Thursday, 8 September 2011
Joint Committee on Health and Children DebatePage of 3
Chairman: I welcome our visitors to our first meeting on the issue of illegal drug use. I welcome Ms Breda Cahill, General Manager, Mr. Raymond McKenna, Ms Geraldine Hartnett and Ms Josephine O’Mara from the Aislinn Adolescent Addiction Treatment Centre and Family Respite Unit and Mr. Ruairí McKiernan, CEO, SpunOut. I also welcome Mr. John McDermott, Chairman of the board of the Aislinn Adolescent Addiction Treatment Centre and Family Respite Unit and Ms Niamh Farrell, Office Manager and Mr. Jason Coomey, web project developer from SpunOut who are in the Visitors Gallery.
The purpose of this meeting is to hear from the delegation on the issue of illegal drug use from a youth perspective. Before we commence, I remind visitors that they are protected by absolute privilege in respect of the evidence they are to give to the joint committee. However, if directed by the joint committee to cease giving evidence in relation to a particular matter and they continue to do so they are entitled thereafter only to qualified privilege in respect of that evidence. Visitors are reminded that only evidence connected with the subject matter of these proceedings is to be given and are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against any person or persons or entity by name or in such a way as to make him, her or it identifiable. Members are reminded of the long-standing parliamentary practice that they should not comment on, criticise or make charges against persons outside the House or an official either by name or in such as a way as to make him or her identifiable. I now invite Ms Cahill to make her presentation.
Ms Breda Cahill: I am general manager of the Aislinn Adolescent Addiction Treatment Centre. I am accompanied by Ms Josephine O’Mara, assessment officer, Mr. Raymond McKenna, treatment manager and Ms Geraldine Hartnett, family services manager. Mr. John McDermott, who is in the Visitors Gallery, is chairperson of our board of management. Before I commence, I take this opportunity to thank the Chairman and members for the opportunity to meet this morning with the joint committee.
Every day in my working week I meet with and talk to parents who ask what the Aislinn centre can do to assist their son or daughter in overcoming their difficulties with drug use, abuse and addiction, a position which none of us as parents would like to be in. Our treatment programme reflects our understanding of what parents go through. We include parents in the process of treatment from the beginning. I am sure members will be aware that there is a cost involved in delivering that treatment. To remain sustainable the Aislinn centre must each year fund-raise for almost 25% of its total income. Such funding comes from the parents to whom I have already referred. One can imagine how difficult this is for these people in the current environment. We are here today to advocate on behalf of the young person and to share that young person’s perspective with the committee, on the basis of us not only being the only residential service in Ireland but also our 13 years experience in this area.
Nationally and internationally, there is an abundance of research that shows an increased and sustained trend in under-age alcohol and drug abuse. Nine out of every ten school leavers have drunk alcohol at least once; more than half of all early school leavers, 57%, have used cannabis at least once; and two-fifths of early school leavers, 40.9%, have tried at least one of these substances. The average age of first alcohol use for children born in 1990 was 14 years of age. These are daunting figures.
In Ireland, the National Drugs Strategy 2009 - 2016 states that its aim is to enable people with drug misuse problems to access treatment and other supports and to reintegrate into society. Adolescents who develop a chronic substance misuse problem need access to a residential therapeutic treatment programme and their families need access to a residential therapeutic respite programme. We believe therapeutic respite empowers change and allows parents to reclaim their families. Aislinn Adolescent Addiction Treatment Centre is a family-oriented service based in Ballyragget, County Kilkenny. It opened in October 1998. The centre was founded by a Mercy sister who recognised the lack of residential, drug-free facilities for young people. With the help of the Mercy Order and a number of volunteers, the story of the Aislinn centre began.
We have assisted almost 1,400 young people and their families with the plight of addiction. The young person comes from the family and returns to the family. It is vital that recovery be a family task. No man is an island and society must recognise and respond to the fact that no child is an island. The nature of substance misuse among adolescents has dramatically changed since the Aislinn centre first started operating almost 13 years ago. In that short space of time four significant changes have presented to us. First, it has become the norm for adolescents to drink, take drugs and go beyond experimentation into addiction. Families do not have the skills to support young people who develop chronic misuse problems.
Second, alcohol continues to be the primary drug and the drug of relapse. This fact is often forgotten or not addressed by society in the more glamorous headlines regarding drug use. As a society, we are unable to stop the flow of drugs and under-age drinking. Parents, society and national organisations need to question their attitudes to alcohol. There must be provision of services to support young people and their families through addiction. It can be very difficult for a young person to begin to recover in his or her own environment for many reasons, especially peer pressure. Hence the need for residential treatment.
Third, suicide is prevalent among young adolescent drug users. Families are experiencing increased violence and intimidation. Family recovery in conjunction with the adolescent increases the chance to establish changed lifestyles and abstinence from the drugs that are destroying their lives. Family involvement in all aspects of treatment is vital.
Another key component for adolescent recovery is a step-down unit following the residential treatment. It is important for the adolescent to develop coping skills to help him or her integrate into the wider community. This greatly reduces the risk of relapse. Unfortunately, the Aislinn centre does not have such a facility. It would be a huge addition to the service we provide. We need the Government to row in behind us so we can continue to maintain the only and unique service available here to our young people. They are such a vulnerable group and they are the future of our country.
As the only national service, Aislinn is a centre of excellence which has proven its ability to meet and respond to the ever-changing trend and challenges young people and their families face. No child is an island. It is not only the work of Aislinn but of the entire country to protect our youth.
Mr. Ruairí McKiernan: Thank you, Chairman for the invitation. I am very pleased to address the issues of young people’s health because the emphasis universally, in the media and elsewhere, currently is on economics. The measure of any decent society should be the health of the nation and that is the context in which I wish to address this topic.
Looking at where young people are today - many members are young - Ireland is unique in that we have the largest youth population in Europe. Some 40% of our population is under 30 years of age. That is a very important statistic. Some 25% is under 18 years of age. We have the highest birth rate in Europe which means youth issues will not go away, certainly for the term of this Parliament.
Many young people today came of age, or were born, during the Celtic tiger years which means they may not have the same coping skills or resilience levels as many of the older generation. Young people are quite often adversely affected by welfare cutbacks, health cutbacks, education cutbacks and, in particular, cutbacks in youth community services. They struggle with stress, exams, parental pressure, money problems at home, increasing levels of sexualisation of young people, pressures from body image, parenting and family breakdowns, lack of facilities in the community and a lack of role models.
The unemployment ratio in regard to young people is disproportionate. Up to 30% of under 25s are unemployed and some statistics suggest that 40% of young men are unemployed. We know from our work with young men and mental health that young men are adversely affected by suicide levels. Emigration has returned with a bang.
