Dr. Liam Mac Gabhann:

Yes. Where we are involved in this, the Garda is involved as well. Everybody needs to be involved, from the pharmacist to the receptionist in the emergency department and everybody else. That is the baseline.

The second consideration is what is leading service providers to say they are not trained to do that or they cannot do it. That is about cultural positioning and the way the training is rolled out. If I come from a mental health professional point of view, I do not understand harm reduction because my culture says my work is not to do with harm reduction. If I come from an addictions field, I do not understand about people hearing voices and experiencing delusions. That frightens me. Both of those instances are easily resolved through dual-diagnosis awareness and a very basic tiered approach to education. That is neither expensive nor difficult to roll out. We have perfect examples of how it can be done. Those are two very simple issues.

The challenge relates to cultural change and operational responsibility for what people have to do. One of the advantages is that probably 60% to 90% of people will be managed in integrated, systemic community services and if those service providers are talking to each other, we will be able to respond to that. For the 10% of people needing specialist intervention, specialist training and a trauma-informed approach are required. At a very basic level, the solution is neither expensive nor difficult. I say that with my fingers crossed behind my back because cultural shift is very challenging. If everybody is doing it together, it is easier for the culture to move. I do not know whether the evidence I have outlined reflects what is needed.