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The North of England characteristically has higher levels of alcohol‐related harm and higher levels of mental illness compared with the South. The purpose of this paper is to present observations on the use of services by people who have both alcohol and mental health problems to explore the equality and economic impact of services.

Inpatient hospital datasets as well as other NHS service datasets were examined to gather intelligence on alcohol and co‐occurring mental and behavioural disorders.

The study finds that there are high levels of dual diagnosis (DD) of alcohol and mental health in the North West with significantly higher rates in the more socially deprived areas and gap in access to services.

These health inequalities in relation to DD can only be demonstrated robustly for hospital inpatient admissions because other datasets currently provide intelligence only at larger geographies – such as Primary Care Trust – or by service provider.

Population surveys are useful to generate estimates of the prevalence of mental health issues in alcohol users which then reveal that there are greater inequalities in access to services in more deprived populations. Such valuable intelligence should be generated at the local level so that the most appropriate and the most cost effective services can be commissioned for the local population.

This is the first time that the economic cost of DD in the various services has been estimated.

The 10 Essential Shared Capabilities (ESC) are a description of the core aspects of practice that support effective implementation and delivery of mental health care. The ESC have been derived directly from work with users, carers and mental health personnel. To support their introduction a learning pack was developed giving examples of the 10 ESC as they relate to current practice.A pilot programme across England was developed to test the acceptability and potential utility of these materials and this paper reports on the evaluation of that pilot programme. Facilitators (n=75) and learners (n=579) were asked to rate each of the seven modules contained in the learning pack. A number of recommendations have been made to improve the materials that are being acted upon.

Approximately 90% of prisoners experience mental health problems, substance misuse problems or both. However, prison reception screening tools are not always effective in enabling staff to identify mentally disordered prisoners. Therefore, to ensure that these individuals get access to appropriate care, custodial staff should be trained in recognising the signs and symptoms of mental health disorders, and in effectively working with these individuals. This paper charts the pilot implementation of a mental health awareness workbook designed for use in custodial settings across England. It examines the variety of approaches adopted to implement the workbook, staff views on the usefulness of the workbook, and barriers to implementation encountered in each area. Recommendations made for best practice in delivering the workbook in other areas suggest a need for changes to its format, but also that time should be ring‐fenced for staff to participate in this training, in groups led by experts such as in‐reach team members.

The aim of the paper is to assess the commissioning systems in place for the commissioning of local dual diagnosis interventions and to make recommendations for the establishment of innovative practice beacon sites. This involves focussing on five areas in the North West: Cumbria, Warrington, Manchester, Lancashire and Bolton.

A diagnostic process was undertaken to determine the characteristics of each area via the filling in of diagnostic tools by local commissioners; interviews; and a consultation event.

The review found that despite the lack of updated policy and guidance around the commissioning of dual diagnosis interventions, there are good examples of innovative practice in the North West. However, it must be noted that these interventions have not been the subject of formal evaluation and this is a recommendation of this review.

This is the first review of its kind into the commissioning of dual diagnosis in this region with the added legacy value of the establishment of the beacon sites, designed to develop and disseminate examples of innovative practice in commissioning dual diagnosis interventions.

The purpose of this paper is to obtain an insight into how mental health and alcohol services are responding to people presenting with alcohol and mental health problems, as a part of a wider North West Alcohol and Mental Health Project commissioned by Drink Wise North West and Alcohol Improvement Programme (Department of Health).

An electronic survey was sent to managers and clinical leads in mental health and alcohol services across the North West region of England.

The paper found a variation in definitions of dual diagnosis and that not all areas had a strategy in place. NHS mental health and alcohol services seemed to offer a wider range of treatment options; but, this reflects the more complex nature of the service users. Workforce issues were identified as an important issue. Barriers to accessing effective care included lack of agreements between local agencies, and solutions included greater partnership working.

This was a small sample of respondents, accessed opportunistically and, therefore, unlikely to be a true representation of all services in the North West of England.

Whilst limited in scope, this survey highlights that even after ten years of service development related to alcohol and mental health, there are still significant barriers to effective care and that more workforce development and multi‐agency collaboration is required.

The purpose of this paper is to assess the health needs of detainees in police custody in Northumbria, England, and to identify any gaps in, or possible improvements to, the current model of healthcare provision.

The current model of service provision was investigated using a combination of existing literature, and interviews with key members of staff. In addition, researchers examined the custody records of a stratified random sample of 1,917 records from 2010 and 2011. Data were collected from the risk assessments completed by Custody Sergeants, and any associated records of medical assessments by Forensic Medical Examiners (FME).

Detainees experience a wide range of health problems. Delivery of healthcare in custody could be improved through increasing the skill‐mix in this setting, computerising FME records and improving communication between agencies.

The police did not always record the reason why a forensic medical examiner was called out, thus this aspect of data collection was limited.

This health needs assessment will help to determine the way in which resources for health care in custody, currently held by the police, are reallocated once the funding transfers to the NHS in the near future.

This paper seeks to outline the nature of early intervention (EI) services in psychosis and to discuss substance use in clients in this setting. It considers ways of working with EI clients where substance use is an issue.

The paper begins by outlining the nature of EI services and early psychosis, then goes on to discuss the impact and management of substance use in this setting.

The authors argue that the El approach may be very appropriate for this subset of clients.

This paper focuses on the issues of treatment of dual diagnosis within a specialised area of mental service provision. EI services for psychosis aim to provide early detection and treatment of psychosis, particularly through increased emphasis on psychosocial interventions.