Individuals with co-occurring mental health and substance use disorders present considerations often requiring interventions from multiple services. This paper describes the development and implementation of an integrated service pathway, emphasising collaborative processes and inter-professional relationships. The model, implemented in partnership between an NHS Talking Therapies service and a local substance use service, aimed to improve care coordination and service delivery for adults with co-occurring disorders. This paper provides a description of the pathway, outlining the challenges that prompted its development, the processes involved in its establishment, the roles and responsibilities of professionals, and the mechanisms for ensuring continuity of care. A small service evaluation, employing a mixed-methods approach, examined the outcomes of nine patients who engaged with the one-to-one integrated pathway within the first 10 months of its inception. The implementation of the model resulted in enhanced inter-service collaboration, with improved communication protocols and a shared understanding of service user needs. Clinicians reported that the reciprocal consultative approach facilitated knowledge exchange and skill development across teams. Initial outcome data from a small sample suggests positive trends in patient wellbeing and substance use, with seven of nine patients discharged in recovery. This model, characterised by a reciprocal consultation approach and an emphasis on inter-professional collaboration, demonstrates potential to improve the care for co-occurring mental health and substance use disorders. While the patient outcome data are limited by the small sample size, the findings offer insights for service re-design and future research.

Key learning aims

1. (1) To gain a clearer understanding of the development and implementation of an integrated care model for co-occurring mental health and substance use disorders.

2. (2) To recognise the impact of collaborative approaches on the professionals involved, including influences in communication protocols, knowledge exchange, and skill development across teams.

3. (3) To learn about the initial outcomes of the integrated care pathway and to recognise the potential for improving care in patients with co-occurring disorders.

Demand for student mental health services is growing, as is the complexity of presentations to university student wellbeing services. There is a need for innovative service delivery models to prevent students falling in the gaps of existing provision, where outcomes from traditional talking therapies services have been shown to be poorer for students than non-student peers. In 2018, Newcastle University established a pilot in-house cognitive behavioural therapy (CBT) service to provide high-intensity CBT for students at the university, harnessing the expertise of qualified and training staff from the psychological professions. This subsequently expanded into the Psychological Therapies Training and Research Clinic, appointing additional clinical staff. Here we present the journey of the clinic, from inception to implementation and expansion. We also present a descriptive evaluation of the first three years of operation, reporting on clinical activity, clinical outcomes and client experiences of the service. Data are presented from 605 referrals. Over 70% of referrals were assessed and over 60% transitioned into treatment. The treatment completion rate was 50%, with an overall recovery rate of 47.3% [using the same definition of recovery as NHS Talking Therapies for Anxiety and Depression (NHS TTAD)]. Satisfaction, measured by the Patient Evaluation Questionnaire, was high. These outcomes are commensurate or better than seen in NHS TTAD services for students and young adults. Overall, the clinic has been a successful addition to the wellbeing offer of the university and has provided a number of positive further opportunities for both research and the clinical training programmes.

The development of Specialist Perinatal Mental Health Services in Ireland in recent years (2018–2021) is described. The paper highlights the role of unexpected opportunity in advancing this much needed service for women, infants and their families. It also emphasises the need for funding combined with an implementation mechanism to ensure that the service emerging is true to the Model of Care designed and is available in a uniform manner to women nationally.