As evidence of early mortality among people with severe mental illnesses has accumulated, so have efforts to detect and treat general medical conditions in this population. What degree of attention to patients' health is reasonable to expect of mental health clinicians, particularly those with little medical training? Nicholas Carson, M.D., and colleagues explored this question in a group of 47 clinicians. Transcription and coding of 120 intake sessions indicated that patients' health was discussed to varying degrees in nearly 90% of sessions, either when clinicians elicited this information (66% of sessions) or when patients volunteered it (67%). Nurses were most likely to elicit health information (100% of their intake sessions), followed by social workers (74%), psychiatrists (63%), and psychologists (44%). Clinicians most attentive to health conditions were those who used the information in case formulations (page 32). In another study focusing on patients' health, Amy M. Kilbourne, Ph.D., M.P.H., and colleagues interviewed directors of 108 of the 133 mental health programs run by the Department of Veterans Affairs to determine whether directors perceived that program clinicians or outside physicians were accountable for clinical tasks related to patients' medical conditions. Only about a third of directors (36%) reported primary accountability for monitoring diabetes and cardiovascular risk from antipsychotics, 10% reported accountability for hepatitis C screening, and 17% for obesity and weight management. Financial bonuses and co-location of general medical providers were associated with greater perceived accountability (page 38). The Taking Issue commentary raises the question of whether referral for medical evaluation is an ethical imperative. Glenn D. Grace, Ph.D., M.S., and Richard C. Christensen, M.D., M.A., argue that all mental health providers, especially those without medical training, should refer newly diagnosed patients for a thorough medical evaluation (page 3).