This report looks at the experience of people who are living with both mental ill health and problematic drug or/and alcohol use. It considers how effective and joined-up their care and treatment is; both from the point of view of individuals and from those who work within health and care services in Scotland.

In total, 426 people engaged with us as part of this work through consultations, focus groups and questionnaires. We were keen to focus on their direct experience of services and working within them. We are grateful for their insight and expertise.

Whilst we found pockets of good practice, and a real desire to improve care and treatment we were concerned to find that national guidance and standards that emphasise the need for services to work closely together to meet all the needs of a person have not been realised.

People with lived experience and families/carers describe a system in which they feel discriminated and are often ‘bounced’ between mental health services and addictions services. The policy ideal that there should be ‘No Wrong Door’ has not necessarily led to every door being open.

People who are working in services echoed those with lived experience, highlighting a lack of protocols that ensure that needs are met holistically, that people should have care coordinators and care plans, are not ‘bounced’ between services, or excluded from services due to their problem substance use.