<p>Communication impairment, learning disability and mental health needs can limit people’s ability to have meaningful consultations with medical practitioners, who are frequently ill-equipped to support such patients to express themselves. Consequently they rely heavily on third-party reporting. This article describes the implementation of the communication tool, Talking Mats®, in a small psychiatric hospital to elicit patients’ views on their health needs. Outcomes and implications for patients, doctors, nursing and care staff are discussed.</p>