In this paper the authors discuss recent research in Victoria exploring the dimensions of co-occurring serious I psychiatric disorder and problematic drug or alcohol use. A mutt-method approach was adopted in the light of I the absence of any previous local studies. The findings highlighted the critical lack of service and care for this most severely disadvantaged group. Of particular importance is the evidence of conflicting conceptualisations of the problem amongst service providers in different health and welfare sectors and the impact of administrative divisions which serve to exacerbate the difficulties of people with these dual problems. The evidence from the research points to a need to develop a common philosophical outlook amongst service providers. It is argued that the social policy of "harm minimisation" may, if developed within the mental heafth domain, provide a crucial first step in addressing the urgent and critical needs for services and management strategies for people with these dual problems.PAUL is in his mid-forties and has professional qualifications. Presently he is free-lancing as he has difficulties working with people. He has been married and has a daughter with whom he has regular contact. He describes himself as having paranoid schizophrenia. He uses alcohol when he is psychotic. Paul does not distinguish between prescribed and non-prescribed drugs because he believes that people use them both for the same thing. He uses alcohol when hearing attacking voices because he states that the alcohol diminishes the voices or makes them kind.SIMON is 30 and has only recently been diagnosed as having chronic schizophrenia. His main concern at present is dealing with his dependency to an over-the-counter medication. Recently he has been in a therapeutic community but although he describes it as 'really good' he was expelled. He also uses marijuana because it is enjoyable and heightens his perceptions: he becomes 'spiritually aware'. His main reasons for using drugs are to remove emotional difficulties, to give himself pleasure, as an escape, because they make him more creative, or to enhance his imagination and spirituality. • JAMES is in his early 20s and is receiving help and support from workers at an outreach service. He has been using drugs (glue sniffing and alcohol) since he was about 14 years of age. He attended a private school and later a community school. At 19 he was hospitalised for alcoholism and mental illness. He is unable to work and unable to stop drinking. When he has been drinking he becomes angry and violent.