Some 50% of people we surveyed say the future is bleak for young people. There is a general sense of fear, uncertainty, frustration, rising tension and rising anger. We recently saw young people turn to head shops and we see them turn to binge drinking. In the UK, we saw them turn to rioting. This is the context within which we must understand youth culture today.
Spunout.ie exists as a youth-friendly and predominantly online service which provides information, support and opportunities to young people. We provide 3,000 to 4,000 fact sheets on everything from mental health to sexual health to physical health, including alcohol and drugs. We provide opportunities for young people to publish their news, views and opinions so that we can keep our finger on the pulse with regard to where young are at, and better understand them. We provide online mechanisms for them to discuss, debate and interact with each other but also for us to signpost them towards help services.
Outside of our online work, we provide small grants of €250 to young people who come up with innovative social solutions to drug or alcohol problems or other pressing needs. We have launched an academy of activism which seeks to empower young people to take action and take control in their communities so that they do not necessarily need to rely on politicians or government to find solutions and can find solutions themselves.
We will launch a national youth summit which will bring together several hundred young people next month to engage and debate all the issues affecting them and also to engage with the presidential candidates.
We started life eight years ago following a multi-agency feasibility study that provided an evidence base for our work which said that young people were not turning to traditional services so much, that the role of parents and schools was not as dominant as it once was and that the Internet was a growing mechanism to reach young people. My motivation resulted from my coming from a small town and growing up with a sense of boredom and frustration and wanting opportunities to engage and make a positive difference and from going to college and being immersed in an alcohol culture, witnessing the drug culture and having first-hand experiences of what the real issues are for young people.
Coupled with my own experiences and the evidence base I went about setting up an NGO from my bedroom in Donegal when I was 23 years of age. For the past eight years I have built up that organisation to the point where we now have six full-time staff, several freelance and part-time staff and a national board of directors. We reach 600,000 unique visitors online each year, making us probably one of the most widely used youth initiatives in the country. We have won several awards, a HSE innovation award, a golden spider award and many others. Our organisation is very much at the cutting edge of understanding and connecting to where young people are at. We seek to work with them but not necessarily for them to enable them to have a voice and make a difference in their own way.
We have noticed that the drugs issue is not going away and is increasing to the point where drug use has become normalised. Young people are turning to drugs out of boredom, escapism, self-medication, fun, fear and peer pressure. We are particularly concerned at the rise in heroin use. We have just moved to a new office in Temple Bar. Every day we witness from our window on the top floor of that building an alley where, in recent days, eight heroin addicts were engaged in heroin misuse. That is something we have all noticed while walking around the city centre. Ireland is in the midst of a very serious heroin epidemic. I am not sure it has made sufficient headlines just yet but that is only a matter of course. Ireland ranks sixth highest in Europe for its use of heroin and has one of the highest drug mortality rates in Europe. Groups such as Merchants Quay Project, the Peter McVerry Trust, the SASSY Project and the Matt Talbot Adolescent Services in Cork are calling for help given that children from eight to 12 years are seeking supports and there is a waiting list of two months.
We have noticed an increase in Circuit Court convictions and the mainstreaming of cannabis use among young people. We are pleased to see that, increasingly, a link is being made between alcohol and drugs and alcohol as a drug within the national health strategy. Alcohol is very much a gateway drug towards other illegal drugs. In the past ten years there has been evidence of a 40% increase in alcohol consumption in Ireland. Alcohol related deaths have increased by 400% and public order offences have increased by 82%. The prevalence of off-licences has increased by 300% in a seven-year period. We are aware from a Eurobarometer survey that 50% of 15 to 16 year olds have been drunk within the past 12 months and that 47% of teenage girls and 42% of teenage boys have been binge drinking in the past month. It is interesting to note that binge drinking in respect of young girls is increasing. The average age for introduction to alcohol has decreased from the age of 16 to 14. We are aware that alcohol is related to death by suicide and its harm rates are also increasing.
It is clear from HSE statistics that alcohol is costing the Irish economy €3.7 billion per year, that is, €3,300 per month for every taxpayer in this country, an issue that merits further exploration by the Department of Finance if we are to address health and economics in an interconnected way. The drinks lobby - the alcohol companies - is targeting young people. Alcohol Action Ireland studies have shown that 50% of young people’s top ten favourite advertisements are alcohol related. One in three 16 to 17 years olds have witnessed alcohol advertising via their social networks, whether it be Twitter or Facebook. There is evidence, therefore, to prove that alcohol companies are targeting young people and also that prices decrease substantially. On the whole, alcohol is not treated with sufficient seriousness in Irish culture.
What is the solution? We need more drug aftercare and out of prison treatment for addicts. There is a need to relate and connect with community groups as innovators and solvers within this area. We need to promote and advance the drugs court. We need to look at international evidence, particularly a recent report from the Global Commission on Drug Policy, which has categorically stated that the global war on drugs in recent decades has failed. It is not just that commission, which involves people like Kofi Annan, which has stated this. The former head of MI5 and the former head of the Crown Prosecution Service in the UK have also said that the war on drugs has failed.
If we look globally for alternatives, we can find many options. The Portuguese model might interest Ireland. I am not saying that we should emulate it, but it certainly warrants investigation, as the Portuguese have managed since 2001 to reverse a situation where they had one of the highest drug misuse problems. The drugs issue needs to be treated as a public health issue, rather than a criminal issue. We know that alcohol is a gateway towards drugs, so we need to tackle pricing issues. The World Health Organisation tells us that pricing determines availability and access. We need to empower educators, parents and communities to act as agents of change. We fundamentally need to have the determination to stand up to the drinks lobby once and for all. We know that the IRFU, the GAA and the FAI lobbied the new Government to ensure that there would be no ban on alcohol related advertising. We need to have political will and courage because this is about our children, and it needs to be taken just as seriously as the banking crisis.
Ultimately, we call for an inclusive process of empowering communities and listening to young people, but we also ask our political representatives to be bold, courageous and radical, because the problem warrants that.
Chairman: I thank Mr. McKiernan and Ms Cahill for the quality of their presentation. When researching this topic, I discovered that 90% of respondents answered “Yes” to Spunout’s Facebook poll on whether illegal drug and alcohol use was a problem for young people, which is a startling statistic. I call on Deputies Kelleher, Colreavy and Naughten to ask questions, and then we will move around the room.
