Professor Gournay's commentary on the issues and roles in mental health nursing could equally have been titled: situation and process, skills and experience, genericism and specialism, clinical and eclectic, or proactive and preventive. His research review supports a viewpoint at the structured/tested end of this continuum, where he sees ready evidence that nurses now require clinically focused training and re-training if they are to provide care and treatment for patients with the most seriously disabling mental illnesses. This reinforces the Butterworth Report's conclusions, the Health of the Nation's expectations and the specifications in Building Bridges.