Layered Care

Twenty years of policy has told services to integrate care for people with co-existing mental health and substance use needs. Twenty years of "no wrong door" commitments. And yet, in 2026, substance use is still being used as a gatekeeping criterion to refuse mental health support. Why? In Episode 1, I told the story of Jayne — a woman in prison who was discharged from both mental health...

Pain comes before everything. Before the substance use. Before the diagnosis. Before the referral. In this first episode, Simon Bratt —social worker, senior lecturer and researcher — introduces co-emergence: a way of understanding why mental distress and substance use cannot be pulled apart, and why our systems keep trying. Through three lives that fell through the cracks, we see what happens when...

What happens when mental health and substance use collide? Too often, people fall through the cracks. Hosted by frontline social worker and researcher Simon Bratt, this podcast digs into stories from prisons, streets, and crisis services — exposing why the system fails, and how we can build care that bends to people, not the other way around.

In this short trailer, you’ll hear what Layered Care is all about — and why it matters. It sets the tone for a podcast grounded in pain, survival, and systems that too often fail to care. This is where the story begins.