sector. Qualitative assessment is being done by using the quadrant model to grant a chance, result and amenability leading to the classification in five risk classes: safe, low, middle, high and fatal. The test at an institution for mental health care shows that the tool does have enough power to distinguish the risky properties in the portfolio at a glance.