Prof Liz Hughes introduces the RECO study on co-occurring mental health and substance use

People who experience problems with both severe mental illness and substance use face poorer outcomes than those with single needs. Substance use has been a key risk factor in suicide and homicides by people with mental illness, and they often experience poor social outcomes such as homelessness, contact with criminal justice system and unemployment. Providing effective treatment for this group is challenging in a system where substance use and mental health services are not well integrated. This is compounded by a lack of skills and confidence in both the substance use and mental health workforce to provide comprehensive and integrated care plans.

The RECO study was commissioned by the NIHR Health Technology Assessment funding stream to provide evidence of what works and in what circumstances for people with severe mental illness and substance use, in order to provide evidence of how care should be provided. The research team are a group of national and international experts on substance use and mental health, clinical academics and realist methodologists from Glasgow Caledonian, Liverpool John Moores University, Kings College, London, University of Birmingham, South London and Maudsley NHS Trust and Avon and Wiltshire Partnership NHS Trust.The RECO study was a 2 year programme of work comprising of a realist synthesis of the literature, mapping of service models in the UK, and a case study evaluation involving 6 sites (5 English and 1 from Northern Ireland) in order to generate theories about how services can best provide care to this group.