Deputy Billy Kelleher: I will be brief. It was stated in the presentations that alcohol is a gateway to substance abuse. There is a strong tradition of alcohol in Irish culture. In recent years, there has been a change to how we socialise, how we consume alcohol, while the age profile of people consuming alcohol has changed quite drastically as well. The pub culture has changed. Looking at the number of slabs of beer bought in supermarkets around the country, we know that there has been a huge increase in alcohol consumption away from the pub. This is creating huge difficulties, simply because it is not monitored. In the pub scene, there is some semblance of monitoring, either by peers or by the public.
Given the amount of cheap alcohol now available, the committee should have a look at this. It was not envisaged that one could buy so much alcohol at the price available. We have the exact opposite policy for nicotine. We have stated that nicotine is bad for our health, so we have increased the price and made it difficult for people to buy it. We also state that alcohol is bad for us, but we have reduced the cost of it to the consumer. There is a dichotomy which this health committee should explore.
Funding and referrals are obviously key issues for the Aislinn Adolescent Addiction Treatment Centre. How is the centre funded? Who funds it? Who refers people with addiction problems to the centre? Many people have been talking about how best to tackle substance abuse. I do not think anybody has found a quick fix solution to it. People have said the war on drugs, internationally, is lost. They say we must deal with drugs as a norm in our society and that they will always be prevalent and available to our young people. The question is how we can educate young people about drugs and discourage them from becoming involved in the first place by making it less attractive. Role models were mentioned, for example. One must be very careful in how this is presented, particularly when one is male. Reference was made to this by Mr. McKiernan in a roundabout way. There are many positive male role models in the context of sport, although there are obviously negative role models as well. However, there are many negative role models putting pressure on young girls with regard to weight loss, including people such as Kate Moss. Is there something that can be done with regard to presenting positive role models in a more favourable way among younger girls? I have two young daughters and I am concerned about the role models they are presented with, about sexualisation at an early age and about the pressures they face with regard to dieting, smoking and so on. Maybe this is something we could do as a society. Most young fellows will be looking to the Kilkenny hurling team this week, unfortunately, but these are positive role models with regard to health and creativity. Even looking at the magazines that are available for young girls, one sees a sinister element creeping through. This is something we should consider. How we present it is a dangerous thing for a male to raise, but as a father of two young girls I should be allowed to do that, and we should be able to have an open debate about it.
These are just a few minor points, but I am most interested in the issues of referrals and funding. Another issue is step-down support. As a person who struggles with addiction to nicotine from time to time, I know that when I am off cigarettes I must avoid certain people because when I see them I think of cigarettes straight away - when we sit down we have a cigarette.
Deputy Billy Kelleher: Yes. This is a key issue. We can spend huge sums of money on taking a person so far, but if they are put straight back into the environment they came from there is a risk of failure. This is something we have not really thought through. I ask the witnesses to elaborate on the issue of step-down support.
Deputy Michael Colreavy: I welcome the delegation. It is good to be given information and knowledge from people who are dealing first-hand with those who are addicted to or abusing drugs and alcohol and to listen to people who are dealing with the consequences of that abuse.
The witnesses have been working with people, particularly young people, over the past several years. The drugs task forces were initially set up to develop local strategies for dealing with the causes and consequences of the drugs crisis in local areas. Since 2004, however, while lip service is still being paid to the national drugs strategy, the outworking of that strategy has been disappointing to me as an observer and as a legislator. This is visibly the case in the Government; drugs used to be the responsibility of one super-junior Minister and it is now one of the responsibilities of a junior Minister. That is a public declaration that the issue is of reduced importance and significance. The reverse should have happened because, based on what the witnesses have said, things are getting worse and will continue to get worse.
I would like the views of the witnesses on whether there might be a better model for local or regional drugs task forces and how the outworking of the strategy might be improved. I would like them to develop the point about cutbacks in the allocation to the organisations and the consequent reduction in the services they are able to provide. Much work which would be cost neutral can and should be done. That requires political will and a different way of looking at the problem and the opportunities. We must do more to involve the various State agencies, not just the usual suspects in terms of health services. I would include for example the Department of Social Protection. It is a Department which must be part of the overall solution. I will leave it at that for the moment. I thank the delegates for giving us the benefit of their experience. I would welcome their views on where they see the national drug and alcohol abuse strategy failing and how it could be improved.
Deputy Denis Naughten: Thank you, Chairman. There are several aspects to the issue and a one-size-fits-all approach will not deal with it. Young people are curious and will be vulnerable. Peer pressure is another factor. One could ask how we can deal with those aspects as well as the larger aspects in terms of demand and treatment. I spoke to someone last night who said that if one went to a medical post at Oxegen or other such concert that one would never go near drugs again given the cases of overdose dealt with by staff.
The issue of escapism arises probably to a greater extent because of the recession. Depression and suicide are tied in to drug use. It is difficult to deal with drugs in isolation without dealing with mental health. As a society we have not been prepared to acknowledge mental health issues and to talk openly about them. We can start to break down that barrier as members of communities throughout the country.
I am very interested in a comment made to me to the effect that it is a scientific fact that what goes up must come down. If we can get the message across it may help young people to realise the impact of drug abuse, including alcohol. The implications of the “down” are evident in society.
Peer support is very important. Mr. McKiernan made a point about innovative social solutions employed by SpunOut such as the superheroes grant. Could he give practical examples of how that works and the type of events that have been supported?
All speakers alluded to the problem of the double-speak from the State on alcohol. The price of alcohol was extremely regulated but that regulation was removed years ago. Now we have below-cost selling of alcohol. The fact that alcohol is costing society €630 per minute every single year shows how big an issue it is currently. Even though it is illegal to cultivate cannabis it is not illegal to purchase the seeds. I came across a website last night which provides free seeds for every Irish order - a five pack of Swiss mix - but shipping to the United States is not possible because receipt of such a shipment could result in life imprisonment in that jurisdiction. That type of double-speak which has been alluded to must be addressed.
Mr. McKiernan flagged what has happened in Portugal in the past ten years. There are two sides to the debate on whether the approach there has been a success. Drug use in Portugal has been decriminalised. The Swiss are also considering going down that road. We have an alcohol industry that is probably more regulated than in any other country in Europe. If we have been unable to get our act together in respect of alcohol, which is a legal drug, is legalising other drugs the best option to take? I throw open this question to both delegations present.
Ms Breda Cahill: I will respond to Deputy Kelleher’s question on funding. The Aislinn centre was founded as a charitable organisation 13 years ago and at that time, we received some funding from the then Department of Health. At present, we are part-funded by the State, as well as receiving funding from private organisations such as VHI, Quinn Direct, BUPA and Hibernian. However, as I noted earlier, on top of that we must depend on fund-raising, from which most of our income comes. We also receive some funding from the probation services but I refer to the sums required in today’s world to keep sustainable the Aislinn centre and to take it into the future. Unfortunately, what we receive from the Government in no way covers the present demand for services as experienced by the centre. Ms Josephine O’Mara will take members through the referral process in response to that question.
