Dr Simon Bratt (PhD) 💭
@simonbrattcems.bsky.social
PhD Researcher, mental health social worker, AMHP, reforming fragmented systems for people with co-existing mental health and substance use needs, with a dash of realism—and a bit of humour http://time-to-listen.com #policyreform
Layered Care – Episode 1: Welcome
From a 6am doorway on the streets to the prison wing where I first met “Jayne,” this episode asks what happens when #MentalHealth and #SubstanceUse collide.
#Podcast #LayeredCare #Addiction #SocialWork
open.spotify.com/episode/0eh6...
From a 6am doorway on the streets to the prison wing where I first met “Jayne,” this episode asks what happens when #MentalHealth and #SubstanceUse collide.
#Podcast #LayeredCare #Addiction #SocialWork
open.spotify.com/episode/0eh6...
Through the Cracks
Layered Care · Episode
open.spotify.com
August 16, 2025 at 2:50 PM
Layered Care – Episode 1: Welcome
From a 6am doorway on the streets to the prison wing where I first met “Jayne,” this episode asks what happens when #MentalHealth and #SubstanceUse collide.
#Podcast #LayeredCare #Addiction #SocialWork
open.spotify.com/episode/0eh6...
From a 6am doorway on the streets to the prison wing where I first met “Jayne,” this episode asks what happens when #MentalHealth and #SubstanceUse collide.
#Podcast #LayeredCare #Addiction #SocialWork
open.spotify.com/episode/0eh6...
🧠📄 New paper just published in Discover Public Health:
“Structural and cultural barriers to integrated care for co-existing mental health and substance use”
Read 👉 link.springer.com/article/10.1...
#CEMS #MentalHealth #Addiction #SocialWork #IntegratedCare
“Structural and cultural barriers to integrated care for co-existing mental health and substance use”
Read 👉 link.springer.com/article/10.1...
#CEMS #MentalHealth #Addiction #SocialWork #IntegratedCare
Structural and cultural barriers to integrated care for co-existing mental health and substance use: a morphogenetic analysis - Discover Public Health
Co-existing mental health and substance use challenges (CEMS) remain a critical barrier to integrated care due to systemic fragmentation, rigid eligibility criteria, and risk-averse service cultures. ...
link.springer.com
June 21, 2025 at 2:22 PM
🧠📄 New paper just published in Discover Public Health:
“Structural and cultural barriers to integrated care for co-existing mental health and substance use”
Read 👉 link.springer.com/article/10.1...
#CEMS #MentalHealth #Addiction #SocialWork #IntegratedCare
“Structural and cultural barriers to integrated care for co-existing mental health and substance use”
Read 👉 link.springer.com/article/10.1...
#CEMS #MentalHealth #Addiction #SocialWork #IntegratedCare
🧵After 20 years in social care and health, I’m writing about the quiet force that shapes who we help—and who we leave behind.
I call it: helpability.
painfirstdrugslater.substack.com/publish/post...
#MentalHealth #AddictionServices #SocialCare
I call it: helpability.
painfirstdrugslater.substack.com/publish/post...
#MentalHealth #AddictionServices #SocialCare
Sign in to [email protected]
painfirstdrugslater.substack.com
May 1, 2025 at 8:11 AM
🧵After 20 years in social care and health, I’m writing about the quiet force that shapes who we help—and who we leave behind.
I call it: helpability.
painfirstdrugslater.substack.com/publish/post...
#MentalHealth #AddictionServices #SocialCare
I call it: helpability.
painfirstdrugslater.substack.com/publish/post...
#MentalHealth #AddictionServices #SocialCare
Stigma kills.
My latest Substack explores how services judge, exclude, and moralise those in pain:
“Stigma Kills: How Care Systems Decide Who Deserves Help”
painfirstdrugslater.substack.com/p/stigma-kil...
#Addiction #MentalHealth #CEMS #Stigma #HarmReduction
My latest Substack explores how services judge, exclude, and moralise those in pain:
“Stigma Kills: How Care Systems Decide Who Deserves Help”
painfirstdrugslater.substack.com/p/stigma-kil...
