There is limited access to specialist clinical psychology services in psychiatric rehabilitation. The paper describes a needs assessment that informed decisions about the most effective way to use available psychology resources. The psychological needs of 24 service users residing in three rehabilitation units were assessed using the Health of the Nation Outcome Scales. Managers and 12 members of staff were also interviewed to elicit their views about the psychologist's potential role. Across all services, there were high levels of unmet needs that could be addressed by psychological interventions. Psychological assessments would help identify which service users would benefit from interventions and should include neuropsychological measures. Staff also reported that they would benefit from consultation and training in psychological approaches. Although this way of working would increase access to psychological resources across the services, it would require commitment from managers towards psychological-orientated models of care. Copyright © 2007 John Wiley & Sons, Ltd.