Dessie Ellis (Dublin North West, Sinn Fein) | Oireachtas source

Tá ceann amháin maith go leor. Today is World Mental Health Day. It is a day for raising awareness of mental health issues. It is also a day when we talk about mental health in a way that breaks down the stigma around mental health. It is a day that shows those struggling with mental health issues around the world that people really care about them, empathise with what they are going through and want to show that they are there to support them and to tell them that it is okay to not be okay. Today is important but we should be conscious of the struggles people go through every day of their lives, all of the time. We should not just think about it one day in the year. We should always be mindful of the stresses and pressures on people who suffer from mental health issues and understand the impact this has on those around them, their immediate families and their friends.

Since I became a TD, I have spoken on mental health issues on many an occasion in the Dáil. I have spoken on Private Member's Bills on mental health, I have raised mental health issues as Topical Issues and I have spoken on them during Questions on Policy or Legislation. One of the areas of mental health I have a particular interest in and have spoken about previously is the area of dual diagnosis. Over the years, I have been a strong advocate for the acceptance of this concept by the medical and psychiatric professions. Having a dual diagnosis means that you have both a mental disorder and a substance use disorder with either alcohol or drugs. It was very frustrating for people who presented to a hospital with mental health issues to be turned away because of their addiction issues. This attitude in the health sector left many people outside of available treatments that were necessary for both their mental health issues and addiction issues.

Mental health and substance use disorders often occur together and studies have shown that many people who have substance misuse issues are also diagnosed with mental disorders. The reverse is also true in that many people with mental disorders will develop a problem with substance misuse. This occurs for many reasons. At its simplest, mental disorders can contribute to substance misuse because people with mental health issues may get temporary relief from using drugs or alcohol. This is a form of self-medication.

Progress has been made in that the understanding of dual diagnosis has grown. It has become a more accepted diagnosis in the medical and psychiatric spheres. It should be acknowledged that the acceptance of dual diagnosis is in part down to the long campaigning and advocacy of voluntary groups such as Dual Diagnosis Ireland and particularly that of Barbara Condon of that organisation and individuals such as Dr. Eamon Keenan, a HSE consultant psychiatrist in substance misuse. Both Ms Condon and Dr. Keenan have travelled throughout Ireland educating people about dual diagnosis and advocating for the appointment of a clinical lead in dual diagnosis.

In 2023, the Keltoi centre in St. Mary's Hospital, Phoenix Park, Dublin was designated the national dual diagnosis rehabilitation centre. At the moment, the centre only offers a day service. During the pandemic, it was converted into a Covid-19 isolation unit. There was some doubt and concerns were raised as to whether it would be returned to its intended use afterwards. No funding was allocated for its re-establishment in the budget. The centre's redesignation is to be welcomed but it is urgent that progress is now made to renovate the building to bring it up to HIQA standards, particularly in light of the significant loss of a substantial number of beds across a number of facilities that treat addiction.

There is a lot more to be done in the provision of mental health services. Mental Health Reform has done great work in highlighting many of these issues over the years. Charities and voluntary organisations cannot be expected to substitute for Government services that are poorly funded and overburdened. Mental health is important at every stage of life from childhood and adolescence through to adulthood. Without increased investment and properly resourced mental health services, we are failing not just the people who suffer from mental health issues, but the country.

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