This article provides evidence to suggest that mental health nurses may not be as competent in medicines management as they believe themselves to be. A psychological model of skills awareness is used throughout the article to offer a theoretical explanation of this putative deficit and provide discussion of the possible causes. Training directed towards improving medicines management skills will be introduced. Training such as this is essential if mental health nurses are to offer the best care to those in receipt of their services and make best use of the opportunities provided by prescribing legislation.