For many years, substance use disorders and mental illness were generally construed as issues that were best treated separately. It was common that patients in psychotherapy for mental health issues, upon revealing significant substance use problems, would be referred out for substance use treatment and told to return when their substance use issues were treated—presumably rendering them “ready” to do the work of psychotherapy. As our understanding of the interconnection between “psychiatric” and “addiction” issues has improved, the treatment system has begun to change. But has that change gone far enough? Here, Dr. Ross Ellenhorn advocates for a broader view of both our understanding and treatment of the inextricable connection between mental health, addiction and the life circumstances into which they are embedded…