PurposeThe purpose of this paper is to obtain an insight into how mental health and alcohol services are responding to people presenting with alcohol and mental health problems, as a part of a wider North West Alcohol and Mental Health Project commissioned by Drink Wise North West and Alcohol Improvement Programme (Department of Health).Design/methodology/approachAn electronic survey was sent to managers and clinical leads in mental health and alcohol services across the North West region of England.FindingsThe paper found a variation in definitions of dual diagnosis and that not all areas had a strategy in place. NHS mental health and alcohol services seemed to offer a wider range of treatment options; but, this reflects the more complex nature of the service users. Workforce issues were identified as an important issue. Barriers to accessing effective care included lack of agreements between local agencies, and solutions included greater partnership working.Research limitations/implicationsThis was a small sample of respondents, accessed opportunistically and, therefore, unlikely to be a true representation of all services in the North West of England.Originality/valueWhilst limited in scope, this survey highlights that even after ten years of service development related to alcohol and mental health, there are still significant barriers to effective care and that more workforce development and multi‐agency collaboration is required.