#Addiction #MentalHealth #CEMS #Stigma #HarmReduction
🩸 Stigma Kills: How Care Systems Decide Who Deserves to Live
What if stigma wasn’t a feeling—but a function? A structural logic that decides who gets care, and who gets left to die?
painfirstdrugslater.substack.com
April 23, 2025 at 8:30 PM
Stigma kills.
My latest Substack explores how services judge, exclude, and moralise those in pain:
“Stigma Kills: How Care Systems Decide Who Deserves Help”
painfirstdrugslater.substack.com/p/stigma-kil...
#Addiction #MentalHealth #CEMS #Stigma #HarmReduction
My latest Substack explores how services judge, exclude, and moralise those in pain:
“Stigma Kills: How Care Systems Decide Who Deserves Help”
painfirstdrugslater.substack.com/p/stigma-kil...
#Addiction #MentalHealth #CEMS #Stigma #HarmReduction
Mental health & homelessness are deeply intertwined. People adapt to the chaos of the streets—but when they finally get housed, the silence can be unbearable.
time-to-listen.com/2025/02/15/m...
#Homelessness #MentalHealth
time-to-listen.com/2025/02/15/m...
#Homelessness #MentalHealth
Mental Health and Homelessness: A Complex Interplay of Trauma, Survival, and Systemic Failures
The relationship between mental health and homelessness is as intricate as it is urgent. Homelessness is often associated with a range of mental health symptoms—primarily anxiety and depression—but…
time-to-listen.com
February 15, 2025 at 10:16 PM
Mental health & homelessness are deeply intertwined. People adapt to the chaos of the streets—but when they finally get housed, the silence can be unbearable.
time-to-listen.com/2025/02/15/m...
#Homelessness #MentalHealth
time-to-listen.com/2025/02/15/m...
#Homelessness #MentalHealth
Pain comes first. The drug comes next. Always. If we want to address addiction, we need to treat the pain—especially the psychological pain—first. #Addiction #MentalHealth #Trauma #HarmReduction #EndStigma”
February 10, 2025 at 6:13 PM
Pain comes first. The drug comes next. Always. If we want to address addiction, we need to treat the pain—especially the psychological pain—first. #Addiction #MentalHealth #Trauma #HarmReduction #EndStigma”
Addiction isn’t just about the drug. It’s about where you are. Who you are. What you have to fall back on when the high is gone.
February 6, 2025 at 4:21 PM
Addiction isn’t just about the drug. It’s about where you are. Who you are. What you have to fall back on when the high is gone.
We’ve been discussing this for over 22 years, yet stigma and discrimination against people who use alcohol or other substances persist. This must change! #EndStigma #AddictionAwareness #Equality
A man walks into crisis care, intoxicated. He’s dismissed as “just drunk,” his pleas for help ignored. Treated as less worthy because he drinks, no one sees the trauma he’s endured or that alcohol is his way of coping. #MentalHealth #Trauma #AddictionStigma
January 17, 2025 at 7:44 PM
We’ve been discussing this for over 22 years, yet stigma and discrimination against people who use alcohol or other substances persist. This must change! #EndStigma #AddictionAwareness #Equality
Trust the @dailymail.co.uk to use stigmatising language that further alienates an already vulnerable group of people. This is exactly why I avoid that paper! www.dailymail.co.uk/news/article...
Taxpayers foot the bill to ferry addicts to inject free heroin
Thousands of pounds of taxpayers' money has been spent on hiring taxis to take drug addicts to an NHS clinic to be injected with 'free' heroin.
www.dailymail.co.uk
January 7, 2025 at 7:42 AM
Trust the @dailymail.co.uk to use stigmatising language that further alienates an already vulnerable group of people. This is exactly why I avoid that paper! www.dailymail.co.uk/news/article...
🎄 Merry Christmas! 🎄 This season reminds me of the importance of integration—not just in co-existing mental health & substance use care but in our communities too. Here’s to fostering connection, compassion, and change. Wishing you all a joyful holiday and a hopeful New Year!
December 24, 2024 at 8:04 PM
🎄 Merry Christmas! 🎄 This season reminds me of the importance of integration—not just in co-existing mental health & substance use care but in our communities too. Here’s to fostering connection, compassion, and change. Wishing you all a joyful holiday and a hopeful New Year!
