Oireachtas Joint and Select Committees
Tuesday, 21 March 2023
Joint Committee On Health
Dual Diagnosis and Mental Health: Discussion
Ms Sarah McGillivary:
There is a platform of understanding when it comes to addiction, mental health and the duality of experience in both respects. We often think that people will learn from the consequences of a loosely termed behaviour, but the people accessing these services are experiencing cognitive dissonance - whenever any of us makes a decision, we experience some degree of cognitive dissonance - and it is not always understood for what it is. If I am doing drugs down the road, gardaí catch me and I get put in prison for a little while, it will not reduce the harm. It will not stop someone from returning to drug use after six months in prison. What has he or she done in those six months? Has he or she used time effectively to look at the reasons he or she engaged in substance use? Has he or she had access to mental and physical care? Is the person returning to homeless accommodation or transitional housing? We can set up specialised residential care and have stabilisation units, detox wards and treatment centres where people go to address their substance use, but what if they are returning to homeless accommodation? I understand that the staff in homeless accommodation do their best to provide care, but it is often like firefighting for them, with staff not having the time to sit down with individuals.
Behind what society might see as a behavioural issue is a person who is suffering, who usually does not want to engage in criminal behaviour and who does not understand the reason he or she is doing so. During the heroin epidemic in the 1980s and 1990s, there were drug marches. We have moved away from that to some degree, but we still have another further to go. We have a responsibility to educate not only services and the people who access them, but also society about what it means to be someone who wakes up and has to reach for a drug to be able to get through the day. That is not a life – it is an existence. One definition of "addiction" is the deadening of emotions that someone might not be able to cope with. Why do we not consider people's emotions or situations instead of saying that they just use drugs because they want to, so they are going to prison for six months and everything will be fine afterwards? There is so much reoffending because we are not addressing the issue. We are removing it from society for a period and then returning it to society and telling people they will be fine. This is an important point.
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