Background A patient-centred approach to care, focusing on recovery, demands a reconsideration of how choices are made about treatment, how this affects medication adherence, and the role of long-acting antipsychotics (LAIs) in this process. Aims To explore the role of the mental health professional (particularly nurses) in helping patients manage their medication, with a specific focus of the use and administration of LAIs. Method A pragmatic review of the literature. Results Patients (by experience) and mental health professionals (by training and clinical practice) are experts in the care and treatment of psychosis. When patients and clinicians make a joint decision both are more likely to adhere to the treatment plan. In this paper we consider good practice in the administration of LAIs that focuses on where and when they should be given and administration techniques. Skills for talking with patients about their medication that include exchanging information, monitoring the effects of medication and making advance choices about treatment in the event of a crisis are also discussed. Conclusions Mental health professionals require a range of competences to help patients manage their medication effectively.