Mr. Hugh Greaves:

I am grateful for the opportunity to address the committee. To do this, we consulted with a range of the different partners we work closely with in the Ballymun area. They were very happy to provide their experience of what it has been like over almost two years of lockdown in trying to provide services to an already overloaded community. The Ballymun local drugs and alcohol task force is a partnership that works with statutory services, local people, local services, voluntary agencies and local public representatives to provide a cross-cutting response to drug and alcohol issues in the local community. It represents a broad range of experiences all coming together to address drug and alcohol issues in a local setting. The information conveyed is garnered from a range of different services, such as youth services, community drug services and homeless services all working together. The issues that were presented are similar to some of the issues mentioned by Ms Leonard earlier and they are also reflective of feedback that was garnered from different drugs and alcohol task forces throughout the country by the Department of Health recently, and a paper is being presented soon by the Department on some of the difficulties experienced by those services.

In terms of an overview of the key issues, as I said, we work in an already overloaded community where there is a large concentration of intergenerational drug and alcohol use and, in some cases, some families are experiencing their fourth generation of people getting involved in serious and problematic drug use. Covid, which nobody could have legislated for, then came on top of that. What we found was that this added extra loads onto already overloaded families in the community in general. We have broken the issues down under various headings, as follows: connecting, connections and support; risk, safety and danger; coping and stress responses; access to service provision and engagement; drug and alcohol behaviour and patterns; and maintaining service delivery and practices. I will try to paraphrase my speaking notes as much as possible in order to keep my speaking time short.

With regard to connecting, connections and support, considerable work has been undertaken by all of the services in an ever-changing environment to provide supports to clients, their families and the local community. There was an increase in client needs and that resulted in a whole range of different things, with much higher and more dangerous levels of drug and alcohol use and people who had been doing very well relapsing because of the lack of daily contact with local services. It took a while for services to reorientate and to provide online and phone support and so on. Those were the overarching issues. We saw that where people had already experienced high levels of trauma in their family environments when growing up and in their current family environments, the isolation and the unknown factors led to that coming out in all sorts of negative ways for people. There was a serious rise in anxiety and stress, and this resulted in issues like domestic violence and so forth. Individuals using drugs and alcohol services indicated the resurfacing of feelings of loneliness, emptiness and abandonment. That led to heightened levels of stress and anxiety, social anxiety and depression, and there was a lack of structured connection with their peers and with the services people relied upon.

Parenting issues came to the fore and became much more acute, with an increase in stress in homes for both parents and children, and Ms Leonard mentioned child to adult violence. Services reported there was a lot of difficulty in emotional regulation when dealing with children’s stress. For children who were being cared for by other family members, such as siblings and grandparents, the separation for both child and parent was challenging, with people experiencing lost opportunities and missed milestones, and we have all seen the missing of things like communions, school graduations and similar milestones.

I will turn now to risk, safety and danger. Vulnerability within home environments or family dynamics associated with increased drug and alcohol use surfaced in regard to issues like financial debt, intimidation, loss of employment and relationship breakdowns. There have been increases in reports of suicidal ideation among those using alcohol or drugs, which did not feature too much as a self-identified concern pre-Covid. Family members experienced more conflict within the home as their loved one’s drug and alcohol use increased. They experienced constant pressure for money due to reduced income, which led to issues like food poverty, although services tried to respond as best they could to some of those issues. Family members’ awareness and anxiety was heightened in terms of their loved one’s increased use due to greater visibility from them being out of work, working from home or being constantly at home. There was increased aggression and domestic violence, and a rise in support in regard to seeking barring orders and protection orders. There was experience of inconsistent or non-use of mental health medication during Covid, which is linked to patterns of drug and alcohol use, disconnection from supports, limitations on phone support or regular reviews or both. Physical health issues also emerged as an issue.

