Mental health nursing: supporting people with co-occurring needs
New guidance for nursing staff, Co-occurring mental health and substance use delivery framework, aims to improve the care and services offered to those with concurrent substance use and mental health disorders
New guidance for nursing staff is intended to improve the care and services offered to those with concurrent substance use and mental health disorders
Up to half of people accessing mental health services experience mental health disorders and substance use and almost three quarters of people starting drug and alcohol treatment experience mental ill health.
‘People should receive the care they need when, where and from whom they need it’
Lack of timely and appropriate support risks creating gaps in services, poorer outcomes, increased crisis presentations and premature deaths.
The latest Department of Health and Social Care (DHSC) and NHS England (NHSE) guidance, Co-occurring mental health and substance use delivery framework, is intended to improve the care and services offered to those with concurrent substance use and mental health disorders. At its core it champions the ‘no wrong door’ approach, meaning that people should receive the care they need when, where and from whom they need it.
This new guidance is important for nurses and other healthcare professionals because it standardises the approach to service delivery, offers professional development and prioritises person-centred care.
Joint responsibility to work together and support people with co-occuring needs
One new national action described in the guidance is the introduction of statutory duty to co-operate. It states that DHSC and NHSE will issue guidance, standards and practice tools to improve joint working, strengthen oversight by the Care Quality Commission regulator and promote person-centred care.
The delivery framework emphasises that it is ‘everyone’s job’ - a joint responsibility to support those with co-occurring needs by working together - and that there should be ‘seamless’ multi-agency partnerships.
Key messages in the guidance for the mental health and substance use workforce include:
- Considering co-occurring needs as the ‘norm’ not the exception.
- Not excluding individuals from services because of their mental ill health or substance use.
- Providing integrated, person-centred support concurrently, not treating issues sequentially.
- Recognising trauma as a common factor.
- Collaborating through shared communication and care planning.
- Recognising suicide risk is significantly higher in those with co-occurring needs.
- Challenging stigma and using non-judgemental language.
Further information
- Department of Health and Social Care, NHS England (2025) Co-occurring mental health and substance use delivery framework
- GOV.UK (2025) Adult substance misuse treatment statistics 2024 to 2025: report
- Royal College of Psychiatrists (2025) Co-occurring substance use and mental health disorders (CoSUM)
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