The concepts of faith and hope are not explicit in the language of psychiatry. It is suggested that this is a result of the cultural gap that exists between psychiatrists and the Australian community, assisted by a clinical approach that seeks to avoid exploration of the difficult experiences of helplessness and hopelessness. Hope and faith are multilayered phenomena involving a belief about things of which we are uncertain accompanied by an expectancy and/or conviction. Many things in life are uncertain. However, the ‘reasonableness’ of a belief is an important judgement that psychiatrists make. Hopefulness (genuine hope as compared to false hope) and optimism are associated with positive health outcomes. Hopelessness is associated with poor outcomes. Psychiatrists need to be able to explore issues of hope and faith with patients at times of life crises in order to facilitate adjustment. This can be an important part of the treatment of a depressed or demoralized person.