Comorbidity of substance misuse and mental illness in community mental health and substance misuse services
Open accessAbstract
Background: Improved management of mental illness and substance misuse comorbidity is a National Health Service priority, but little is known about its prevalence and current management. Aims: To measure the prevalence of comorbidity among patients of community mental health teams (CMHTs) and substance misuse services, and to assess the potential for joint management. Method: Cross-sectional prevalence survey in four urban UK centres. Results: Of CMHT patients, 44% (95% CI 38.1-49.9) reported past-year problem drug use and/or harmful alcohol use; 75% (95% CI 68.2-80.2) of drug service and 85% of alcohol service patients (95% CI 74.2-931) had a past-year psychiatric disorder. Most comorbidity patients appear ineligible for cross-referral between services. Large proportions are not identified by services and receive no specialist intervention. Conclusions: Comorbidity is highly prevalent in CMHT, drug and alcohol treatment populations, but may be difficult to manage by cross-referral psychiatric and substance misuse services as currently configured and resourced.
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Up to 86% of individuals who use substances also meet criteria for common mental health disorders.
“Poor emotional regulation and avoidance are closely intertwined with mental health difficulties, and up to 86% of individuals who use substances also meet criteria for common mental health disorders (Weaver et al., 2003).”
From “I don’t want to take buprenorphine for the rest of my life”: Acceptance and Commitment Therapy for a Client Struggling to Reduce Low-Dose Buprenorphine (a Hermeneutic Single-Case Efficacy Design) (2023) · cites this paper as Weaver et al., 2003
Table 3 (prevalence of comorbidity in drug and alcohol services; page unavailable) reports a psychiatric disorder in 53 of 62 alcohol-service patients (85%) and 161 of 216 drug-service patients (75%). This supports a high rate of comorbidity, but not the stated 86% or its extension to all individuals who use substances. The table counts any psychiatric disorder, including psychotic and personality disorders, rather than only common mental health disorders. (LLM, conf=0.88)
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- Charing Cross Campus,The Reynolds Building, St Dunstan's Road, London W6 8RP,UK.Tel: 020 7594 0863; fax: 020 7594 0866; e-mail: t.weaver 0863; fax: 020 7594 0866; e-mail: t.weaver@ @imperial.ac.uk imperial.ac.uk (First received 27 November 2002, final revision 12 May 2003, accepted 13 May 2003) (First received 27 November 2002, final revision 12 May 2003, accepted 13 May 2003) https://doi.org/10.1192/bjp.183.4.304 Published online by Cambridge University Press
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- Authors
- Weaver, T., Madden, P., Charles, V., Stimson, G., Renton, A., Tyrer, P., Barnes, T., Bench, C., Middleton, H., Wright, N., Paterson, S., Shanahan, W., Seivewright, N., Ford, C., & Comorbidity of Substance Misuse and Mental Illness Collaborative (Cosmic) Study Team
- Affiliations
- Imperial College London (GB)
- University of Nottingham (GB)
- Nottinghamshire Healthcare NHS Foundation Trust (GB)
- Corresponding author
- Weaver, T.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2003-10
- Volume
- 183
- Issue
- 4
- Pages
- 304-313
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2117568383
- Cited by
- 386
- References
- 31
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 16 · 2023: 10 · 2022: 13 · 2021: 14 · 2020: 14 · 2019: 11 · 2018: 11 · 2017: 24 · 2016: 24 · 2015: 16 · 2014: 23 · 2013: 30 · 2012: 26
- FWCI
- 9.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- substance abuse, mental illness, comorbidities, community mental health teams, substance misuse services, alcohol abuse, drug abuse, prevalence, cross-referral, service integration
- MeSH terms
- Adult, Mental Disorders, Community Mental Health Services, Cross-Sectional Studies, Delivery of Health Care, England, Female, Humans, Interprofessional Relations, Male, Patient Care Team, Referral and Consultation, Urban Health, Comorbidity, Prevalence, Diagnosis, Dual (Psychiatry), Substance-Related Disorders
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