Mark Ward (Dublin Mid West, Sinn Fein) | Oireachtas source

I thank everyone. I am sitting here enjoying the debate. I really do not want to take part in it because it is so good. I met several of the witnesses before in different walks of life and other professions. Dual diagnosis is something I have always been passionate about. As someone who has worked in addiction and community services, as was said and articulated much better by the witnesses, we saw people who arrived at a service. We sometimes did not have the confidence or the ability to be able to help a person, but we helped as best we could anyway. This is what seems to be happening. I worked in a service in Inchicore for several years and we were trying to get some kind of dual diagnosis service there. I could see the mental health service across the road which some of our service users were also using, but there was no connection between that mental health service and the addiction service until I started knocking on that door. That broke down that barrier, but it should not be necessary to do that.

Mention was made of people falling through the cracks. I thank Ms Murphy for telling her story. She was brilliant. It was a fantastic description of how someone with lived experience feels and of having to go to deal with an addiction issue and then return to deal with a mental health issue, or vice versa. Ms Murphy explained it very well. I am delighted she eventually found a service that saw where she was at, because this is so important. It is important for that service, and the people within it, to see this as being about a person and not a statistic. It is about a person with a real life, real hopes and real dreams. As Ms Murphy said, it is about a person with potential and value. We all are, but sometimes when people are in services like that they do not always get that recognition. This is very important.

My Health (Amendment) (Dual Diagnosis: No Wrong Door) Bill 2021 was debated in the Dáil recently.

The Bill was the first legislation I introduced after I was elected. It was probably the worst-written legislation I introduced and I have no problem saying that. It was my first Bill and I wished to tackle dual diagnosis. The Government decided it would push the legislation down the road for a year, last week. I did not oppose it, because the Government said there were many things coming down the road. I said I would work with the Government in a tangible and real way on this.

The model of care for dual diagnosis is coming down the road. I will ask Dr. Mac Gabhann a question about that in a second. The review of the Mental Health Act is what we will go through on this committee in the next while. There is an opportunity there to have dual diagnosis. It was mentioned that the citizens' assembly is coming up as well, where there will be an opportunity to include dual diagnosis. Due to those three things, I decided work with the Government and give it a chance to put things in place. I hope that by next year, we will not need that dual diagnosis bit, but we will see.

My first question is to Dr. Mac Gabhann and to anyone else who may wish to answer. Dr. Mac Gabhann mentioned it and that is why I wish to bring it up. It is good to see him in person and not on Zoom. He mentioned the dual diagnosis clinical programme and the finally released model of care. This model of care should have been released last year. It was ready to go. It was sent to the College of Psychiatrists of Ireland on 13 April 2022 and it was only endorsed on 2 March this year, a couple of weeks ago, which is absolutely not good enough. It shows a real lack of urgency to get this issue resolved. I have seen the model of care and I have had meetings with the HSE. The HSE seemed to tell me that there will be a separate entity, whereby addiction services will look after people with an addiction and people within mental health services will look after people with mental health issues and a dual diagnosis service, to which both services can signpost people. Dr. Mac Gabhann mentioned that 90% of clients would not be able to avail of the specialist services.I wish to tease that out a little bit. Who are the people who are likely to fall through the cracks of the new model of care the HSE is bringing in?