By Lucy Bryant

Many people who misuse alcohol have a mental health difficulty, and many people with mental health problems also misuse alcohol. Indeed, Public Health England (2017) estimate that 86% of people using alcohol treatment services have a co-occurring mental health difficulty. Despite this co-morbidity being so common, it is these very people who struggle to access support.

For this reason, the Institute of Alcohol Studies and Centre for Mental Health came together to collaborate in 2017. While there had been no recent examination of the state of service provision for those with co-occurring alcohol use and mental health difficulties in England, it was an accepted truth in both fields that support for this group has been lacking. Anecdotally, some service users and providers tell of being unable to access either alcohol or mental health services until the other difficulty has been addressed, leaving people stuck between both services with little joined-up support. We set about researching this, through a national survey of service providers and commissioners and an expert seminar held early in 2018.

Some service users and providers tell of being unable to access either alcohol or mental health services until the other difficulty has been addressed, leaving people stuck between both services with little joined-up support

Speaking to service workers and experts who understand exactly what the frontline of service provision is like, our work confirmed what was suspected. We found a system driven to disarray by sustained funding cuts, workforce shortages, and a lack of join-up between mental health and alcohol services. A governmental neglect of alcohol and mental health issues has meant there is no place for these individuals in today's treatment landscape.

The report recommends a new alcohol strategy and a second Five Year Forward View for Mental Health which consider this comorbidity. But we need to do more. Not only must we consider the situation of those in need of access to treatment services, we ought to look wider at how we can prevent future generations of harmful drinkers. We need to get up front as a nation and look at our relationship with alcohol. Alcohol is more affordable and available than it's been in decades, and as a nation we have changed how we drink.

We found a system driven to disarray by sustained funding cuts, workforce shortages, and a lack of join-up between mental health and alcohol services. A governmental neglect of alcohol and mental health issues has meant there is no place for these individuals in today's treatment landscape.

Affordability gulfs have opened up between the pub and the supermarket and today more than two thirds of all alcohol sold is drunk at home behind closed doors. When the equivalent to 22 shots of vodka is available for just £3.59 in newsagents up and down the country, is it any wonder alcohol is affecting our health - mental and physical? For some people, drinking can also become a form of self-medication for psychological distress, with very serious consequences for their health.

The Scottish Government have taken substantial action on the issue this week in the form of minimum unit pricing. The governments of Wales, the Republic of Ireland, and Northern Ireland have also announced intentions to do so. We hope we can see the Westminster Government take similar decisive, necessary action. As Lord Brooke of Alverthorpe comments in response to our research, “It is clear that urgent action must be taken; we cannot continue to fail those who need support in this way.” 


See our latest report with the Institute of Alcohol Studies