Fragmented care systems fail those with mental health & substance use challenges. My research calls for national integration model - a framework that bridges gaps, reduces stigma, & centers lived experiences. #CEMS #IntegratedCare #PolicyReform
December 23, 2024 at 9:27 AM
Fragmented care systems fail those with mental health & substance use challenges. My research calls for national integration model - a framework that bridges gaps, reduces stigma, & centers lived experiences. #CEMS #IntegratedCare #PolicyReform
Over 80% of individuals with co-existing mental health & substance use challenges face barriers accessing care due to stigma or service eligibility rules. This has to change. #CEMS #DignityInCare
December 21, 2024 at 8:08 AM
Over 80% of individuals with co-existing mental health & substance use challenges face barriers accessing care due to stigma or service eligibility rules. This has to change. #CEMS #DignityInCare
Mental health & substance use care systems are broken—fragmented, stigmatising, & ineffective. We need to shift from silos to integrated care. #CEMS #IntegratedCare #PolicyReform
December 20, 2024 at 6:06 AM
Mental health & substance use care systems are broken—fragmented, stigmatising, & ineffective. We need to shift from silos to integrated care. #CEMS #IntegratedCare #PolicyReform
Honoured to be recognised by social work apprentices—it truly means the world to me. This reminder of why I’m passionate about teaching and supporting future social workers is deeply meaningful. Thank you to the cohort—it’s a privilege to witness your potential. #Gratitude #SocialWork
December 16, 2024 at 9:00 PM
Honoured to be recognised by social work apprentices—it truly means the world to me. This reminder of why I’m passionate about teaching and supporting future social workers is deeply meaningful. Thank you to the cohort—it’s a privilege to witness your potential. #Gratitude #SocialWork
Homelessness is not just a housing issue—it’s a symptom of our deeply individualist society. We need more than homes; we need a shift toward a collective mindset that prioritises solidarity, community, and shared responsibility. #Homelessness #SocialChange
www.theguardian.com/society/2024...
www.theguardian.com/society/2024...
Shelter condemns ‘shocking’ 14% rise in homelessness across England
Charity says soaring private rents, rising evictions and lack of affordable social housing are to blame
www.theguardian.com
December 11, 2024 at 9:07 PM
Homelessness is not just a housing issue—it’s a symptom of our deeply individualist society. We need more than homes; we need a shift toward a collective mindset that prioritises solidarity, community, and shared responsibility. #Homelessness #SocialChange
www.theguardian.com/society/2024...
www.theguardian.com/society/2024...
1/4: I love psychiatry, but my faith is being tested. Diagnostic labels like schizophrenia or bipolar disorder are often reassessed and changed to EUPD/BPD. While diagnostic refinement is vital, it can have unintended consequences. 🧵 #MentalHealth #Psychiatry
December 7, 2024 at 9:09 PM
1/4: I love psychiatry, but my faith is being tested. Diagnostic labels like schizophrenia or bipolar disorder are often reassessed and changed to EUPD/BPD. While diagnostic refinement is vital, it can have unintended consequences. 🧵 #MentalHealth #Psychiatry
Shocking stats:
📈 64% rise in alcohol-related liver disease deaths (2006–2023)
📈 4.6% increase in just one year (2022–2023)
Alcohol deaths are spiralling. We need urgent action: prevention, better care, & policy reform.
How do we turn the tide? www.gov.uk/government/s...
#AlcoholAwareness
📈 64% rise in alcohol-related liver disease deaths (2006–2023)
📈 4.6% increase in just one year (2022–2023)
Alcohol deaths are spiralling. We need urgent action: prevention, better care, & policy reform.
How do we turn the tide? www.gov.uk/government/s...
#AlcoholAwareness
Liver disease profile, December 2024 update
www.gov.uk
December 4, 2024 at 4:18 PM
Shocking stats:
📈 64% rise in alcohol-related liver disease deaths (2006–2023)
📈 4.6% increase in just one year (2022–2023)
Alcohol deaths are spiralling. We need urgent action: prevention, better care, & policy reform.
How do we turn the tide? www.gov.uk/government/s...
#AlcoholAwareness
📈 64% rise in alcohol-related liver disease deaths (2006–2023)
📈 4.6% increase in just one year (2022–2023)
Alcohol deaths are spiralling. We need urgent action: prevention, better care, & policy reform.
