In this guide, we have sought to examine and understand the experiences of people who are (or have been) both using alcohol and self-harming, and to offer some suggestions for ways for services to better support them. We expect the main audience for this guide to be substance use (drug and alcohol) treatment services and services specialising in self-harm support. However, it will be of use to a wide the range of services likely to encounter people facing these two challenges in life: social services, the emergency services, education providers, healthcare providers, and community and voluntary organisations supporting vulnerable people.

This is not a definitive treatment manual. Each practitioner must use their own professional judgement to tailor the support that they provide. What it does provide is some insights into what people with experience of alcohol use and self-harm say they need from services, and what practitioners have found useful in seeking to work with people in that situation.

Our hope is that this guide will enable workers in both self-harm and alcohol treatment services, and others, to increase their confidence and skills in working holistically with this group, and so improve outcomes and quality of life. We also hope that it will lead to more and better joint working and understanding between services: to the realisation of a “no wrong door” approach, whereby “every door in the…system should provide access to the services needed”.[iii] Given that both self-harm and harmful alcohol use appear to have increased amongst some of the most vulnerable sections of the population in recent years, this seems more important than ever.