The Australian mental health context has been in an intense state of flux over at least the last 30 years. The role of clinical psychologists in inpatient units has changed in the context of wider systemic change to mental health care. This chapter’s authors have worked extensively in inpatient services and the associated community services over the last two decades. After briefly describing the recent past and current state of the Australian mental health context, the authors will describe the challenges faced and contributions made by clinical psychologists in inpatient settings. The chapter will then outline some of the exciting developments in the treatment of major mental illness, advances that clinical psychologists have been at the forefront of developing and implementing. Finally, the authors will argue that clinical psychologists can enhance their effectiveness and better navigate the ethical complexities of working within inpatient settings by maintaining an explicit focus on human rights principles that arise for those utilizing inpatient care. Vignettes provided throughout the chapter offer clinical examples consistent with the points discussed.