Paul McAuliffe (Dublin North-West, Fianna Fail)

I welcome the amendment because it opens the discussion on dual diagnosis, which is incredibly important. I was lucky enough to be part of the DCU Finglas Addiction Support Team, FAST, peer-reviewed research on dual diagnosis. There were a whole range of recommendations included within it. One of those was an amendment to the Mental Health Act that would ensure a no wrong door approach.

Of course, the no wrong door approach applies not just to those with dual diagnosis but also to those with other complex needs in the mental health space. The Minister of State’s answer is quite useful in the sense that report was drafted in 2019 and a number of the recommendations have already been implemented. There is a clinical lead in this space and a number of intervention teams are also in place. That has happened as a result of budgetary changes which I thanked the Minister of State for. She has engaged with me on it as well.

There is probably more we can do to incorporate the spirit of what she said here and what the Deputies opposite have put forward. I only say this to be helpful, but often on Committee Stage a Member is offered the opportunity to withdraw the amendment on the basis we might come back to it at a later Stage to examine the proposal. If that was to be the case, I wonder whether there is an opportunity for the Minster of State to be able to examine the inclusion of dual diagnosis. I appreciate the difficulty of getting into the business of having one specific condition referenced in the legislation, but the report spoke about the no wrong door approach being enshrined in legislation. Perhaps on Report Stage the Minister of State can come back with amendments of her own that take into account the spirit of what Deputy Clarke is proposing.

The no wrong door concept is an appropriate one. The Minister of State is familiar with it but I will outline it for the record. It is very common that people present at a mental health facility and are not treated because they are engaged in substance abuse, or they seek treatment in a recovery centre but will not be treated because of a mental health condition. This means they often fall between two stools. The DCU report is very extensive. Very senior HSE officials and so on were involved in it. Perhaps the Minister of State’s Department will examine it for Report Stage, whether the amendment is withdrawn or not. The Minister of State might consider bringing forward an amendment to encapsulate some of that.

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