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Lack of joined-up action between alcohol and mental health services


The UK Government's next alcohol and mental health strategies must address the needs of users with co-occurring conditions. This is the central message of service providers from both sectors following a seminar which discussed the findings of a new survey looking into current provision standards and the barriers to effective help.

Produced by the Institute of Alcohol Studies and Centre for Mental Health, the report Alcohol and Mental Health: Policy and practice in England found that the treatment systems of both the alcohol and mental health sectors fail to regard each other's existence, even when identified by patients and and service providers. More than two-thirds of respondents felt that support for people with co-occurring conditions was 'poor'.

It also found that trust and understanding between alcohol and mental health services were weak, largely due to barriers to greater integration including funding and workforce shortages (especially in alcohol services through lack of training), and the stigma facing people with co-occurring conditions – more than 90% of survey respondents viewed funding shortages as a problem.

A particular area of concern among respondents was the accessibility and quality of care offered to homeless people, with three-fifths (61%) of respondents suggesting they receive worse than average access to services and almost half of them (46%) suggesting they receive a worse than average standard of service.

Service workers from both fields attending the seminar supported the finding, believing that such an issue would require a particular effort from central government to identify and implement the necessary solutions on a national scale.

Homeless people are most likely to have worse than average access to or standard of treatment in mental health services

Homeless people are most likely to have worse than average access to or standard of treatment in mental health services

 

Treatment service staff in either sector were likely to be critical of their own services' levels of support for users with co-occurring conditions. Alcohol service staff were, however, overall more critical of mental health services than vice versa – only 7% of alcohol workers thought alcohol was adequately considered in mental health services compared with 45% of mental health staff.

The report calls for concerted national leadership to improve the support offered to people with alcohol and mental health problems.

It recommends the UK Government should develop a comprehensive alcohol strategy for England that will include action to ensure more people get effective, joined-up help, while prioritising help for people with co-occurring alcohol problems in the next Five Year Forward View for Mental Health.

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.'