This paper is part of a larger study examining the role of the nurse practitioner and its potential utility in mental health nursing. Two methods were employed for data collection: a focus group interview with eight RCN qualified nurse practitioners, the result of which informed the development of a postal questionnaire which was distributed to the remaining RCN qualified nurse practitioners (n=130). Forty seven questionnaires were returned (a response rate of 36 per cent). Over 80 per cent of respondents did not feel adequately equipped to assess a mental health problem, despite nearly a third identifying mental health issues as a primary problem with which their patients presented. Just over 40 per cent of respondents stated that mental health needs were not met within their community and 78.7 per cent of respondents supported the development of a mental health nurse practitioner. In light of these findings the concept of a mental health nurse practitioner is discussed, alongside the need to clarify other advanced nursing roles.