ABSTRACT
This chapter highlights key issues for the person experiencing co-existing mental health and substance misuse issues. It focuses on the evidence base about this subject, alongside the views of a service user who has experienced co-existing mental health and substance misuse issues. The chapter explores some of the main approaches and processes involved in facilitating natural change behaviour in mental health nursing practice for people with mental health issues who misuse substances, including practical examples of screening and assessment tools. Mental health services in the United Kingdom have been mandated to follow a categorization system which places people in clusters of mental health distress, including specific clusters for ‘psychosis and affective disorder’ and ‘psychosis and affective disorder – difficult to engage’. A cluster is a global description of a group of people with similar characteristics, as identified from a holistic assessment and rated using the Mental Health Clustering Tool.