Ms Josephine O’Mara: Referrals can come from a broad area. They may come from any place in Ireland because we are a national rather than simply a local service. Referrals can come from private health care sources such as VHI, Quinn Direct or Hibernian, from the Probation Service within the Department of Justice and Law Reform, from addiction counsellors or from outreach workers who work within different HSE areas nationwide. However, we take referrals from anyone on a national basis.
Mr. Raymond McKenna: On the step-down unit, I will speak briefly on getting to that point. I note Deputy Kelleher referred to his daughters and I am sure everyone present has sons, daughters, grandchildren, nephews or nieces. In the Aislinn centre, we work very much from the heart because we work with this highly vulnerable group of people. I reiterate we are the only unique organisation in the nation that addresses this problem head-on. Adolescence is an extremely difficult time in anyone’s life and members should think back on their own experiences in this regard. It is a difficult time without being interrupted by addiction. As my colleague noted, families are neither educated nor know how to cope with this issue.
If I may, I will take members briefly through what presents at the Aislinn centre. Members should picture their sons or daughters arriving home stoned or high at the age of 13. They then should picture them slowly starting to develop other problems, whereby they begin to use other substances such as ecstasy, weed, cocaine or head shop drugs. Suddenly, they disengage from activities such as hurling, sports, Irish dancing in the case of girls, hip-hop or whatever activity in which they are involved. Suddenly, they switch off their telephones when they go out and one is unable to make contact with them. One lies in bed wondering what will happen to them or whether they are going to die. Suddenly, one begins to receive telephone calls from the Garda asking one to collect one’s son or daughter. Members should picture the shame felt by such a family, as well as by the young person in question, only for him or her to recommit the same action over and over again.
Deputy Naughten referred to mental health issues. Many of the parents in question have to bring their children suffering from depression to mental health services. Their brains have not fully developed, yet they are putting large quantities of substances into their systems. Other medical issues also arise as a result.
On top of this, there is a large gap in the mental health system for dealing with 15 year old patients. Over the past 13 years, the Aislinn treatment centre has been able to create an environment in which adolescents and their families can be held and feel they are safe, allowing them to come out of the chronic world of addiction. We treat the whole person mentally, physically, emotionally and spiritually. We are dealing with human beings and, in these cases, the most precious of our society. They can take time out away from their community and peer pressure in an environment in which they are treated with respect and dignity and in which trust can be built.
Over time, they can explore the issues that contribute to their addiction such as grief and loss at home, abandonment, eating disorders, rejection, and physical, emotional or sexual abuse. They can also address in detail the problems that were caused by the addiction. With the help of the staff, they look in depth at how their addiction affected themselves and each member of their family. They can begin to rediscover who they really are. The six-week course is intense with a two-year after care programme. We prepare people on how to reintegrate into the community.
We also work with other organisations. Family conferences are held, with a family therapeutic programme running through the addiction counselling process. Some people may not have a safe environment to go home to and may not have familial supports.
There is no step-down unit for 15 to 18 year olds leaving a residential centre like ours, even though it is 2011. What will be done about this? We talk about under age drinking but why is it happening? Why can politicians not stop it? One cannot get a drink in America until one becomes 21 years of age. Why can it not be done here? Members should imagine what it would be like were it their families who were affected.
Mr. Ruairí McKiernan: Deputy Kelleher raised the point about role models. Positive role models, especially for young males and women, are required. We need social marketing campaigns in this area. Their development and design is critical. If we continue to commission such campaigns from high-end agencies without any grassroots understanding of where young people are at, we will end up with expensive and ineffective billboard posters and flyer leaflets which will be irrelevant to young people.
Agencies such as ours, however, are that little bit closer to the ground in understanding role models for young people. When we invite a celebrity or guest speaker to an event, it is difficult to find a role model with whom all young people will identify. As we interact much with young people, however, we have sense of where they are at. Over the years the State has moved back a little from health promotion and social marketing, which are areas we need to ramp up again. I agree that not everything is funding dependent. Much creativity and innovation can happen with the existing resources. I still think there is a great deal of waste in terms of social marketing expenditure on public health and so forth.
Deputy Naughten asked about the superhero grants. The philosophy behind it is that those between the ages of 16 and 19 have ideas, are intelligent and are ready to rock, and merely need a leg-up. Some €250 will not solve the world’s problems, but it might help - that is the beauty of it. That €250 is an award to them. It is an investment in them. It is an acknowledgement of them. They are running around chuffed and excited, and feeling like they can do anything. That is the message we need to give young people, that they can do anything rather than that it is all uphill. Young people do not have barriers in front of them; they are not beaten down. They are energetic and enthusiastic; they are not disillusioned. The grants are a nod to that.
We have only had one round of the superhero grants so far. People have come up with entertainment events, gigs, alcohol-free and drug-free events. Young brothers launched a tree planting initiative in their community where they rallied their entire community to get active in planting trees rather than waiting for Coillte or whoever to plant them. A DIY culture is what we are trying to promote. There are also youth media initiatives where young people start publishing on their own websites, news and magazines. They complain that there is negative stereo-typing of young people, so why not let them take control of their own media? There are other great initiatives around the country such as the Young Social Innovators, which would be one of the bigger ones.
I agree with the comment Deputy Naughten made about the one-size-fits-all approach. It is not black and white. This is not Portugal or the Netherlands. No one piece of magic legislation will sort any of this out. A holistic approach is needed.
Deputy Naughten was correct to identify mental health as one of the big issues here because if people are unhappy and depressed, they will look for solutions, either legal or illegal medications. We can address much of this at source if, particularly at early childhood and in schools, we start to look at investing in helping young people to explore their emotional and spiritual well-being. It is interesting to look at the revelations and the tyranny of abuse that has happened in this country. As we start to try to understand who we are as a nation, we need to look back to our history which has been one of wholesale abuse, whether it be physical, sexual or mental.
We have a great opportunity here. I am quite optimistic about much of it, if we make the correct decisions, but there is every chance we will go back into the same circular process of despair. We have been there, in the Famine and on many occasions. We have an opportunity for a fresh-start to some extent here and some radical thinking is required. Now is the time for people to be bold and imaginative. It is time to get stuck in.
I am in favour of being interconnected and relating to the Department of Social Protection. We should not have this discussion in any little myopic silo whereby the drugs committee meets and the alcohol committee meets. They all should talk to each other because these are interconnected issues.
