Staff often overlook substance misuse, which can be detrimental to treatment outcomes. Chris Sheret and colleagues present a simple instrument for staff to use in collaboration with clients

An assertive outreach team has developed and introduced a monitoring tool to improve identification of substance use in service users with serious mental health problems. The tool enables staff to record the extent of dependence, associated mental and physical health problems, social difficulties, risky behaviours and motivation for change. Feedback on the tool from staff and clients has been positive. Screening for substance use and its consequences should be part of routine practice and requires adequate training and updating for staff.