When something does not work, we have a tendency to believe we just need to do more of the same, ie try harder. Mental health treatment is an example of this. When our patients fail to heed what we are saying, we often blame them for not listening, instead of asking why they are not compliant to our best intentions. The reality is that, for our patients and society in general, we lack credibility, as there is a general belief that treatments for mental health problems do not work. We reinforce this by maintaining people in secondary care services, rather than actively working to discharge them back into primary care services and the community. Copyright © 2009 Wiley Interface Ltd