This study examines the degree to which perceptions of open communication between patients and staff affect patients’ mental health. Open disclosure correlated independently with lower levels of depression at baselineand a predicted significant decrease in depression over time. Other interpersonal characteristics (limited equality, respect and helpfulness) did not correlate with depression or subjective well-being at baseline or longitudinally. The interpersonal climate in chronic dialysis units influences patient well-being. Open disclosure in patients’ relationships with staff is not detrimental and contributes to well-being.