I would encourage the following as priority areas of action. We need to prioritise alcohol abuse. We need to tackle it head-on, to start owning up, to tackle the drinks industry, to tackle pricing, to tackle the consumer legislation around availability and marketing, but also to make the link with alcohol as perhaps the gateway drug.
We need urgently to tackle the heroin issue. We will have no choice. It is so visible everybody is talking about it. People are starting to lock their doors driving through the city centre. It is a critical issue. I would encourage the setting up of a task force or commission with real teeth to promote real investigation into these issues and to promote debate and recommendations because they are serious public health issues that will have further economic consequences.
Deputies Kelleher and Colreavy asked about funding and cutbacks. During the first few years of our existence, we survived on crumbs from different places and we did projects and consultancy. We winged it but we started to get money from the then health board and the HSE for project funds and, over time, the health promotion unit and the national suicide office have joined forces to invest in us for three years. This provided 30% of our funding. The other project funding came from different small grants, community fund-raising and, particularly, philanthropy. The One Foundation invested up to €500,000 in us for three years and, more recently, Atlantic Philanthropies has invested in us for three years. However, our One Foundation cycle has concluded, as have many of the other initiatives, as Senator van Turnhout will know from her work with the Children’s Rights Alliance. The One Foundation and Atlantic Philanthropies have been propping up the positive high end delivery in the non-profit sector and both of them are exiting stage left in the coming years. We are in a bit of a crisis at the moment. Our HSE funding has diminished from 30% to 20% and it is hard to get confirmation of multi-annual funding. It was only this summer that we found out we would be funded for this year. There is anxiety about how we deliver and plan an effective service if we do not know that we will be around in a period of months. At the same time, demand for our service is increasing exponentially. We are reaching 600,000 unique users a year and there is no reason we cannot reach upwards of 1 million within the next year or two.
The Internet is one of the more effective solutions. The European Commission released a report last month regarding effective solutions to drug abuse among young people, which highlighted the Internet as the number one way young people like to receive information and support.
Ms Breda Cahill: I refer to Deputy Naughten’s question about funding for Aislinn. This year’s funding was cut by 3% by the HSE and, therefore, from the perspective of trying to plan for a three to five-year programme, it is hard at the moment. Money was stopped completely for our family programme, which was funded by the south eastern regional drugs task force on the basis that we were a national service. We are trying to continue to deliver the family service, which is vital, on the same income we have had for the past two years. Ms Hartnett will talk to the committee about that. It is vital that Aislinn be given a definite figure going forward. This year we were lucky to open a detoxification unit in conjunction with the HSE as a pilot project. A number of people have gone through that programme over the past number of weeks and it has proven to be beneficial. We see that as an important aspect of our programme going forward but it has hard for us, as managers, to sit down and put on paper anything we would like to plan over the next three years because it is all based on our funding.
Deputy Catherine Byrne: I thank Mr. McKiernan for his comprehensive presentation and, in particular, for the facts and figures. For somebody who comes from a community ravaged by drugs over the past 20 years, it is encouraging that many young people want to become involved. The organisation contacts a huge number of people. Is there anything SpunOut can do in communities? I accept the comments about planting trees and so on but many organisations, youth clubs and community centres are finding it difficult to get volunteers, particularly young volunteers. Older people are still willing to give up their time but young people do not have the same interest. I joined a youth club at the age of six and a half and I would not be the person I am today without the contribution that was given to me in my local community. As the witnesses have such a unique way of contacting so many people, it is important that they try to promote people’s involvement in communities. We are at a time when there is not the amount of money there was and our communities need to refocus and go back to the earlier days when people gave voluntarily of their time, but most of all of their skills. Many people are now unemployed and they need different skills, so people have a significant contribution to make to their local communities. It might be true of organisations such as those the witnesses represent. Perhaps it would be possible for them to reach out to the 600,000 people with whom they deal and ask them to get involved in their communities, because there is a real opportunity to do something locally, especially for young people.
I absolutely agree with Deputy Colreavy’s remarks about the Minister of State’s position. For all the failings of the previous Government, one positive thing and probably one of the most important things it did was to appoint Pat Carey as Minister with sole responsibility for the drugs issue and the national drugs strategy. I am a lot younger than him, but I know from way back in my youth when I was involved in the Catholic Youth Council that Mr. Carey, through his work and through being a teacher, had a real insight into dealing with people with drug addiction and with communities. It is a failing of the present Government, of which I am a member, that we have not appointed a Minister at Cabinet with such responsibility, someone to be part of that unique forum. If there is one thing that we will regret in ten or 20 years time besides the loss of jobs, it is the loss of young people through drug and alcohol addiction. We will keep on regretting it until someone decides to do something serious about the issue. We should step up to the mark and appoint someone to a position in which they will be able to make the necessary decisions. For all those reasons, I agree with Deputy Colreavy’s important comments.
If committee members look into their hearts and minds and consider the huge sum of money that has been spent on dealing with drug addiction in terms of investment in rehabilitation and communities through the national drugs task force, the regional drugs task forces, community partnerships and community development groups, they will see that there has been substantial duplication and a great wasting of money. We need to tackle that rapidly because we no longer have the money we had and we are getting to the stage where such groups are fighting for their existence. Some of them should not be funded but should be done away with - that is my personal response.
For all the bad things the church has done in this country and all the evil that has come out of it, in fairness to people such as Sister Consilio and the Sisters of Mercy who set up the Aislinn centre, there are glimmers of hope. That is why I still believe the church has a major place in our society.
When I was Opposition spokesperson on the national drugs strategy, I visited many places throughout the country, using my own car, spending my own money on petrol and giving of my own time, so I can talk well on the subject. While I come from an area that has been ravaged by drugs and I have been a voluntary youth worker for most of my life, which gives me an insight into this subject, nonetheless, I wanted to see what was out there, what money was being spent and how we were going to tackle the problem in the long run, whether with small or large groups. The Merchants Quay Project, which will be attending later, is probably one of the best organisations in the country in this area.
Regarding the Aislinn group, I agree with Mr. McKenna, who said it better than I ever could. I was inspired when I visited the building. It was a beautiful morning and the building, which is in a quiet part just outside the town, has a lovely entrance. What struck me going into it was the sense of peace and the sense that I was going into a very special place. This is regardless of whether one is a spiritual person. Certainly, by the time I left I was very touched. I could also see an effect on the people working there and on those involved in the programme. The 12 steps through which the organisation takes people were explained to me. What most inspired me was meeting the parents of children and young adults who were involved in the service.
