Oireachtas Joint and Select Committees

Thursday, 24 October 2024

Committee on Drugs Use

Family and Community: Discussion

9:30 am

Mr. John Paul Collins:

I thank the Chairperson and members of the committee. Pavee Point welcomes the opportunity to make a presentation today and in particular is encouraged that this Joint Committee on Drugs Use is undertaking a health-led approach and that the needs of Travellers and Roma are included in overall discussions of the committee. We also welcome yesterday's interim report by the committee that largely reflects the citizens' assembly recommendations. We call on the State to urgently ensure both reports are reflected in the upcoming national drugs strategy.

Today, we will focus explicitly on Travellers and drug use. However, we encourage the committee to examine the needs of the Roma community at a later stage in its deliberations. This committee will consider the recommendations in the report of the Citizens' Assembly on Drugs Use. We have provided a detailed submission which will serve as a reference document should members need it. We broadly endorse all of the citizens' assembly recommendations. We will look at the specific issues regarding Travellers and the recommendations, leaving time for a discussion, which will be the best use of the committee's time.

My name is John Paul Collins. I am a community worker with Travellers and a Traveller. I have been working in this area for almost 30 years and I stress to the committee that in those years I have not seen the situation on the ground as bad as it is now. In 2010, the All-Ireland Traveller health study reported that almost seven out of ten Travellers considered illicit drug as a problem within the community. Today, I believe we are closer to almost all Travellers reporting this as an issue. It would not be an exaggeration to say that most Traveller families across the country are in some way impacted by drug use or the drugs market, whether directly or indirectly. This is an issue for Traveller women, Traveller men and Traveller children who are all witnessing what I can only describe as an epidemic. While we know this is an issue for the general population, the experience of Travellers is acutely felt and informed by institutional racism which creates the conditions for inequality of access, participation and outcomes as related to drug policy and services. This is particularly pronounced for Traveller women, Travellers with a disability and LGBTQI Traveller community. We cannot talk about a health-led approach to drugs without referencing the fact that 90% of what affects a person’s health happens outside the medical system and, therefore, racism, discrimination, living conditions, poverty, employment, educational attainment all impact Travellers and require a wider response that includes collective community development and a robust policy response. The unacceptable poor health status of Travellers should not be a surprise to members of this committee or others in the Oireachtas.

Pavee Point has been here many times, highlighting these appalling statistics: the mortality rate and infant mortality in the community are four times higher than in the general population. Travellers live on average more than decade less than non-Travellers. To put into context, as a Traveller man, I will be lucky to see my 65th birthday, whereas for my colleagues here today, that is a given. Our suicide rate is the highest in the country at seven times higher than the national average and accounts for one in ten Traveller deaths, some of which we know are a result of addiction. Some 39% of Travellers are effectively homeless, which means doubling or trebling up on unsafe sites and includes those living on the roadside or in emergency accommodation. Living in such desperate and stressful situations leads people to cope in different ways including drug use. This was particularly apparent during Covid-19, when an increase and normalisation of substance misuse was very evident in our community.

When it comes to substance misuse, we know that Travellers are disproportionately represented in the available drug and alcohol statistics, accounting for almost 3% of drug and alcohol treatment episodes in 2023. This is four times the national average according to the Health Research Board. We understand these figures are a conservative estimate as some Travellers are reluctant to reveal their ethnicity due to fears of racism and discrimination in services. We also know that not all services collect information on ethnicity or do not do it within a human rights framework, which Pavee Point urgently recommends they do in line with public sector duty. We need good information to inform evidence-based policy-making and improve service provision. Without proper data we cannot see how Travellers, Roma and other minorities fare in services. What we do know from our work is that Travellers experience discrimination and racism in accessing services. This has been validated by a number of pieces of research, including the All-Ireland Traveller health study, which reported that seven out of ten healthcare professionals admitted that anti-Traveller racism and discrimination existed in services. Drug services are not immune to this. Traveller organisations are working to encourage Travellers to get help for substance misuse but Travellers and other minority groups have particular needs which are not being met. We also know that Travellers are disproportionately overrepresented in the criminal justice system. Travellers make up 8% of the male prisoner population, 16% of the female prisoner population and almost one fifth, 21%, of children detained in Oberstown. In many of these cases, addiction is a mitigating issue. A recent report by Irish Travellers’ Access to Justice highlighted systemic racism within An Garda Síochána and the judicial system which has led to racial profiling and criminalisation of Travellers. This has led to poor relationships and low levels of trust within our community. Travellers are particularly vulnerable to the illegal drug market and criminal drug gangs both within and outside the community. Gangs target and intimidate Travellers and exploit the vacuum left by inadequate Garda protection, leaving Travellers to feel like they need to fend for themselves.

