Changing patterns of care for the mentally handicapped are having a profound effect on the roles of all professions concerned—not the least mental handicap nurses. Many will continue their caring role in the community. Others will work as community mental handicap nurses providing domiciliary support to families and local authority services. Those remaining in the hospital service will be increasingly concerned with the care of the psychiatrically ill and behaviourally disturbed, the profoundly and multiply handicapped and the elderly. This has important implications for training nursing staff both at present and in the future.