Young people who were being groomed for various criminal activities became much more susceptible and vulnerable due to the withdrawal of key supports, such as youth supports. Anecdotally, there was an increase in the number of young people holding drugs and weapons for organised gangs and getting involved in low-level dealing for very little money. We are currently seeing the consequences of this, with a palpable increase in reports of coercion, violence and so forth.

In terms of coping and stress responses, there was a fear of Covid transmission, especially in families where their loved ones were still out on the streets, doing their drug dealing, drug scoring and so on, in that there was a fear of what they were bringing to the door.

Outreach services engaged with young people reported difficulties with young people understanding the ever-changing situation, although that was the case across the country and there is nothing unique in that. It was also observed that people were sharing coping techniques and responses with one another. For example, those in contact with services were sharing the support they received, such as breathing techniques and so on.

With regard to access to service provision and engagement, delays in access to residential treatment due to Covid became a real issue as there was reduced bed capacity in the residential treatment services.

Appointment dates were either delayed or extended thus making it difficult for clients to maintain progress and motivation. There were experiences of undertaking detoxes without the same support systems in place making things very problematic.

Ongoing issues with access to adult mental health services and long waiting lists for the adolescent service were exacerbated during Covid.

The phone supports were not always suitable. There was a reluctance to use, or unsuitable technology available, in terms of people accessing online services. Some people reported that they had low self-esteem or confidence so did not like seeing themselves on screen and, therefore, chose not to avail of the support.

There were also tech literacy issues, Wifi issues and a lack of devices. A big issue was people having little or no privacy in the home environment. People had nowhere to avail of supportive services because of overcrowding.

Individuals with addiction and homeless issues found it difficult to access personal care arrangements such as showers and safe sleeping environments. All of this had a negative impact on self-esteem and increased stigma.

There was a decline in motivation and goal setting was disrupted which made care and case management processes more difficult. People were anxious arising from court dates being rescheduled and delayed. Not knowing the situation and an inability to plan also increased anxiety.

In terms of drug and alcohol behavioural patterns, drug use increased. There were particular concerns about the rise in the use of stimulants, particularly crack cocaine, which increased in a much bigger way during the last couple of years.

We witnessed among young people a rise in the use of party-type substances such as nitrous oxide, which reflects the trend that happened in other areas of the country. We note that the sale of nitrous oxide is completely unregulated.

As Ms Leonard said, there was an increase in the frequency and quantity that people were drinking. People made all sorts of local arrangements to facilitate drinking. This was exacerbated by the free and easy delivery of drink to local parks, local shebeens, etc. at any time of night. It was reported that there were consequences on people and their families because of this changed use.

There was feedback that there was isolation, boredom and worry, which was attributed to a large level of relapse. The people in recovery found it difficult to remain drug free without the support of things like their fellowships and local support services.

As has been mentioned earlier, there was a big increase in reports of service users being attacked and beaten up in connection with drug-related debts. At the beginning of lockdown when Garda checkpoints were visible on the roads many dealing networks were denied a lot of their income so called on people to collect debts, which led to a large level of increased violence.

In terms of maintaining service delivery and practices, a number of services developed new ways to engage with their client groups. This included the creation of walk and talk sessions, garden games, balcony chats and food distribution. In terms of the latter, a lot of services thought that they understood the needs of individuals and families but when their staff called to people's doors they were shocked at the level of need. When the front door opens and one sees the state in which children and families are living, it becomes a completely different animal.

Once restrictions eased everyone welcomed the resumption of one-to-one sessions, in-house group work for indepth personal work, and the efforts to restore and rebuild shared feelings of belonging, hope and resilience. The stop-start engagement highlighted unmet needs and increased vulnerabilities for many.

Funding was challenging. With the ongoing restrictions and new environment in which we work there is need for capital funding to be provided so that premises can facilitate more specific service provision, and separated service provision.

I have given a snapshot of the feedback from a range of different local services that work in partnership on the Ballymun local drugs and alcohol task force. We thank the committee for listening.