May 13, 2025

Royal College of Psychiatrists Report – Co-occurring substance misuse and mental health

For those who have both ongoing mental illness alongside substance use disorders, it can be particularly hard to access the most effective treatment and support. This group has poorer physical and mental health, poorer social and occupational functioning, poorer treatment engagement, and higher mortality rates. They represent one of the most vulnerable groups seen by mental health services with the highest risk of violence and suicidal acts. Despite this, mental health and substance use services tend to function independently with poor co-ordination of care for those who need support from both services. Outcomes for this group have been getting progressively worse, and too many lives are being lost.

Opportunities to deliver the best care possible are being missed. This is a real concern for the Royal College of Psychiatrists and their report makes practical recommendations for clinicians, commissioners and Government.

Journalists came to the SMC to hear from authors of this report into co-occurring substance use and mental health disorders on:

-What is co-occurring substance use, what does it look like, how common is it, and why is it so complex to manage?

-Why has this become a priority issue for the Royal College of Psychiatrists?

-What is the evidence of how best to treat this group and is this currently happening in all countries across the UK?

-What must be done to improve support and outcomes with these conditions and who is responsible for this?

Speakers included:

Dr Lade Smith CBE, President of the Royal College of Psychiatrists

Prof Owen Bowden-Jones, Lead author of the report and Consultant in Addiction Psychiatry

Dr Emily Finch, co-author of the report and Chair of the Royal College of Psychiatrists Addictions Faculty

Dr Jenny Drife, co-author of the report and Consultant General Adult Psychiatrist with a focus on homelessness