Emotional problems occur regularly after stroke and are distressing, but also impact on functional outcome. The UK experience is that there are not insufficient resources for psychologist to review every patient, nor is it felt this is necessary. On this account a stepped approach to psychological care has been developed, encompassing prevention and intervention, stepped according to need. Carmen Lahiff-Jenkins, Managing Editor of the International Journal of Stroke spoke to Ian Kneebone as an IJS/SmartStrokes collaboration.