Dr. Liam Mac Gabhann:

It is also not recognised that up to 45% of people in urban areas use substances and alcohol recreationally. However, when you look for a clinical diagnosis, you might actually be diagnosed because of your recreational-use lifestyle. This makes researching dual diagnosis a genuine challenge.

There were two questions. Everyone has answered, in one way or another, the question, "Will this happen?" Members have heard, undisputed, the response "Yes" every single time. Policy and operations have allowed us to do that.

I cannot overemphasise the opportunity we have now. We now have a mental health policy, Sharing the Vision, that states we are not allowed to exclude people from any service anymore; yet, three years later, we are still doing it. That is something politicians can do something about. We now have a model of care that means we will respond with a no-wrong-door approach. We have the ability to operationalise mental health policy. On the ground, people are ready. Maybe it will take time to get the specialist teams recruited in respect of 10% of the people, but 90% of the people can be responded to now. On the question asked, we now have a mandate stating what was happening should never happen again, but we need political power behind it so people can operate on the ground.

The second question was on the chicken and egg. As Mr. Williams said, that is an old story. It is a bit like the story that mental illness is a chemical disturbance in the brain. Interestingly, the same people who argued that threw it out as a misconstrued basis for mental illness 35 years ago. It does not exist as a theory anymore although we still think it does and talk about it. I like to refer to what we colloquially call "Em's theory" in responding to questions on the chicken and egg, putting trauma first. Would Ms Murphy like to articulate it? It is now well known almost across the land.