Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank Deputy Neville for raising this important issue. I also want to use the opportunity to commend his work on mental illness and substance misuse.

The HSE has recognised the need for a clinical programme for dual diagnosis to respond to people with concurrent mental illness and substance misuse issues. Budget 2018 allocated an additional €35 million to develop mental health services in 2018, which has helped facilitate programmes such as the clinical programme for dual diagnosis. The aim of this programme is to develop a standardised evidence-based approach to the identification, assessment and treatment of co-morbid mental illness and substance misuse. This includes increasing awareness of the frequent co-existence of mental illness and substance misuse; ensuring there is a clear clinical pathway for management of people with such a dual diagnosis, including when they present to emergency departments; ensuring a standardised service is provided throughout the country; and ensuring adolescents are also included within the scope of this clinical programme.

Work has already taken place to progress this aim. This includes the appointment of a programme manager and national clinical lead, the commencement of a literature review and clinical service mapping exercise and the establishment of a national working group. The purpose of the national working group is to develop a national model of care for specialist dual diagnosis services for adults and adolescents which is person-centred, ensuring people get easier access to the right treatment at the right time and in the appropriate setting. Towards this end, the group has initiated a work plan to develop a model of care based on a programmatic approach to service improvement and development. The working group held its first meeting on 19 October 2017 and has met each month since.

The national working group recognises the need to hear from other service providers and support organisations on the needs of this particular client group. The group plans to host a forum to link in with this aspect, as well as discussion on possible care pathways during the development of the model of care. An integral part of the dual diagnosis programme will be to devise a model of care that will ensure all adolescents and adults suspected of having a moderate to severe mental illness, co-existing with significant substance misuse, have access to a timely mental health service nationally. This is to be delivered on a community health care organisation, CHO, basis. The service will be provided in an integrated manner across the primary care division and the mental health service. This will ensure there are close working relationships with the relevant specialties in the acute hospital groups which would deal with any medical co-morbidities which may occur, particularly in those with alcohol misuse.

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