Mental health nursing as a distinct speciality has been in decline in New South Wales, Australia for two decades. Arguably, this decline has worsened both consumer outcomes and the workplace experiences of mental health nurses. This paper reports on a study designed to ascertain the nature of contemporary mental health nursing practice in New South Wales. The study utilised focus group research methodology, with participants recounting the realities of their day-to-day professional practice and perceptions of their professional identity. The findings indicate a contracting, if not moribund, profession, a decrease in the value attached to mental health nursing and a pattern of persistent underfunding by successive governments of mental health services. Analysis of present and historical trends reveal there is a pressing need for a restructure and re-formation of mental health nursing in rural areas.