Ms Marian Sloan:

Much work needs to happen to put addiction out to social inclusion. There was not the oversight that there should have been from the clinicians and psychiatrists. They may have been quite happy when that happened at that stage. We need to review how young doctors are trained. In the North they had to do a six-month rotation and also come into the addiction services meaning they are familiar with those presentations. Those presentations are quite unique and are not easily medicated. The raison d'êtreof the psychiatric services is to try to diagnose and alleviate symptoms, and prepare some kind of care plan for the person's mental health. They need to have greater insight of comorbidities. Like the Deputy, I have brought people to accident and emergency departments only to discover that they were so distressed that one would nearly have to sit on top of them to keep them sitting there. One is nearly like a garda. Gardaí are often called in those cases.

The mental health teams need to take responsibility and perhaps have a dual diagnosis unit to support the person. We thought when the new unit was established in Drogheda it would help to alleviate the situation, but while under the influence of substances, they cannot move across from the accident and emergency department to be assessed by that psychiatric service. It is not that people do not want to help. It is the fact that it is outside their competencies. There should be a greater sense of training. This is how we live in real time. I am sure it will be there for some years to come. It is about how they garner the experience and expertise so that families are not left behind. As Ms McKenna said, we may need a small unit with those trained experts in psychiatric and comorbidity in having dual diagnosis as well. In the north east we do not have-----