As the witnesses said, the Aislinn centre is a unique organisation. We can do far more with small groups such as this than with major organisations. The personal touch in the Aislinn centre left a deep impression on me, as did the dedication, kindness and heartfelt and genuine concern for the young people availing of the service. I felt a sense of hope from what was said by the people I met when I visited. Many of them had a certain clarification in their minds, if not their bodies, about where they should be in the coming years. For me, this was part of the uniqueness of the centre. It helps people find themselves. One of my children told me I had to find myself, whatever that means. Many people in the centre were beginning to find themselves for the first time, beginning to respect themselves and above all beginning to believe in themselves. As a parent, I feel that sometimes we do not listen enough when our children catch us in the kitchen or put their arms around us in the evening and want to sit there and speak to us. Sometimes, we do not give them that time. If we did, many children would be in a better place.
I recommend to the committee, if the Chairman allows, that we appeal to the Minister of State, Deputy Róisín Shortall, and the Minister for Finance to allocate money to centres such as the Aislinn centre and to restore funding to continue to help this service. I have known many young people in my community who have lost their lives, including four or five members of the same family. There is a sense of hope in an organisation such as Aislinn. It may not deal with thousands of people but it helps those with whom it does deal and it changes their lives forever.
Since the day I visited the Aislinn centre I have looked at myself, my community and, above all, my children in a different light. Mr. McKenna stated that it is only when the issue knocks on one’s own door and calls to one’s own house and community that one realises how important it is to have little groups of people making a difference. I compliment the witnesses. I have no words to portray the centre better than Mr. McKenna did. I thank him for his presentation.
Chairman: In fairness, Deputy Byrne does not and I appreciate it. Eight more members wish to speak and I must find a balance between the Government and the Opposition. I know people are getting frustrated. We must also return to a discussion on our work programme and correspondence.
Senator Jillian van Turnhout: I thank both groups for coming before the committee today. I thank the representatives from the Aislinn centre. I did not know of its work prior to today. While preparing for today’s meeting I researched it, and hearing the testimony of some of my colleagues has also helped. I also thank the representatives of SpunOut. I was aware of its work and I have been involved.
The witnesses clearly outlined for us the direct harmful effects of alcohol and drug misuse. It is also important to realise the indirect effects on children and young people of adults drinking alcohol. All too often we speak only about young people and we neglect the effects and impact of parental drinking and drug misuse. It is estimated that 104,000 children under 15 years of age are living in households where there is drug and alcohol misuse. One in six cases of child abuse is attributed to alcohol abuse. The old saying “They do not pick it off the ground” is true. While we often shine the spotlight on young people and children we neglect to acknowledge from whom they get their standards. I am sure members of the delegation will agree with that. I am encouraged by the increase in membership in sport and youth organisations. The biggest problem faced by these organisations is finding adult leaders. We must do all we can to encourage adults to get involved as volunteers.
An important point was made earlier in regard to the drinks lobby. I would like to share my experience of the drinks lobby. I have written two EU reports on the harmful effects of alcohol, one of which brought the drinks lobby down on top of me with a mighty bash. I was a member of a European Economic and Social Committee made up of 344 members, all of whom were individually lobbied to discredit me and the report I wrote. I was fortunate in that I had built up a good reputation as a member of the committee and my colleagues stood with me and voted in favour of the report.
While in 2003 draft legislation to regulate the exposure of children to alcohol advertising received Cabinet approval, following a change in Minister for Health and Children a voluntary code for such regulation was put in place. It will come as no surprise that that voluntary code mirrors exactly the proposals put forward by the drinks industry, including the grammatical errors put forward in the proposal. That is absolute fact and is on record. That is the type of influence being had at every level. As representatives, we should be open about the representations we receive and should be able to discuss them.
The delegation spoke about funding. We take on board their views in that regard. The joint committee will be meeting with the Minister with responsibility in this area. While I acknowledge there is no one solution to this problem what one action would the groups take or suggest we should be focussing on?
Senator John Gilroy: I was a psychiatric nurse for 25 years and as such I have a particular interest in mental health issues. I was recently appointed by the joint committee as rapporteur on suicide. I live in a constituency with possibly the largest emerging suicide cluster among young people in this country and, perhaps, even further. Some 18 young boys, aged between 15-16 years to 19-20 years in a small area within my constituency have committed suicide during the past two and a half years. Members and I am sure the delegation will be aware that the unit by which the instance of suicide is measured is per 100,000 of population. In this cohort of people one might expect to find 35 per 100,000. In the area in which I am living the figure is 350 per 100,000, which is awful. As a society and as politicians must do something about this.
I smiled when Mr. McKiernan said SpunOut is offering strategies without depending on politicians or the Government. I smiled because Mr. McKiernan is dead right. If we wait for Government or official agencies to do anything we will be left waiting a while. We have in this country replaced political courage or activity with political expediency. I am 44 years old. I believe young people should attend school, come home and do their homework, play a game of soccer, football or hurling and then watch television for half an hour before going to bed. However, I do not believe that is what they do. We need to stop being paternalistic about how we view young people and should listen more to them. It is in this regard SpunOut can be particularly useful and valuable. There appear to be few facilities or places available for people who are in immediate crisis. We see that all the time. Gardaí tell us that they encounter young people out late at night who perhaps have consumed alcohol and are upset, depressed or even transiently unhappy, but they can do nothing short of arresting them. That is a terrible indictment of our society as well.
The mobilisation of community and voluntary services is the way to go. The resource in that sector is enormous and must be utilised. “Exploited” is the wrong word but that is the way we must go. Alcohol has correctly been identified as the main drug that is misused here and we must have the courage to do something about it. Sometimes one hears talk about headline options such as banning advertising, introducing minimum pricing or restricting access. These are just headline issues and by themselves will not make the difference. I agree with Mr. Michael McDowell, and I hope it is the last time I am ever heard to do so, that there must be a cultural change. His idea of introducing a cafe-bar element into Irish society was probably the way to go but, again, we lacked the political courage to do it.
I commend Deputy Byrne on everything she said. She spoke eloquently and articulately today and at our last meeting and I was struck by her comments. I am a member of the same Government and I am disappointed that we have not given mental health, as well as the drugs strategy, a junior ministry. Mental health has been allocated to a Minister of State who is responsible for three other areas and that is disappointing. If we are serious about tackling the incidence of suicide, there should be a Minister of State working across every Department on that issue.
Ms Breda Cahill: The way society is at present, young people appear to have the money regardless of what price is put on a bottle of alcohol. What might be more beneficial is an initiative in the education area. If their parents were educated and could talk to them in a more structured way about the use and abuse of alcohol, it would be better than putting a certain price on alcohol. If they were more educated, that education could be brought into the home or into the schools. We should start to educate young people at a much earlier age. There is a small amount of education about alcohol and drug abuse in some schools but the Aislinn centre believes it should be introduced at an earlier age, from the age of eight or nine years. What we see presenting and the queries we receive at present relate to 11 and 12 year olds, so that would be a greater help.
