Dr. Helen McMonagle:

In terms of the multidisciplinary and interdisciplinary approach required for alcohol-related brain injury, while addiction services and acute services have a crucial role to play in the prevention and early identification of this condition, meaningful rehabilitation, sustained recovery, quality of life and supported independence will never be achieved without the inputs of specialists in neurorehabilitation. Addiction services and services for brain injury or neurorehabilitation exist as distinct service entities with little cross-sectoral collaboration. This cannot continue. Brain injury teams and addiction teams working together could provide the core skills required to provide ongoing rehabilitation and support for this condition. I know we are here to talk about addiction but the reality is that addiction is causing brain injury. As many as 35% of people who are dependent on alcohol will develop an alcohol-related brain injury. Between 24% and 50% of traumatic brain injuries are caused by alcohol. Those of us working in the addiction sector have a really important role in advocating for better provision for people who develop brain injuries and we need to have a really strong desire to be neuro-informed given the prevalence of brain injury within our services. We need to be willing to play a role in advocating for greater provision for people with alcohol-related brain injuries.

Brain injury and addiction services are chronically under-resourced, particularly brain injury services. I believe the Government needs to address the chronic under-investment in neurorehabilitation as a whole, which is a persistent barrier for people with all kinds of neurological conditions, including alcohol-related brain injury. I would mirror calls from other agencies, including the Neurological Alliance of Ireland and the Disability Federation of Ireland, to address the significant dearth of appropriate regional residential and localised neurorehabilitation services. These specialist services constitute a really important component of recovery from alcohol-related brain injury. What we are talking about here is a condition that has a high potential for recovery. Over 75% of people with alcohol-related brain injury can make some degree of recovery while over 85% of people can be supported to live independently in the community. What underpins that happening is the provision of specialist residential rehabilitation and this is best supported by joint working arrangements between brain injury services and addiction services.

The Senator mentioned the national working group. I do not want to oversimplify the issues associated with alcohol-related brain injury. They are complex and nuanced and are influenced by a myriad of interconnected and interconnecting systems. Most fundamentally, that social problem is a product of a network of cause and effect between multiple different systems. If we want to act to improve the responses for alcohol-related brain injury, we need the co-ordinated action of many people, systems and directorates working in a networked way across different organisations in different service areas.

That is what we need to progress with the national working group. We need buy-in from mental health, social inclusion and disability services to begin a conversation about the key barriers that we are experiencing with regard to alcohol-related brain injury.