Background: Participating in working life is important for most peoples’ economy, self-confidence, independence, social life, and feeling of belonging. Persons with co-occurring severe mental health difficulties and substance use problems have challenges in entering working life. Objective: The aim of the study was to explore the importance of work and activity for the recovery of persons with co-occurring severe mental health difficulties and substance use problems and to determine the significant elements that aid them in getting into work and/or meaningful activities. Methods: A professional development program was conducted to explore how following-up on these persons could lead to participation in working life. The data were collected through qualitative interviews with 24 participants, and with 25 of those carrying out the follow-up. Results: The participants described the benefit from the follow-up as well. They expressed enthusiasm for work and vocational training, although they all did not obtain work. Many had a better life, with more daily structure and less substance abuse. The personal encounter between the helper and the participant was ascribed crucial importance— being respected and valued, being relied on, and being able to be honest were considered significant. Conclusions: The participants valued work and regular activities, a more structured life, decreased drug abuse, and altogether a better life. The helpers’ respect, recognition and their ability to see dignity through wretchedness and broken agreements were important. The participants emphasized the importance of getting help for different problems from different helpers at the same time, and the providers’ interdisciplinary collaboration in teams was essential. It seems that the supported employment philosophy on speedy job seeking ought to be adapted to this target group and that prior social training may be necessary.