Ms Paula Leonard:

I thank Deputy Gould very much. I will be brief. What Ms Lawless has just said about the importance of communities is really important. Communities can identify problems and issues as they are emerging. They can work across services and build intersectoral collaborative partnerships at the local level. They can bring local government, An Garda, education providers, family resource centres and those working in treatment together to decide what services should look like in the community. We can only do that by listening to people. Ms Lawless has emphasised the importance of conversations. The listening part of conversations is really important. I have done quite a bit and I have learned from my colleagues this morning.

The question raised was on access to services. The people working in the services might be better placed to discuss that. However, there are no services for a number of alcohol-related conditions in this country. There are no diagnostic services for children and families that have been impacted by foetal alcohol spectrum disorder. One cannot get one's child a diagnosis of foetal alcohol spectrum disorder. There is no specialised family support, there is no care and there are no specialised interventions for those families. When we appeared before the Joint Committee on Health in 2019, we talked about the need for agreed diagnostic criteria, for the establishment of multidisciplinary teams and for the putting in place of support for those families who are raising children with foetal alcohol spectrum disorder. It is really important that the Joint Sub-Committee on Mental Health think about the profound impact that foetal alcohol spectrum disorder can have right across a person's lifespan. Some 50% of people who have foetal alcohol spectrum disorder will serve time in jail or will spend time in a residential drug treatment or psychiatric facility. Some 92% of children who have foetal alcohol spectrum disorder will receive a formal mental health diagnosis in their adult lives.

We also know there are 428 co-occurring physical disabilities and conditions that are associated with foetal alcohol spectrum disorder, including epilepsy, heart defects, compromised auditory function or hearing and compromised immunity. It is important to talk about dual diagnosis, access to timely support and intervention for people when they are in addiction. We also need to acknowledge and talk about the complete lack of services for people with foetal alcohol spectrum disorder. I will ask my colleague to talk about the issue. We have the only specialised rehabilitation service for people with alcohol-related brain injury in the country. There are no similar services in the parts of the country other than the Donegal area in which Dr. McMonagle works. We need to see similar services. I will hand over to my colleague.