Ms Kate Mitchell:

I thank Deputy O'Connell for raising that question. It is a fundamental issue. We hear consistently of adults and children not getting access to mental health services because they have a dual diagnosis of mental health difficulties and addiction. My understanding is that there are practices in operation in other jurisdictions that focus highly on integration between addiction and mental health services and co-location of addiction counsellors on mental health teams. I gather that is proving effective. Within the Irish context there has been a pilot involving integration between addiction, mental health supports and co-location of addiction counsellors on a mental health team. This is the "no wrong door" approach piloted in north Tipperary. It proved positive outcomes in terms of people being able to access the services they required as well as showing marked improvements in their mental health and well-being. We really need to look to these kinds of initiatives in Ireland in terms of what is working. We need to look at rolling them out at a national level. However, it requires a multi-pronged approach in addition to co-location of addiction counsellors on teams. That is happening in certain areas but it is certainly not happening everywhere. There is also a requirement to increase the capacity within community mental health teams to support people with addictions. That applies across the disciplines. We need to increase capacity and adequately resource addiction services so that they can provide low-level mental health support.

We also need formal processes and protocols to ensure collaboration and integration between addiction and mental health services. It requires significant investment attention and focus to ensure we see progress in this area.