["Health Expectations, Volume 29, Issue 4, August 2026. ", "\nABSTRACT\n\nBackground\nCo‐occurring mental health and substance use disorders remain a major challenge for treatment and recovery in low‐resource settings where services are often fragmented. People with these conditions usually receive care in systems with limited coordination, financial barriers and stigma. Our study explored the treatment experiences of individuals with co‐occurring disorders and the perspectives of mental health workers.\n\n\nMethods\nA qualitative exploratory design was used to examine the treatment experiences of service users with co‐occurring mental health and substance use disorders and the perspectives of mental health workers. Guided by an interpretivist approach and reflexive thematic analysis, 24 service users and 10 mental health workers were purposively selected. Data were collected through semi‐structured interviews between December 2025 and March 2026, audio‐recorded, transcribed verbatim and analysed using NVivo 12. The study adhered to the COREQ: a 32‐item checklist to ensure rigour, transparency and trustworthiness.\n\n\nResults\nFive interconnected themes emerged: fragmented and unstable treatment pathways, hidden economic burden of care and relapse cycles, stigma and social withdrawal, emotional exhaustion and psychological distress and health system constraints with gaps in community follow‐up. Participants described care as discontinuous, characterised by repeated cycles of relapse and re‐engagement, financial hardship and weak coordination between services. Stigma at family and community levels discouraged timely help‐seeking. Mental health workers highlighted systemic constraints, including inadequate staffing, transport challenges and inconsistent outreach services. There was strong agreement between service users' experiences and health workers' accounts of system‐level challenges.\n\n\nConclusion\nTreatment experiences are shaped by interacting social, economic and health system factors that disrupt continuity of care. Strengthening integrated, person‐centred mental health and substance use services, alongside improved community follow‐up and psychosocial support, is essential to improving outcomes in similar low‐resource settings.\n\n\nPatient or Public Contribution\nService users with lived experience of co‐occurring mental health and substance use disorders participated in this study and contributed to the development of interview topics by sharing priority areas of concern during data collection. Their perspectives informed the interpretation of findings alongside mental health workers. There was no formal involvement of patients or the public in study design or manuscript preparation.\n"]