This guideline covers assessing and managing people aged 14 years and over with coexisting severe mental illness (psychosis) and substance misuse. It aims to help healthcare professionals guide people with psychosis with coexisting substance misuse to stabilise, reduce or stop their substance misuse, to improve treatment adherence and outcomes, and to enhance their lives.
NICE has also produced a guideline on coexisting severe mental illness and substance misuse: community health and social care services.
This guideline includes recommendations on:
- principles of care
- recognising psychosis with coexisting substance misuse
- primary care
- secondary care mental health services
- substance misuse services
- inpatient mental health services and staffed accommodation
- specific issues for young people with psychosis and coexisting substance misuse
Who is it for?
- Healthcare professionals
- People working in services delivered by the third sector and commissioned by the NHS
- People with psychosis with coexisting substance misuse, and their families and carers
Is this guideline up to date?
We reviewed the evidence in November 2016. We found no new evidence that affects the recommendations in this guideline.
Guideline development process
This guideline was previously called psychosis with substance misuse in over 14s: assessment and management. The name was changed to clarify the population and show how the recommendations in this guideline fit with those made for community health and social care services.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.