This is a recipe for disaster and conflict. We endorse citizens' assembly recommendation 26, which calls for a zero-tolerance approach to drug-related intimidation and violence. However, we need to ensure that measures are not used to further criminalise Traveller drug users or as pretence for over-policing of our community. We do not present these statistics lightly. We do so to show the interconnection between what we see on the ground and the need to ensure that a health-led approach to drug use is inclusive of the broader social determinants. Cross-government and agency responses and resources are required if we are to seriously tackle these issues. The citizens' assembly was also very clear on this, recommending the that the Government provide leadership and accountability at the highest political level, including a dedicated Cabinet committee on drugs chaired by the Taoiseach, which we also endorse. While the national drugs strategy referenced social determinants as a key principle, it has not been applied in practice, particularly in relation to Travellers. We feel that for the most part, we have been left behind. Despite the overwhelming evidence of the devastating impact of addiction on Travellers, we remain invisible in mainstream drug and alcohol policies. The national drugs strategy contained only two actions with reference to Travellers, combined with other groups of interest.

The national oversight committee of the national drugs strategy, the body that oversees the implementation of the strategy, has ignored requests by Pavee Point for direct Traveller representation on this structure. Instead, we have been advised that the national Traveller health action plan is a mechanism that will address these issues. However, the plan only contains two actions related to substance use and addiction and, although welcomed, the plan has not received any new core funding since 2022. We believe this demonstrates the lack of political will and that Traveller health is not a priority at departmental level. It is important that this is addressed in the development of the next strategy. There is a need for both targeted and mainstreaming actions to address the needs of Travellers. It would be remiss of me to not acknowledge some of the positive developments over the past number of years, particularly the work of those in the drug and alcohol sector and the HSE that is innovative, impactful and show outcomes. These models should be further developed, resourced and mainstreamed.

Paul Reid, the chair of the Citizens' Assembly on Drugs Use, advised this committee that the clock is ticking. Our community’s lives and future are on the line. There is no time to waste. To address these issues, we recommend the following. There should be urgent development of the next national drugs strategy, inclusive of a robust implementation and monitoring plan with clear targets, indicators, timeframes and budget lines, with actions being resourced and implemented by all Government Departments and relevant statutory agencies. Target actions, in particular, are required to address the intersectional needs of Traveller, Roma and other ethnic women. The national Traveller health action plan should be fully implemented, with increased multi-annual funding for Traveller organisations to support targeted measures related to substance misuse and addiction. Traveller and Roma health inequalities, including addiction, should be prioritised and mainstreamed within the Department of Health and across the HSE into existing and forthcoming health policy and service developments. A social determinants of health response that is culturally appropriate should be provided to addiction, in partnership with Traveller organisations. This should be underpinned by the community development approach, including mandated anti-racism training, inclusive of anti-Traveller and anti-Roma racism, to all relevant agencies. Ethnic identifier monitoring should be implemented, including a standardised ethnic identifier across all health administrative systems, including drugs services, to inform evidenced-based policies and services. It should also be ensured that reporting of disaggregated data based on ethnicity and gender, at a minimum, forms a part of the ongoing annual reporting requirements set out by the Department and HSE. I again thank the committee for inviting us in.