Mental health nurses are in challenging positions. They have the opportunity to support people hospitalized for the treatment of mental illnesses on their recovery journeys, but are simultaneously required to manage a burgeoning administrative burden, maintain organizational 'order', and contain risk. While obliged by policy to engender an environment that promotes recovery, they receive little guidance about how this should be achieved. When feedback from people hospitalized in our service indicated the experience of care was variable, we undertook a pragmatic inquiry examining consumers' views about what makes an excellent mental health nurse. We interviewed 20 people with lived experience of hospitalization and analysed transcripts thematically. To ensure findings were relevant and useful, we consulted mental health nurses about nurses' needs, and incorporated this with the views of service users. The analysis demonstrated that personal qualities, professional skills, and environmental factors all influence the experience of mental health nursing. Our findings highlight a need for renewed attention to the basics of relationships and the importance for nurses of self-awareness and support. We urge nurses to make time to really get to know the people for whom they provide care, and to work to maintain passion for mental health nursing. It seems likely that attention to the simple things has the potential to improve levels of satisfaction among service users, decrease distress, and support the development of an environment in which can nurture recovery.

While therapeutic relationships are appropriately recognised as the foundation of mental health service, service users commonly report suboptimal experiences. With shared understanding critical to improvement in practice, we explored service users' experiences and expectations of psychiatrists and consultations, engaging psychiatrists throughout the process. Using an iterative qualitative approach we co-produced a response to the question 'what makes an excellent mental health doctor?' Experiences and expectations of psychiatrists were explored in interviews with 22 service users. Data collection, analysis and interpretation were informed by consultation with peer workers. Findings were contextualised in formal consultations with psychiatrists. As 'masters of their craft', excellent mental health doctors engage authentically with service users as people (not diagnoses). They listen, validate experiences and empathise affectively and cognitively. They demonstrate phronesis, applying clinical knowledge compassionately. Psychiatrists share service users' aspiration of equitable partnership but competing demands and 'professional boundaries' constrain engagement. Consistent delivery of the person-centred, recovery-oriented care promoted by policy and sought by service users will require substantial revision of the structure and priorities of mental health services. The insights and experiences of service users must be integral to medical education, and systems must provide robust support to psychiatrists.

What is known about this topic • Reducing readmission to psychiatric hospitals is an economic and ethical imperative.