Mid West earmarked for pilot to help people with drug and mental health problems

Mick Lacey, chair of the Mid West Regional Drugs and Alcohol Forum, said parents "are told if they have a drug problem, they need to sort that out first before the mental health service will take them.” 

Carol Moore of Dual Diagnosis Ireland said: "The majority of people in addiction have mental health issues." File photo

A pilot for a long-awaited health programme to help people with both a serious drug problem and a mental illness is due to start by the end of this year.

The HSE said it accepted there was a “clear need” for this intervention – which has been identified by health officials as far back as 2007. Advocacy groups and activists welcomed the development but said it was still just a “drop in the ocean” in terms of the ‘dual diagnosis’ (addiction and mental health) need among individuals and their families.

The HSE has earmarked the first pilot for the Mid West region, covering Limerick, Clare and North Tipperary, with confirmation of a second pilot pending.

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“We can confirm that posts are approved for the first pilot site, based in the Mid West Community Healthcare (CHO3) and negotiations are ongoing for the second pilot site,” a HSE statement said. 

“It is expected that the recruitment for the CHO3 pilot will be completed by the end of 2022.” It said the “further expansion” to any of the remaining nine CHO areas will be based on “available resources”.

It said this development came from the Dual Diagnosis Clinical Programme working group, which was finalising a model of care. The multi-agency group is under the corporate and clinical governance of the Mental Health Division.

“We recognise this as an extremely important development for which there is a clear need,” it said.

It said the programme "will be of significant benefit" to individuals with co-occurring mental health and substance use problems. Dual diagnosis needs have been highlighted in HSE reports and national drug strategies going back to 2007, including the 2012 National Substance Misuse Strategy.

A Clinical Programme for Dual Diagnosis was developed in late 2016 and the 2017 Sharing A Vision strategy called for a tiered model of integrated service. Sources said neither the mental health nor the addiction services had “stepped up to the mark” until now.

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Carol Moore of Dual Diagnosis Ireland said the previous programme “fell asunder” and said the current system was “fundamentally flawed” with some people adopting a purely medical model and not a holistic one.

But she welcomed the pilot: “It’s a drop in the ocean but it is a step in the right direction. It’s also going to be evaluated by patients – the first time that's happened. The majority of people in addiction have mental health issues." She called for addiction services to be regulated as part of the reforms.

Mick Lacey, chair of the Mid West Regional Drugs and Alcohol Forum, said: “There is an absolute need for this. The HSE needs to run this out as soon as possible. 

I would say the bulk of people with addiction have underlying mental health problems.

He said parents were “running around from one service to another” seeking help for their son or daughter. He said: “They are told if they have a drug problem, they need to sort that out first before the mental health service will take them.” 

Paul Sheehan of Cork Simon welcomed the move and said people have been “falling between the cracks”.