There needs to be continued collaboration between NSW Health and the Department of Housing to improve the availability of one and two bedroom apartments long-term. To allow for the ongoing success and expansion of programs such as the Housing and Support Initiative (HASI), there needs to be additional accommodation made available so NGO's can support new clients when the needs of the original consumers to reduce.

24-hour services to review their policies in regard to consumer involvement in the management and evaluation of the facility. Funding bodies to ensure that their procedures permit such initiatives.

Accommodation support services should consider adopting a needs-led approach utilising the CAN. The clinical version (CAN-C) can be used as the basis for developing individual service plans whilst the research version (CAN-R) can provide detailed information on consumers' satisfaction with different areas of service. The Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) is short enough to be used for review purposes on a routine basis. Any of the three tools can be used as an outcome measure.

Introduce the routine use of Quality of Life (QoL) measures. Research suggests that reducing unmet needs leads to improvements in quality of life making QoL assessments a valuable outcome measurement tool.

Invest in flexible and assertive social and leisure programs that utilise community facilities but also provide the opportunity to interact with other mental health consumers. These services are necessary for those people without the confidence or resources to access mainstream services.

Increase investment in daytime activities for individuals who do not want to attend social and leisure programs or drop-in centres e.g. links with supported employment services, TAFE, volunteer organisations etc. Increased access to the resources described above may also provide opportunities for consumers to meet their needs for intimate relationships and sexual expression.

Improve access to information about mental illness and the treatment options available. Regular information sessions are necessary not only to keep consumers updated but also to build confidence amongst consumers that they are being kept informed.

Increase collaboration between primary health care providers and mental health services to reduce the number of people who continue to have unmet needs in the area of physical health.

Access to psychological services should be increased to address the post- traumatic stress/ depression and anxiety experienced by many consumers.

There should be more family support services linked to mental health services to provide education and assistance to family members in recognition of the unique contribution they can make toward addressing consumers' social and psychological needs.

- Investment in the development of partnerships with other agencies and government departments to provide solutions to the problems faced by people from particularly disadvantaged groups eg a Joint Guarantee of Service between the Department of Health and the Department of Ageing, Disability and Home Care to address the needs of people with a dual diagnosis.

- Ensure that any 'Accommodation Support Access Planning Tool' developed is able to differentiate between consumers who want or need residential rehabilitation, and those who would be better served by a supported housing service. It should also thoroughly address consumer preferences regarding sharing or living alone.

- Recognise the importance of flexible funding models which allow for brokerage. When money is not tied to properties or individuals, services have the opportunity to be more responsive to individual needs.

When considering the recommendations listed above, it should be remembered that accommodation support services are not a 'one-stop-shop'; they cannot and should not be expected to meet all of a consumer's needs and require the support of other government and non-government services to be successful at working with consumers to improve outcomes.

This project has the potential to inform both the continued improvement of existing services, and the establishment of alternative models of care for mental health consumers with high needs. However, there are many consumers with high needs who are not residing in high support settings and therefore did not participate in this project. Research into the needs of mental health consumers living in sub-standard accommodation or on the streets is essential.