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Dáil Éireann debate -
Thursday, 21 Jan 2021

Vol. 1003 No. 4

Health (Amendment) (Dual Diagnosis: No Wrong Door) Bill 2021: First Stage

I move:

That leave be granted to introduce a Bill entitled an Act to provide for the inclusion of services for persons with dual diagnosis in the annual service plan prepared by the HSE for approval by the Minister.

I am sharing time with my comrade, Deputy Gould.

There can be no wrong door when it comes to treatment for dual diagnosis. The Health (Amendment) (Dual Diagnosis: No Wrong Door) Bill aims to compel the Government to uphold its promise in the programme for Government where it states its intention to "Progress the National Clinical Programme for Dual Diagnosis and work to develop joint protocols and referral pathways."

For the purpose of this Bill, dual diagnosis refers to people who present for treatment who have substance misuse and mental health conditions. Most mental health services and addiction services across Ireland are not currently organised or resourced to treat dual diagnosis holistically.

Addiction and mental health often go hand in hand. An addiction may lead to the onset of a mental health issue and a mental health issue can lead to people using substances as a coping mechanism. Because of the inadequacies in our mental health system, people can often turn to drink and drugs and other substances. These substances can give people the ability to self-soothe. They can give calm to an anxious inner world. They can give the ability to self-medicate, for want of a better word. They work until they stop working and this is where the problems can arise. The mental health problems are still there - often worse - but so too are the addiction problems.

I have worked in many front-line addiction services across Dublin and I have seen many people fall between the cracks because of having an addiction and a mental health issue. I have seen people being told to go away and deal with their addiction issue before the service can treat their mental health. This is not good enough. When I was on the board of the Clondalkin Drug and Alcohol Task Force, we delivered evidence-based training to addiction centres so that addiction centres could be upskilled to help people with dual diagnosis. The task forces need to be commended for trying to tackle an emergent need in that area. For such initiatives to work, the Government needs to resource the appropriate agencies so that addiction and mental health can be treated.

This Bill calls for the person to be treated with dignity, no matter what door he or she knocks on for help for addiction or mental health problems. The door the person knocks on has a duty of care to him or her and the proper referrals need to be made. A joint care plan between addiction and mental health services needs to be developed to make sure people get the care they need when and where they need it. There can be no wrong door for dual diagnosis.

I will leave way now for an Teachta Gould.

I will begin by thanking my party colleague, Deputy Ward, for his hard work on this legislation.

For the last number of months, I have had the honour of meeting with addiction services who are working on the ground. The knowledge and the expertise they have shared with me has been invaluable. I take this opportunity to thank them for meeting with me, sharing their experiences and helping me to build Sinn Féin's policy that reflects what is happening on the ground.

Time and time again, these services have raised with me the issue of dual diagnosis. With no support or funding, many of them are developing their own dual diagnosis support services because they have to. They are sick of people coming to them with serious mental health and addiction issues and not being able to help them.

Dual diagnosis comes in many forms. People can have a severe mental health issue with a minor addiction issue or vice versa. Addiction can be used as a means to cope with mental health issues or mental health issues can develop as a result of addiction.

This is not some simple problem that can be magically fixed but this legislation will put it on the agenda. It will give the HSE the responsibility to develop dual diagnosis services across the State properly and it will lift some of the burden off the under-resourced and oversubscribed addiction services.

I will finish up now. There is much more I could say. This legislation gives us a chance to do what, I think, many of us became Deputies to do. We could improve the lives of many ordinary people who are struggling. Ultimately, that is why we came to this Chamber. We came here so that we can make a difference to people's lives and this Bill will certainly do that. I hope we get the support of all parties and none with it.

Is the Bill opposed?

Since this is a Private Members' Bill, Second Stage must, under Standing Orders, be taken in Private Members' time.

I move: "That the Bill be taken in Private Member's time."

Question put and agreed to.