This paper takes as its starting point the paradox of process and care in a mental health setting. On the one hand, a number of ‘care pathways’ can be defined and employed, to ease the administrative and logistical burden of caring for mentally ill patients. On the other hand, the highly individualized interaction with the patient demands constant knowledge ‘refreshment’ and frequent knowledge creation that does not sit easily with re-iterative processes. The paper considers the options for process-based systems as ‘assistants’ to professional staff, and considers the extent to which such systems can complement or manage types of tacit knowledge, such as ‘know-how’ or emotion. A grounded theory approach and discourse analysis were used to obtain data for an exploratory study Keywords Knowledge management, culture, emotional climate, process based systems, PBS, community of practice