How do we turn the tide? www.gov.uk/government/s...
#AlcoholAwareness
Addiction is not a choice—it’s a serious mental health condition. Princess Catherine’s words call for compassion and healthcare-led solutions. It’s time to prioritise people’s mental health first—and address addiction as part of the whole. #CEMS
metro-co-uk.cdn.ampproject.org/c/s/metro.co...
metro-co-uk.cdn.ampproject.org/c/s/metro.co...
Kate Middleton speaks out on addiction saying ‘it is not a choice’
'Everyone suffering from addiction is another human being with a story of their own.'
metro-co-uk.cdn.ampproject.org
December 1, 2024 at 9:11 PM
Addiction is not a choice—it’s a serious mental health condition. Princess Catherine’s words call for compassion and healthcare-led solutions. It’s time to prioritise people’s mental health first—and address addiction as part of the whole. #CEMS
metro-co-uk.cdn.ampproject.org/c/s/metro.co...
metro-co-uk.cdn.ampproject.org/c/s/metro.co...
Dive into the world of #MentalHealth, #SubstanceUse, and #PolicyReform with curated insights, top accounts, and resources.
go.bsky.app/7yEba3c
go.bsky.app/7yEba3c
December 1, 2024 at 12:16 PM
Dive into the world of #MentalHealth, #SubstanceUse, and #PolicyReform with curated insights, top accounts, and resources.
go.bsky.app/7yEba3c
go.bsky.app/7yEba3c
Apple’s 2024 Review is out, and let’s face it—it’s basically a tribute to our dogs. 🐾 From muddy paw prints to sofa snuggles, they’ve made this year unforgettable #bestfriends #YearOfOurDogs 🐶
December 1, 2024 at 11:50 AM
Apple’s 2024 Review is out, and let’s face it—it’s basically a tribute to our dogs. 🐾 From muddy paw prints to sofa snuggles, they’ve made this year unforgettable #bestfriends #YearOfOurDogs 🐶
1/ 10 Mental health needs are on the rise. Nearly 1 in 2 young people (48%) in substance misuse treatment also need mental health support. For girls, it’s even higher—65%. Substance use and mental health go hand in hand. #CEMS #MentalHealthMatters
www.gov.uk/government/s...
www.gov.uk/government/s...
Children and young people's substance misuse treatment statistics 2023 to 2024: report
www.gov.uk
November 29, 2024 at 9:37 PM
1/ 10 Mental health needs are on the rise. Nearly 1 in 2 young people (48%) in substance misuse treatment also need mental health support. For girls, it’s even higher—65%. Substance use and mental health go hand in hand. #CEMS #MentalHealthMatters
www.gov.uk/government/s...
www.gov.uk/government/s...
Mental health and substance use are partners in a complex dance, each taking turns to lead in an unpredictable and interdependent rhythm. To support those affected, we must learn to move with both. #MentalHealth #SubstanceUse #IntegratedCare #CEMS
November 28, 2024 at 8:13 AM
Mental health and substance use are partners in a complex dance, each taking turns to lead in an unpredictable and interdependent rhythm. To support those affected, we must learn to move with both. #MentalHealth #SubstanceUse #IntegratedCare #CEMS
The UK’s first major trial giving cash to homeless people is a fascinating initiative that challenges traditional support models. It’s a bold step in addressing poverty and empowering individuals. A study to watch closely!
#Homelessness
amp-theguardian-com.cdn.ampproject.org/c/s/amp.theg...
#Homelessness
amp-theguardian-com.cdn.ampproject.org/c/s/amp.theg...
Homeless people to be given cash in first major UK trial to reduce poverty | Homelessness | The Guardian
amp-theguardian-com.cdn.ampproject.org
November 26, 2024 at 8:30 PM
The UK’s first major trial giving cash to homeless people is a fascinating initiative that challenges traditional support models. It’s a bold step in addressing poverty and empowering individuals. A study to watch closely!
#Homelessness
amp-theguardian-com.cdn.ampproject.org/c/s/amp.theg...
#Homelessness
amp-theguardian-com.cdn.ampproject.org/c/s/amp.theg...