Substance misuse among clients with severe and enduring mental illness: Service utilisation and implications for clinical management

Abstract

Substance use, in the context of severe and enduring mental illness, is a growing problem particularly among young men and is likely to have implications for the way mental health services are used. The current study compared service utilisation, psychiatric symptomatology and social support among 16 clients with psychotic illness who were regular substance users, with 16 clients attending the same service who did not use substances. The groups were matched on age and gender. The case group evidenced higher rates of in-patient care and intensive crisis support. Their use of the Day-Service was chaotic and reflected social difficulties, such as housing instability, financial and legal issues rather than mental health problems. The findings highlighted the need for an integrated and accessible service which could provide long-term, intensive and practical support.