It is estimated that 75% of people using drug and addiction services and 85% of people using alcohol services had a psychiatric disorder in the past year. In addition, 44% of patients using community mental health services had problems with drug or alcohol use (Weaver et al, 2003). 

In relation to alcohol specifically, morbidity and deaths from alcoholic liver disease have doubled in the last 20 years (Williams, R et al, 2018). People with alcoholic liver disease live with multiple health conditions, including mental health conditions. In this group, people living on lower incomes and who face other health inequalities, are much more likely to become severely ill.   

In spite of the high level of comorbidity, few services provide integrated care for both mental health and substance use disorders. 

Aim of this project 

The aim of this Mental Health Implementation Network project is to implement new integrated care protocols for patients with co-occurring severe mental illness and substance abuse, including alcohol misuse. 

In supporting the implementation of these new care protocols, we aim to: 

  • Improve access to integrated mental health and substance misuse services
  • Ensure more people using substance misuse services are screened for mental health disorders and then receive NICE-approved interventions
  • Ensure more people using mental health services are screened, diagnosed and receive support for substance misuse.

Availability of evidence-based solutions and national guidelines

Prevention and treatment of alcohol misuse are key priorities for the NHS, local authority public health teams in south London and the Long-Term NHS Plan (2018).

There have been numerous recommendations and guidelines to provide integrated care for comorbidity, including for cooccurring mental health and substance abuse problems, but progress in implementation has been limited (Public Health England, 2017). 

Selecting potential interventions  

We will be researching and assessing potential interventions for scale up. Selected interventions will be co-designed and finalised in the next phase of MHIN. 

Find out more


In March 2024, the MHIN team held a webinar to disseminate findings of the project: Integrated protocols for substance use, mental and physical health problems. Find out more and watch a recording of the webinar.

Communities of practice 

As part of this project we launched a Community of Practice for people involved in Alcohol Assertive Outreach Services. Read a blog on The Health Foundation's Q site from Afra Kelsall, senior advisor at the MHIN, who shares her learning about how valuable the Communities of Practice model can be as a quality improvement tool.

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