If you have severe mental health problems and problematic substance misuse, you may be given what is known as a 'dual diagnosis' – when both problems are diagnosed.
If you have a dual diagnosis, a range of services can help you:
Mental health and social services
Important: if you have a dual diagnosis, mental health services should be responsible for your treatment, rather than drug or alcohol services.
They should be able to refer you for help you with:
- suitable housing
The professionals will need to make a full assessment of your needs, so tell them as much as you can about your circumstances.
- be referred to your Community Mental Health Team (CMHT)
- be referred to an Assertive Outreach Team (AOT)
- be allocated a care co-ordinator, and
- have a written care plan under the Care Programme Approach (CPA)
If you find it difficult to get the support you need, you may find an advocate helpful.
If you have dual diagnosis, finding somewhere to live can be very difficult. Many housing agencies and supported housing trusts will not accept drug users.
However, a number of housing associations and trusts do provide suitable schemes. See Housing and mental health for further information.
A self-help group, where you can talk about your mental health problems and drug use with other people who are having similar experiences, can be very helpful.
Many organisations run self-help groups, including some local Minds. For more information see Useful contacts.
Support in the criminal justice system
If you have been in contact with the criminal justice system linked to your drug use, this should not make any difference to the type of treatment you are offered.
If you are in prison, you may be offered a ‘therapeutic community’, developed to help people with drug problems in a prison environment.
Drug and alcohol support services
You may be offered help from drug and alcohol support services to encourage you to stop taking drugs or alcohol. This usually means you are allocated a support worker, and receive quite intensive one-to-one support.
The programmes recommended by NICE (the National Institute for Health and Care Excellence) are:
- Motivational interviewing – this aims to help you decide what to do about your drug use, and to follow up the decisions you make. You may be offered one or two sessions.
- Contingency management – under contingency management, you may be offered incentives (such as shopping vouchers) to encourage you to stay off drugs. You will have to agree to urine or saliva testing as part of this.
If stopping alcohol, you are likely to be admitted to hospital because stopping suddenly after a long period of heavy drinking is dangerous. You may also be given medication to treat withdrawal symptoms – this may be an antipsychotic, a benzodiazepine or a combination.
Bipolar and alcohol
Watch Jonny's vlog on how he has coped with biploar and alcoholism.
This information was published in November 2016. We will revise it in 2019.