People who have difficulties with alcohol and mental health are still not getting the help and support they need, according to a report published today by the Institute of Alcohol Studies and Centre for Mental Health.

Alcohol and Mental Health: Policy and practice in England, is based on a survey and seminar session held with professionals working in mental health and/or alcohol services across the country. It finds that co-morbidity is a barrier to treatment, and support for people with co-occurring alcohol and mental health problems is too often poor and fragmented. Support for homeless people with complex needs is particularly poor, with more than half of survey respondents suggesting they receive worse than average access to services (61%) and 46% suggesting they receive a worse than average standard of service.

A number of barriers to improving this picture are identified. Lack of understanding and join-up between services, funding and workforce shortages, and stigma facing those with co-morbidities are major problems – indeed, more than 90% of survey respondents viewed funding shortages as a problem.

People who have alcohol and mental health problems are not well recognised in national policy. Mental health issues are poorly addressed in government alcohol policies, while alcohol is barely mentioned in national mental health policies including the Five Year Forward View for Mental Health. And budget constraints in both substance misuse and mental health services have put extra pressure on services already struggling to meet people’s needs.

The report calls for concerted national leadership to improve the support offered to people with alcohol and mental health problems. It recommends the Government develop a comprehensive alcohol strategy for England that will include both population level measures to address alcohol harm (including on price, marketing and licensing) and service level action to ensure more people get effective help. It recommends that the successor to the Five Year Forward View for Mental Health prioritises help for people with co-occurring alcohol problems. And makes further specific recommendations relating to all areas of service provision and co-morbidity, including calls for urgent action to review the funding and staffing of addiction services.

Commenting on the findings, Lord Brooke of Alverthorpe notes: "It is clear from this report that not only is it common for those suffering from alcohol use disorders to also experience mental health difficulties, but that these people are being left behind. Government should act on this now – this situation cannot continue. A new Alcohol Strategy and a second Five Year Forward View for Mental Health that consider this co-morbidity are urgently needed."

Centre for Mental Health chief executive Sarah Hughes said: “The links between poor mental health and alcohol misuse are clear and well known. Yet people facing difficulties with both still get little effective help in many parts of the country. Severe financial constraints on local authorities in particular are clearly part of the picture. But our survey also shows that poor communication and a lack of trust between alcohol and mental health services are longstanding barriers to better support. And for many very vulnerable people the result is poor access to effective help when they most need it.

“We hope that the Government will provide much-needed national leadership by setting a clear direction of travel for both alcohol and mental health support and by addressing gaps in funding for local authorities.”

Institute of Alcohol Studies chief executive Katherine Brown said: “Our report shines a light on what professionals in both alcohol and mental health service sectors have known for some time – but the problems of joint service provision have rarely been acknowledged outside both fields until now.

“We hope that bringing such issues out into the public domain will spark a debate in which the views of workers and service users will contribute to the forging and implementation of more holistic public health strategies. Government acknowledging this through a new Alcohol Strategy and a second Five Year Forward View for Mental Health will be central to achieving this.”


Download the report here