Excluding addiction from mental health services

Article written by Health and Wellness Central 

Madam, – The report of the Expert Group on Mental Health Policy, “A Vision for Change”, has determined that people with drug and alcohol addictions will no longer be treated within mental health services in Ireland.This means that the services required by people with substance abuse problems will not now be developed as part of the new comprehensive model of mental health services.

As members of the addiction advisory subgroup whose names are listed in the report, we wish to dissociate ourselves from these conclusions on addiction made by the expert group.


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We are seriously concerned that the general thrust of the recommendations on addiction in the report directly contradicts the approach recommended by the addiction advisory sub-group. We proposed delivering specialist drug and alcohol treatment services within a mental health service framework, as is done elsewhere. We also proposed that these services be delivered in the context of the partnership approach that underlies the current National Drug Strategy.

Despite receiving an interim report from our sub-group, the expert group never indicated that it was considering the dramatic step of excluding addiction treatment from mental health services. We have serious concerns about the effect on clients with drug or alcohol addiction.

No evidence is presented in the report to back up its recommendations and, as practitioners in the field, we are certainly not aware of where such evidence could have been obtained. We are unaware of any member of the expert group who has any specific expertise in treating addiction. Consequently, we are confused as to how the group could ignore our advice so completely.

The report emphasizes that its findings are the product of lengthy and extensive consultation. However, we are unaware of any mental health organisation or professional body which believes the separation of addiction treatment from other mental health services is good for service users. The expert group worked hard to create the illusion of consultation, but in our experience it had little interest in the reality of consultation.

As a multi-disciplinary group, representing the community, voluntary and statutory sectors, we co-operated enthusiastically with the expert group, viewing it as an opportunity to address the very serious deficits in drug and alcohol treatment across Ireland. Not only have we failed in our efforts to ensure a better service for people suffering addictive disorders; we believe that “A Vision for Change” represents a retrograde step for people suffering from drug and alcohol addiction. – Yours, etc,

Dr JOE BARRY, Senior Lecturer, Department of Public Health and Primary Care, TCD; Dr CONOR FARREN, Consultant Psychiatrist, St Patrick’s Hospital, Dublin; Dr EAMON KEENAN, Consultant Psychiatrist, Addiction Services, HSE Dublin Mid-Leinster; FRANCES NANGLE-O’CONNOR, Co-coordinator of Nursing Services, Irish Prison Services; ANNA QUIGLEY, Co-coordinator, Citywide Drugs Crisis Campaign, Dublin; Dr SIOBHAN ROONEY, Consultant Psychiatrist in Addiction Services, Drug Treatment Centre Board, Dublin; Dr BOBBY SMYTH, Consultant Child and Adolescent Psychiatrist, Addiction Services, HSE Dublin Mid-Leinster; JOE TREACY, Addiction Counsellor, Merlin Park Hospital, Galway.

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