Key findings:
• There is a strong multi directional link between alcohol use disorders (AuDs) and mental health disorders which is reflected in the high level of complex needs experienced by the service user grouping.
• Rates of co-occurring substance use and mental health disorders range from 30-85%, according to the measures used and the sub group settings in which they are assessed.
• The variance in prevalence is also mirrored in the range of service delivery models which address the needs of those with co morbid conditions. However, three models are consistently referred to in the literature; serial, parallel and integrated.
• The literature also identifies inconsistencies in regional and UK policy and guidance for working with co morbid AuDs and mental health disorders with gaps in policy and guidance most evident for England and Northern Ireland.
• The development of a UK national policy framework for working with co morbid mental health and substance use disorders is overdue and should specifically address the issues of morbidities related to AuDs.
• A review of interventions indicated some level of success for cognitive behavioural interventions in the treatment of comorbid AuDs and mental health disorders.
• It was also clear that combinations of drug therapies for comorbid AuDs and mental health disorders showed successful outcomes, specifically those which incorporated Naltrexone and Disulfiram in the treatment arm of the studies. Conversely, there were less successful outcomes recorded for singular drug treatments such as Acamprosate.
• The majority of the studies in the review showed evidence of weak research design, including lack of detail as regards appropriate control groups, randomisation and concealment and a reliance on small sample sizes.
• Further methodologically rigorous research is needed to examine the effectiveness of pharmacological and psychosocial treatments for comorbid AuDs and mental health disorders.