We are concerned that a high proportion of people with alcohol dependency are not in treatment and that there are unnecessary barriers to people in need of treatment. Treatment services for alcohol dependency are commissioned by local authorities. They show success rates of around 60% and they deliver an estimated £3 benefit immediately for every £1 invested, and potentially far more in the longer- term. Treatment is also accessible as 98% of peopled referred to alcohol treatment services start treatment within 3 weeks. Yet 82% of dependent drinkers in England are not in treatment. The earlier people get into treatment the better, but too many people are falling through the gaps. Only 23% of people who are referred to treatment for alcohol come from health services. We heard that one of the biggest challenges is that people may not accept they have a problem in the first place as heavy drinking is normalised and public awareness of the associated harms is low. It is not only the drinkers themselves — we also heard that the healthcare workers assessing them often fail to spot early signs of problem drinking. Where people do recognise it, stigma around dependency and a reluctance to receive treatment alongside drug users can prevent them from accessing services. Given the well- established relationship between substance misuse and mental ill health, we were concerned to hear that some people are denied access to mental health services because of their alcohol dependency (and vice versa). Approximately 70% of people entering treatment for alcohol dependency also experience problems with their mental health. Alcohol treatment services 7 Recommendation 4: The Department should set out: • how it is working with local authorities to address the barriers to people with alcohol dependency from getting the treatment they need; and • what it is doing to help improve integrated care for people with co-occurring alcohol and mental health problems and to ensure that they receive