powerful. The annual cost of mental health problems to the UK economy is a staggering £ 117.9 billion – equivalent to 5 % of its annual GDP – with substance misuse adding a further £ 20 billion.
However, these figures tell only part of the tale. While we know that 70 % of people in treatment for drug misuse and 86 % of people in treatment for alcohol misuse have a mental health diagnosis, the full financial impact of people with these co-occurring disorders is probably far greater.
This also includes people who often plough through a punitive and bewildering series of services as they navigate their intersecting problems, encountering barriers at every turn that fail to address their acute health and social care needs. As their distress is amplified, the costs to wider society escalate too – as one social worker explained to me:
I am currently supporting a woman who is struggling with alcohol dependency, a condition that began after she endured significant domestic abuse. The cycle is devastating: her trauma cannot be effectively addressed because of her dependency on alcohol, and she cannot abandon alcohol because it’ s the only solace she finds from her emotional torment. Despite several attempts at rehabilitation, none of the programmes have sufficiently tackled the mental health aspects of her trauma. Now, with cirrhosis of the liver, her health is in critical decline. It’ s a heart-wrenching situation – a stark reminder of the desperate need for integrated treatment approaches that address both substance dependency and the underlying psychological trauma.
‘ I might as well be dead’ In the quiet confines of a West Midlands mental health crisis centre, I’ m preparing to meet someone whose story I know only from the clinical notes on my screen. The phrase“ is alcohol dependent” is highlighted in bold. Behind those words is another person whose life is unravelling in the silence of a battle fought alone.
John walks into the room, a man living in the grip of two relentless forces – addiction and mental illness.“ It was just to stop the noises,” he says of the whisky he uses as medication for his inner turmoil. His hands are trembling. This is the moment of truth – his story is no longer trapped within the clinical pages of a case file.
“ I’ ve lost everything,” he tells me.“ I might as well be dead.” Then John explains why he’ s given up hope: I’ ve asked for help so many times, but all I get told is that I need to stop drinking before my mental health can be treated. However, alcohol is the only thing that works for me. I’ ve gone through detox, but then I had to wait months for counselling. I just can’ t cope that long without any support – antidepressants don’ t do anything for me. What’ s the point?
Over the past 15 years, I have met countless“ Johns”, both during my day job as a mental health social worker and, latterly, in my academic research. This has led me to conclude that the health and social care system in which I work falls catastrophically short.
This is no mere professional critique. It is an impassioned plea for society to rediscover its collective heart; to explore the human stories that lie hidden in statistics such as that, between 2009 and 2019, 53 % of UK suicides were among people with comorbid diagnoses of mental health and substance use.
Instead of viewing people through the limiting lens of labels, we should endeavour to see their humanity. Engaging in conversation, extending empathy and showing compassion are powerful actions. A kind word, an understanding nod or a gesture of support can affirm their dignity and spark a connection that resonates with their innate human spirit. Or as John, whose journey I’ ve had the privilege to witness, puts it:
It’ s not about the help offered but the meaning behind it. Knowing you’ re seen as a person, not just a problem to be solved – that’ s what sticks with you.
* All names in this article have been changed to protect the anonymity of the interviewees.
While we know that 70 % of people in treatment for drug misuse and 86 % of people in treatment for alcohol misuse have a mental health diagnosis, the full financial impact of people with these co-occurring disorders is probably far greater.
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