Spirituality was embedded in the underpinnings of nursing when care of the sick was a 'good work' in the medieval monastic Christian tradition and human beings were recognized as spiritual beings. Contemporary mental health nursing practice is slow to recognize the value of the spiritual. This paper explores the nature of spirituality and communication about spirituality in mental health nursing practice. Philosophical, biological, psychiatric and psychological arguments antithetical to spirituality are explored. Effective mental health nursing practice incorporates conceptual frameworks and skills that reflect universal spiritual wisdom by means of various therapeutic modalities.