During qualification for mechanical circulatory support, the comprehensive assessment of a patient’s mental state is an integral element of the overall medical evaluation. It encompasses a range of psychosocial issues, and as such provides information helpful in the selection of a suitable candidate for the required treatment, and sometimes identifies contraindications to it. It allows ensuring that the patient meets expectations regarding both mental health stability and adherence to medical recommendations. It is also helpful in an early detection and diagnosis of mental problems before the surgery, which can increase the possibility of implementation of appropriate treatment and intervention. Due to the lack of generally accepted guidelines, this assessment can be subjective to some extent, especially if it takes place outside experienced transplant centres. This article presents the core principles of mental status evaluation and psychosocial factors increasing the risk of poor prognosis in this group. The article aims to share with psychiatrists and psychologists the clinical experience and comprehensive knowledge about psychosocial eligibility criteria for mechanical circulatory support or heart transplantation.