Dr. Helen McMonagle:

Absolutely. It is not specific to Ireland, rather it seems to be the case internationally. It is only in the last ten years that research in this area has spiked, given the increased number of people coming through with the condition. We know from a recent research paper published by the Care Services Improvement Partnership in the United Kingdom that there is a lack of diagnostic expertise and training to diagnose an alcohol-related brain injury among core professional groups. The paper also set out that professionals often stigmatised patients and failed to see an underlying brain injury because they believed challenging behaviours or individual difficulties were due to individuals' alcohol use. Professionals failed to recognise that it might be the result of a brain injury and to question whether something other than alcohol use might be going on with someone. The consistent absence of resources in this area in Ireland does not incentivise professionals to identify the condition. If it is identified, what does the professional do with the person who has it? There is a great deal we could do to increase the identification rate and adopt best practice in the management of this condition. We need to build expertise in the recognition and management of this group not only in addiction services but also in acute services. There should be routine screening of cognition and malnutrition among long-term heavy users of alcohol. That would help greatly to improve identification rates. It should be spurred on by the fact that the prognosis for the condition is very good if identified early enough. Over 25% of people can make a full recovery, while a further 25% can make a partial recovery and another 25% can make a significant recovery.