The Case for Integrated Support in Wales

As Wales welcomes a new government, there is an opportunity to rethink how support is delivered for people experiencing co-occurring mental health and substance use issues. 

Despite growing recognition of the relationship between mental health and substance use, services are still too often commissioned and delivered separately. For many people, this creates fragmented pathways into support and unnecessary barriers at the point help is needed most. 

At Adferiad, we believe integrating mental health and substance use services must become a core priority of the new Welsh Government. 

A system that does not reflect people’s lives 

Across Wales, people with co-occurring needs are frequently advised that one issue must be addressed before another can be treated. In practice, this can mean that someone is told their substance use must stabilise before accessing mental health support, while another service may consider their mental health needs masked by their substance use. 

This approach fails to reflect the reality of co-occurring needs and can lead to delayed intervention, repeated assessments and duplication, poor continuity of care, escalation to crisis, and disengagement from support altogether.  

These challenges are often intensified for people experiencing homelessness, trauma, inequalities, or contact with the criminal justice system. 

While the previous Welsh Government made important commitments around prevention and person-centred care though legislation such as the Social Services and Well-being (Wales) Act 2014 and the Well-being of Future Generations (Wales) Act 2015, integration between mental health and substance use services remains inconsistent and fragmented. 

Why integration matters 

Mental health and substance use challenges rarely exist in isolation. They are often shaped by wider social factors or even one another. 

Integrated support is, therefore, not simply about improving communication between services. More importantly, it is about designing systems around how people actually experience challenges and needs. 

A more joined-up approach can improve access to support, reduce duplication across systems, support earlier intervention, improve long-term recovery outcomes, and reduce avoidable pressure on emergency and acute services. 

Significantly, integration also supports more effective use of public resources at a time of increasing demand across health and social care.

What Adferiad is calling for 

As part of our priorities for the new Welsh Government, we are calling for a coordinated national approach to integrated mental health and substance use support. 

Services that work together 

People experiencing co-occurring needs should receive joined-up support through a single pathway, integrated care planning, and multi-disciplinary approaches across mental health and substance use services. 

No one should be left out from support because their needs cross traditional service boundaries. 

Simplified and streamlined pathways 

Current systems can be difficult to navigate, particularly during periods of instability or crisis. 

We are calling for: 

• Simple referral pathways 

• Reduced duplication in assessments and processes 

• Clear access across services 

• Better continuity between providers and sectors 

People should not need to navigate multiple disconnected systems to access support. 

A community hub and “no wrong door” approach 

Support should be accessible, community-based, and focused on prevention and early intervention.  

We are campaigning for stronger community hub models across Wales that bring together multi-disciplinary teams through a “no wrong door” approach, making sure that people are connected to the right support whenever they seek help. 

Moving from commitment to co-ordination 

There is growing consensus that co-occurring needs require co-ordinated responses. However, genuine integration requires more than strategic ambition alone. 

Implementation requires sustained investment, shared accountability, stronger partnership working, and the meaningful inclusion of lived experience in policy and service design. 

We will continue to advocate for services that are integrated, person-centred, and built around the realities of people’s lives. 

Click here to learn more about our campaign.