This paper reviews issues in the provision of services to individuals who are mentally ill chemical abusers and addicted (MICAA). Introductory material defines this population and notes that these people are frequently ineligible for services aimed at either mental illness or chemical abuse alone. Service provisions within the psychiatric/mental health care system are briefly described. Topics discussed include: implementing alcohol/substance abuse programs in the psychiatric care system for MICAA's; content of treatment; special problems when mental health staff are not substance abuse experts; the training of mental health professionals in substance abuse concepts; working with families, friends, and advocates of MICAA patients; services not provided by mental health agencies (e.g., drug and alcohol detoxification and rehabilitation); and continuity of care. Specifically mentioned are programs under the leadership of the New York State Office of Mental Health, including five training sites. (Contains 19 references.) (DB)