Drugs, drink and mental health: The impact and consequences of dual diagnosis for mental health service delivery

Mental health service users with co-morbid alcohol and/or drug use problems (which will be referred to as ‘dual diagnosis’) have presented one of the most significant challenges to British and international mental health and wider health and social care services, as well as the criminal justice system in the last two decades. The National Service Framework for Mental Health (Department of Health, 1999) and the review of implementation (Department of Health, 2005) highlighted dual diagnosis as ‘the most challenging clinical problem we face’, which required urgent action from mental health and substance use services, and a broad coordinated response including better collaboration between agencies, training in assessment and clinical management, preventative work and prevention of drug misuse on inpatient units.