The face of mental handicap nursing has changed dramatically over the last decade with the move away from institutional care toward a developmental rather than a clinical approach. The larger institutions have been replaced by smaller, more homely units and ordinary houses where 24 hour care is provided by registered mental handicap nurses, experts in developing the potential of individuals. RNMHs now work in a multi-agency system, their fellow professionals being psychologists, social workers as well as staff from other branches of nursing.