Understanding treatment pathways and integration of services for people with co-occurring mental health and alcohol problems

Alcohol specific deaths are rapidly increasing and there were 7,423 alcohol-specific deaths in 2020, up 20% on the previous year. There are nine times more deaths in younger/middle-aged people with an alcohol problem, compared to those drinking at a low risk level (Hayes et al., 2011) and there are greater alcohol harms for people of lower socioeconomic status (SES) (Katikireddi et al., 2017). There is also at least a 10-year reduced life expectancy in individuals with a common mental disorder (CMD) or a severe mental illness (SMI).
Our research has shown that people with a range of mental health problems are more likely to drink at a harmful level, compared to those without a mental health problem (Puddephatt et al., 2021).

This suggests that they also more likely to develop physical diseases that are attributed to alcohol. Our recent unpublished research has confirmed this and patterns of physical multimorbidity were more common in individuals with co-occurring mental health and alcohol problems compared to those with a single problem.
Given all of the above it may be surprising to learn that it is currently not typical for individuals with a mental health problem to receive more support around their drinking. Due to the complexities surrounding these issues, there is an urgent need to do more to integrate mental health and alcohol services so that people with co-occurring problems do not lose out from receiving the best care. This is not an easy problem to resolve and following the 2012 Health and Social Care Act, all alcohol and substance use services are now commissioned by Local Authorities, resulting in reductions in funding for alcohol treatment services by Local Authorities (Roberts et al., 2020).