ABSTRACT
In the United Kingdom, there is broad recognition of the increase in the number of mentally ill patients who misuse psychoactive substances. Alcohol and drug problems are associated with depression, anxiety disorders, schizophrenia and personality disorders amongst other conditions. The combination of substance misuse and mental health problems is associated with a host of serious social, behavioural, psychological and physical problems, resulting in increased demands on mainstream services. Dual diagnosis has gained prominence partly as a result of the closures of long-stay psychiatric institutions, increasing emphasis on care and treatment in the community and the increasing prevalence of alcohol and drug misuse amongst the general population (Rassool 2006). The easy access of psychoactive substances has drawn those individuals with mental health problems into the drug subculture. Some individuals may selfmedicate in an effort to treat their psychiatric symptoms, to counteract the effects of their prescribed medications or to alleviate distressing symptoms from chronic illness. It is stated that, with dual diagnosis patients, the psychiatric disorders and the substance misuse are separate, chronic disorders, each with an independent course, yet each able to influence the properties of each other (Carey 1989).