Deputy Robert Dowds: I will try to be brief. I particularly sought to have this presentation to the committee because I represent a constituency where many people suffer hugely due to alcohol abuse and, by extension, drug abuse. I appreciate the work the delegates and their organisations do and the time they have given to talk to the committee. I strongly support what my colleague, Deputy Catherine Byrne, said, particularly about encouraging people to become involved in their communities. That is really important. People who are so involved are highly unlikely to abuse alcohol or drugs.
I agree with Senator John Gilroy in regard to minimum pricing. I will be interested to hear Mr. McKiernan’s comment on that because there should be a minimum price on alcohol. The idea of being able to buy 24 cans for €24, as in a recent Tesco offer, is absolutely outrageous.
I would like to hear the witnesses’ views on whether they think it would be a good idea if we could manage to ban the advertising of alcohol. I think I know their views on whether we should try to break the link with drinks companies promoting sporting events. I would like to hear the witnesses’ views on whether reducing the use of alcohol would have a knock-on effect of also reducing people’s involvement in taking drugs.
I have asked the following question of community workers working in the drugs area in my constituency. Given what Mr. McKiernan said - unfortunately, I am inclined to agree with him - that our tackling of illegal drugs has been a total failure, how does he think we should approach that whole issue? For example, should we go for selective legalisation of some drugs in order that we can work on tackling more serious drugs or would it be better simply to stick to the bans which currently exist and try to encourage people away from drugs in other ways, some of which have been suggested by others here?
Deputy Peter Fitzpatrick: I thank the delegates for coming and for their fantastic presentations. I consider myself very gullible when it comes to alcohol and drugs for the simple reason that I do not drink and have no involvement with alcohol. I also come from a sporting background.
It is very important to educate parents. I am a parent and it is important to identify the early signs of alcohol and drug abuse. I have children and would like to know whether there is any indication, at an early stage, that one’s child is involved with alcohol or drugs. The reason I ask that is that many children stay overnight with friends and for some reason, they seem to be the one’s covering up all of this. Can the witnesses educate us and tell us the best way to look for signs?
We realise the damage alcohol and drugs can do. I was educated today and want to be further educated. We need much help from these organisations to educate us. That is all I want to say because the answers to questions asked have been fantastic. It is a learning curve for everybody, especially for me. I very seldom call myself gullible but I realise this is a very serious issue. We will help the organisations but most important, they must help us to educate ourselves.
Deputy Regina Doherty: I join with colleagues in thanking the delegates for the presentations, which were outstanding. In particular, I congratulate and am in awe of Mr. McKiernan who started an organisation like SpunOut at such a young age.
I wish to ask two questions already asked but perhaps with a slightly different slant. The minimum price has been bandied about a lot. While that might feed into certain elements of the drinks industry, which is none of my concern, I am conscious that even if we did have a minimum price for alcohol or drugs, people who really want them tend to find the money somewhere. That is borne out by the fact that the likes of heroin and cocaine are not cheap for the average teenager, so where do they get the money?
Accessibility is more of an issue. I disagree with the previous Government’s policy of this cafe culture. We have opened up to every dog and devil selling wine in not only supermarkets, which is seriously wrong, but in almost every petrol station. One can almost buy it on the corner of the street at this stage. That might be acceptable in countries such as France, Spain or Greece where there has been a culture of introducing alcohol into families at home from a very young age where they have a very strict control on how they drink it. They drink socially and take very little in comparison with the Irish who gulp it and try to take in as much as possible and as frequently as possible. I do not know how we can change that culture, other than through education.
Do the delegates agree that if accessibility was reduced and restricted it would have a serious enough impact? I am also curious about the influence of marketing. While I appreciate that for major sport events drink is big business, how influential is marketing to the average 14 or 15 year old, particularly the glossy magazines which have pictures of beautiful, skinny women? I am not sure the average 14 year old is experiencing the alcohol of choice in the same image depicted in the magazines. Does it still have the same effect? The reason I ask is that when I was young, which is a good few years ago, my first choice of tipple was Smithwicks. That was not because I saw a glamorous woman in a magazine drinking it but it was what my father drank. How much of an influence does marketing have over and above practices in the family home or in the wider circle?
Ms Geraldine Hartnett: We need to remind ourselves that we are talking about 15 to 18 year old children and our job is to protect them, not to worry about prices. We are responsible for the care of children. If drugs were legalised the effect on the developing child would be very dangerous. Drug use would inhibit brain development, coping skills and general development as a human being. We need to protect children from that. The way this can be done is by revising the SPHE programme and making it compulsory in every school. Parents need education and much support. The most important thing in a home is communication. One of the things we have discovered in the Aislinn centre is that kitchen table communication is gone. At a meal, children let things drop into the conversation when something is not right. We have to bring it down to the simple things in life.
The age at which a person should be allowed to drink in Ireland should be 21. I sat outside an off-licence one night in a southern county. The programme on head shops had been on television the previous week showing the number of people who frequented those shops. I can guarantee that the same number of people frequented the off-licence that night in one small town as frequented the head shop. The drink was carried out in boxes and bags.
Some of the drugs task force actions have not been followed through. They have recommended support for families. We run a therapeutic respite programme for families. However, our funding was withdrawn because we were a national organisation and it was a regional organisation. It has a point, but 52% of that group was from that region. There is no common sense. Dr. Comiskey said the centre is of value to parents, it is an excellent service and well run, yet our funding was withdrawn. Parents must be educated. Deputy Fitzpatrick is correct. Parents do not have a clue, there is a huge generation gap and they do not understand drugs. Were it not for the fact that I am in this business I do not think I would understand it.
I gave a talk in a school to fifth and sixth classes but kept it to the minimum. They asked afterwards if they could show me a book, saying they knew how to skin joints and so on. I agree with Ms Breda Cahill that education must start at fourth class and parents need a great deal of support. Suicide, intimidation and violence have crippled parents. Parents are remortgaging their houses to support their children to pay drug dealers or to keep them alive. Increased violence in the home due to alcohol and drugs has affected parents, but I would say that communication at the kitchen table and education are important. It is wonderful to see a service where children can link in with education and such supports. We need to work together as a country. No individual has the proper answer, but together we all have the right answer.
I agree with Deputy Byrne. Some services are being duplicated. Deputy Byrne visited us, so perhaps other committee members need to visit some services to see for themselves what is going on. Suicide is crippling our country, so I commend the committee on taking on that job because it is tough.
