A lack of research and education, and conflicting policies and working practices between agencies, are obstacles to effective care of young people with this dual diagnosis. Child and adolescent mental health services aspire to an integrated, comprehensive approach to care provision and delivery, and to ensuring that help is also offered to the children of adult clients who have mental health and substance misuse problems. Early, robust intervention can be effective in the long term, preventing these young people becoming the adult clients of the future.