Ms Ber Grogan:

I love the talk of the pipeline. Something we are really good at in Ireland is developing a theoretical pipeline, but we are less good at following through on the plans. Sharing the Vision as a national mental health policy is really good. What we are doing differently this time, to give credit where credit is due, is that there is a national implementation monitoring committee. There are action plans and deadlines. The first implementation plan for 2022-2024 has been published with specific short-term, medium-term and long-term goals. If you were to look at all of the plans, you would say it is absolutely brilliant and that it is going to work really well. Specifically on Sharing the Vision, recommendation Nos. 48, 50, 51 and 57 all relate to mental health and intellectual disability, dual diagnosis and speech and language therapists. The commitments are there, but it is the follow-up that is the issue.

Dual diagnosis is interesting. We did a piece earlier this year around mental health and addiction, such as alcohol and substance addiction. Dual diagnosis is also used if people have a mental health issue and an intellectual disability or a number of different disabilities or health issues affecting them. It comes back to that piece about looking at the person and their scenario, such as whether they are in insecure housing; have grown up in poverty; have an intellectual disability; and are living in poverty. It is similar to what was said about the funding streams - people will not fit nicely and neatly into these boxes. If we start to look at people in terms of the whole person - I see Mr. McGrath smiling, I hope that is a good smile - and all of the social aspects that affect their lives, that will make a difference. There is the national clinical programme around dual diagnosis as well. Anita White in the HSE is doing great work on a model of care for dual diagnosis. There are a lot of good national clinical programmes around early intervention in psychosis, eating disorders and ADHD. There are lots of good things happening in different community health organisation areas and different silos. That is one of the reasons we have been calling for the reappointment of the national lead in mental health in the HSE, so that you have someone who has strategic oversight pulling all of those pieces together.

If I may, Chair, on Article 14, to answer Deputy Ellis, when Ireland ratified the UNCRPD in 2018, we said we would do all of these things, except maybe not Articles 12 or 14 and only relating to people with mental health difficulties. We are either ratifying and implementing the UNCRPD or we are not. It is like Mr. McGrath's point about consulting with people with disabilities, we are either listening to disabled people and their organisations or we are not. It also highlights the importance and need for the fully-funded independent advocacy service. If people do not have anyone or if they are coming up against the notion that, "You have rights, but there is a reservation on that article, so you might not have those rights", where can they go? As was said, people are trying to get by with housing or work and if you have a fully-funded independent advocacy service that is fully resourced, they have somewhere they can go.