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these issues raised by metropolitan based nurses in large hospital emergency departments, mirror the same issues and concerns of remote general nurses. Sivakumar et al.’s study (2011) is not isolated but is supported by other studies with very similar findings (Gerdtz, Weiland, Jelinek, Mackinlay & Hill, 2012; Happell & Platania-Phun, 2005; Jelinek et al., 2013; Kerrison & Chapman, 2007). Notably the same issues and concerns arise, irrespective of location (remote, rural, metropolitan) for remote general nurses delivering mental healthcare (Jelinek et al., 2013). Another study of rural general nurses by Clark et al. (2005) reported ‘that most [rural] nurses perceive … low levels of role competency … [and] adequate knowledge or skills to identify, assess and treat patients with mental illness; and a significant proportion … felt that they could not appropriately advise patients about mental health problems’ (p. 211). Of the factors that affect rural nurses’ attitudes towards mental health patients, the frequency of treating patients with mental illness is significant in influencing levels of therapeutic commitment, yet did not affect perceived role competency. Those rural nurses who treat mental health patients more frequently reported higher positive levels of role support. Not surprisingly, those nurses who have specialist experience in caring for mental health patients reported significant positive levels of role competency and therapeutic commitment. This is consistent with Wynaden, O’Connell, McGowan and Popescu’s (2000) study which reported that 58% of remote general nurses lacked confidence and 62% felt their relevant knowledge and skills were inadequate, in caring for mental health patients. It is innocent perfidy of their real worth and importance in caring for remote mental health patients.