People in addiction forced to lie to access mental health services, former addict says

People in addiction are forced to lie to access much-needed mental health services due to the lack of dual diagnosis support for those suffering both mental health and addiction issues, an Oireachtas sub-committee has heard.

Many people suffering complex mental health concerns only have access to mental health care if drug- and alcohol-free, which is a particular problem when people rely on substance misuse to cope with mental health problems, the Oireachtas mental health sub-committee heard.

Em Murphy, a peer educator with the Dublin North North East Recovery College and the Recovery Academy of Ireland, said that, as a one-time service user with a dual diagnosis of mental health concerns and substance misuse problems, she had to lie about her addiction just to access help.

Many people are still in that predicament due to continued separation of the treatment of mental ill-health and addiction, when these problems often occur together.

Ms Murphy said she was one of the lucky ones who found help.

“Many people are still unable to access support. Many people are dead,” she said.

I started using drugs before my brain was even developed enough to understand why I was doing it.

"By the time I reached an age of being able to understand, I was already using drugs as my only means to cope with the weight of the world and how unsafe I felt in it.

“I didn’t know there was any alternative, or even that this was abnormal until a much later stage.”

Ms Murphy said it is not an unrelated coincidence that she grew up poor in a deprived council estate.

Substance use and mental health issues don’t develop in a vacuum separate from the social conditions of the people experiencing them.

Ms Murphy said people need “to see a light at the end of the tunnel”, to know life can be better to motivate them to tackle addiction.

At a low ebb in 2017, after losing her job, her home, and “battling a worsening drug dependence and health crisis”, Ms Murphy said she went to her GP for help.

“I was barely able to feed or wash myself, and had very little grasp on reality,” she said. “I went to a GP to ask for a counselling referral. I was refused a referral because of my substance use.

“I was instead put on anti-depressants and told to sort out my substance use issues first. I wasn’t advised on any resources to help me to engage with my substance use issues, such as information on local drug projects.

“Many addiction services also refuse care to people with mental health issues, and are told a similar story — ‘sort out your mental health issues somewhere else, we’re not qualified to deal with you’. 

As well as this, many addiction services refuse to see clients who are not drug-free.

Ms Murphy found a community drug project that accepted her still using drugs and got on a disability payment of €200 a week which allowed her to access private, low-cost counselling.

Liam Mac Gabhann, associate professor, mental health practice, at Dublin City University and chairman, Dublin North, North East Recovery College, has been working on the issue of dual diagnosis since 1999 — the “coexistence of mental health problems and significant substance misuse problems in an individual”.

He welcomed a policy mandate for dual diagnosis in the Government’s Sharing the Vision policy, but said planning for and delivering gold-standard dual diagnosis services requires adequate resourcing.