Drug and alcohol services - co-occurring substance use and mental health concerns: literature and evidence review

1. Background

The level of harms from alcohol and drugs in Scotland are high in comparison to the rest of the UK and Europe, and cause avoidable damage to people's lives, families and communities. Tackling the high level of drug related deaths and harms in Scotland is a priority for the Scottish Government. On 20th January 2021, the First Minister made a statement to Parliament which set out a National Mission to reduce drug deaths and improve lives through improvements to treatment, recovery and other support services.^[1] One of the objectives is to address the requirements of people with multiple and complex needs, which includes people experiencing both substance use and mental health concerns.

In October 2021, the Minister for Drug Policy and the Minister for Mental Wellbeing and Social Care announced a rapid review of mental health and substance use services to better understand the current provision of services in Scotland. The announcement was made in the context of current commitments by the Scottish Government to improve the support available for those who have mental health concerns alongside problem substance use.

This report forms part of a wider research project exploring the provision of provision of support for people with co-occurring substance use and mental health concerns in Scotland. It aims to review the literature on co-occurring substance use and mental health concerns and the integration of mental health and substance use services over the past 20 years in Scotland. Where relevant, literature from a UK-wide and international context have been referenced. In doing so, the report presents evidence from the published literature on mental health and substance use services across primary care through to inpatient services, the third sector and local support services.

This review is published alongside the results of a survey undertaken to better understand the provision and availability of care for people who experience co-occurring substance use and mental health conditions in Scotland. The survey's respondents are individuals who work within services that provide support to people who use substances.