Recent research has suggested that mental health problems are over-represented in the homeless population. Currently mental health services are under-utilised by this group in proportion to need. It is often assumed that psychological intervention is unlikely to be helpful with a client group where basic needs are often not met. The Transtheoretical Model of Change is used as a framework to describe the complex, dynamic processes that are likely to impact on a homeless person with mental health problems' ability to seek help for their mental health difficulties. This model is also applied to services. The empirical evidence for Maslow's Hierarchy of Needs as a help or hindrance to help-seeking behaviour is examined. This study asked homeless people to identify their own needs and explored current working practices of the few clinical psychologists who work with them directly. Interpretative phenomenological analysis (IPA) was used to explore the role for clinical psychology for homeless people. A pilot study was conducted. In the main study, nine men from two day centres/night shelters (one rural and one inner city) were recruited opportunistically. Five clinical psychologists working within the homelessness field were recruited. Psychopathology of the homeless participants was measured using the GHQ-12 and BPRS. Within a user-designed approach a semi-structured interview was developed for the main study from the pilot study.