Mr. Mick Williams:

I would like to begin by thanking the Chair and the members of the committee for inviting Sankalpa to make a presentation. Sankalpa welcomes the opportunity to address the sub-committee and to discuss with members the issue of dual diagnosis.

Sankalpa began providing a community access programme for the Finglas and Cabra areas in 2008. We are a section 39 HSE-funded community-based recovery treatment service for people with drugs and alcohol issues.

The average participant attending Sankalpa is an educationally disadvantaged early school leaver who is unemployed, has experienced homelessness and time in prison, and has been involved in substance use for more than five years. Presenting to Sankalpa, they are seeking support to reduce their current substance usage, stabilise on their prescribed medications and move forward in their lives. However, assessment usually highlights a history of mental health difficulties, inadequate social attachments, experiences of trauma and poor coping skills.

Sankalpa runs four core programmes that are underpinned by a commitment to evidence-based intervention, professionalism and quality of services adhering to national protocols for drug and alcohol services. These four programmes are: stage 1, "Access", is a low threshold pre-entry assessment; stage 2, “Turning Point”, is a full-time non-residential stabilisation day programme; stage 3 , "Connections", is a full-time non-residential substance free programme; and stage 4, “Connect”, is a targeted training and employment community employment programme.

Sankalpa is different. Sankalpa's service and the integrated pathways we provide are unique among the range of services available elsewhere in this sector. No other service provider can be compared with our bespoke model, which has proven success rates. Sankalpa is changing people's lives.

Sankalpa is entrenched in the communities of Finglas and Cabra. We have forged a close working partnership with community-based hubs, including Safetynet and HSE case management teams, that refer participants to our services. We work directly with other agencies for efficient case management in order that people do not fall through the cracks, especially on completion of residential treatment programmes.

Sankalpa has adapted over the years to meet the changing needs of the people we serve. We continue to evolve and provide accessible and meaningful supports for people in our communities experiencing drug and alcohol issues. We also provide intervention for their unmet issues of mental health and well-being.

Sankalpa does not operate on the basis of a deficit model of care and is certainly not restricted or ill-equipped in the context of working with people with dual diagnosis. In 2022, Sankalpa worked with 162 new people seeking supports. Of these, 79 were recorded as having dual diagnosis. Some 58 were male and 21 were female. More than half, or 46, were people aged between 30 and 50.

On completion of our programmes, our participants reported that non-medical interventions, specifically our mental health and well-being workshops, gave them a greater understanding of their diagnosis and provided them with practical coping skills.

Recovery is contagious and has the potential to be transformative at family and community and societal levels. Up until now, in the initial stages of rehabilitation, treatment has focused on harm reduction and acute clinical care. Now there is a growing movement towards a more holistic recovery paradigm which involves developing insights into thoughts and behaviours to prevent relapse. Sankalpa seeks to optimise recovery capital by providing specific and practical supports. We focus on three key components, namely, personal, social and community, and how they influence and shape each other. We do this by channelling our interventions to support and help participants to develop personal resources, like resilience and coping skills, and by fostering social skills, such as by means of belonging to recovery groups, that have an impact on society, such as via access to recovery communities and pathways to training and jobs.

We are operating in a changing policy context whereby we frame the drugs problem as an individualised issue rather than one that is situated in the context of poverty, inequality and social exclusion.

Sankalpa seeks to be at the lead in developing an effective drug and alcohol service by meeting current complexities and providing recovery services in Finglas and Cabra. Central to this, Sankalpa pledges a commitment to working with the dual diagnosis teams, offering our expertise and excellent and effective treatment support for the growing number of people seeking recovery help.

I thank the committee for its time. We welcome any questions and are happy to share our thoughts and experiences on the issues.