Mr. Ruairí McKiernan: I will respond first to Deputy Byrne’s comment on working with more disadvantaged communities. We have found that working with people who come from disadvantaged backgrounds is very time intensive because there can be issues around literacy, family breakdown and so on. We have found that we have had to resource that much more. Unfortunately, we have lost one of our roles in our team that specifically dealt with youth engagement. That is not to say we want to cop out of that. In previous years, the Internet was seen as more of a middle class venture, but it now penetrates most areas of society.
We have tried to integrate an awareness into all our work so that when we are holding an event, we are not just conscious of people’s backgrounds but also have a policy of reverse discrimination. In our academy of activism, we will select people we feel will benefit most or who may have the fewest opportunities in life.
We are very supportive of volunteering and Volunteering Ireland. There is a great deal of focus on that at the moment because 2011 is the European Year of Volunteering. Politicians do not have all the answers, but people should not expect them to have them all either. There are 4.4 million people living in the Republic of Ireland, and each one of them can be his or her own politician. If we mobilise them as agents for change, then we will not have to continue to rely on dwindling resources. Volunteering is part of that process.
Much of the duplication and waste at NGOs has been stripped away. There are now many lean and mean charities, but I suspect there are always ways to be found which will require extra digging. I recently learned that another student youth website has recently been funded and a whole range of them have popped up over the years. We will support them and co-operate as best as we can, because we do not own the space as such. I learned that this group got €1 million in various forms of State funding. How and when did this happen? I have been lobbying for eight years for State funding, yet we have got nothing from the Department of Children and Youth Affairs. It has all been from the HSE. Silly decisions are still being made somewhere. This leads charities to being competitive with each other, and that is unhealthy because we spend much of our time trying to get seen and heard in the right places and putting much of our energy into lobbying for funding, whereas we should be getting on with our job. It introduces an unhealthy competitiveness within the charity sector, although an element of competition is not necessarily bad because it keeps people on their toes.
I appreciate the comment about the church. It is important that we provide credit where it is deserved on the welfare and pastoral role provided. There is a lack of spiritual mentoring in the country and the baby has been thrown out with the bathwater to some extent. The role of the church to lead the flock has been left to the advertisers. Who is there to promote a healthy vision of how to live a good life? The parents can do that to some extent, but when we have a generation of parents who are in crisis and are contending with their own faith struggles, a vision of a better life is being provided through images of beautiful women, successful lives and Hollywood. We have abandoned many young people to the market forces of advertisers and marketing, and they provide the pastoral role at the moment. The community, parents, politicians and youth groups need to reclaim that pastoral role urgently from those who seek to profit from it.
Mr. Ruairí McKiernan: All right, so I have to be practical. We have an alcohol crisis; we have talked about it. We have lots of research and evidence for it. It is time to mobilise to tackle the crisis, and this requires willpower, muscle, credibility and urgency. We must stop dilly-dallying around and not spend another five or ten years discussing whether we have an alcohol problem. We have an alcohol problem. Let us get stuck into it.
We covered the issue of mobilising the voluntary sector. On the question of minimum pricing, as raised by Senator Gilroy, there is not a quick solution that will tackle all these problems. There is evidence to suggest that the real price of alcohol has gone down 50% in recent years, and the World Health Organisation has evidence that pricing has a real, direct and immediate effect on availability, so I will defer to it on those grounds, but I do not think it is as simple as that. Minimum pricing will not solve all our problems. We need to tackle marketing and education. The SPHE curriculum is key in this regard. Underlying all of this is the mental health issue: if we want to move on from fire-fighting mode, we must get underneath the surface of the country and the culture and find out what is eating us.
With regard to the question of a ban on alcohol advertising, the National Youth Council of Ireland has done some good research on whether advertising has a real effect and has proven pretty much categorically that advertising works. It targets and reaches young people, and that is why advertisers do it. They spend a hell of a lot of money on this, including employing psychologists, and they would not do it if it did not work. Alcohol Action Ireland also does a great deal of work on this.
With regard to the debate on legalisation of drugs, I do not know. I would certainly advocate for an exploration of decriminalisation because the State is using up many resources arresting people for small things. It is a public health issue. People may get a slap on the wrist or whatever. It is a serious issue and it must be dealt with, but a great deal of Courts Service time is being used, money is being spent and many people are going to jail because of what is probably more of a public health issue in some instances.
One programme I would like to highlight is the alcohol and substance abuse prevention, ASAP, programme run by the GAA, which has 1,500 regional community officers to promote positive outcomes for young people.
Somebody brought up the issue of role models. The onus is on each of the members to be role models because they are public representatives. They have all been young and been through their own problems, and will probably go through more, although I hope not. It is up to them to be courageous and speak openly and candidly about the issues facing the country rather than falling victim to political expediency.
Senator Colm Burke: I thank the delegation for their comprehensive submissions. It is interesting to see where they are coming from. One of the things that struck me was the number of people who touched on the issue of certainty of funding. A number of years ago I was involved with a centre which provided full-time training to 50 young people who had dropped out of school. They had major problems with literacy and numeracy. I remember, as chairman of the board, having to spend a great deal of money without any certainty about whether more would come in, so I know where the delegates are coming from. The one advantage I had was that we were funded by FÁS. Many people criticise FÁS but we were lucky because we knew funding would come in at the end of every year. We are talking about putting together, in the next two or three months, a three-year budget, as opposed to a one-year budget. I wonder about the approach of the organisations if funding is provided by the Government or the HSE not on a year-to-year basis but on the basis of a set commitment for a three-year time period. This would provide certainty in the same way as the groups that provided funding for the organisation for three years. One of the requirements of organisations such as Aislinn is certainty of funding so that they do not spend a significant amount of time trying to source funding when they could be doing more constructive things. Have the organisations approached it from that point of view and has there been any indication that such an approach may be considered as opposed to funding for one year or two years?
One positive thing based on the project with which I was involved is that five years after leaving the centre more than 70% of those involved were employed and some of them were self employed. It goes to show the positive impact and benefits that accrue from the investment of even a small amount of money. Aislinn is an example of that. It is good value for money. It is important to ensure certainty of funding for the organisation.
Deputy Ciara Conway: I promise I will be brief. I thank the delegates for their presentations. I have a question for Ms O’Mara on the assessment of children. We are speaking about children. I have worked in this area as a social worker in south Tipperary and I dealt with the Aislinn centre previously. I am familiar with the service it offers. Often the sad child becomes the bad child. I do not say that in a flippant way. There is a severe failing in the system. I do not wish to categorise but from my experience many of the children we are talking about come from poor backgrounds with significant family breakdown. They fill a void not because of marketing but because they have nothing else in their lives, they feel sad and those issues are not being addressed. How does one assess those children and how is the waiting list? My fear is that it is high.
A survey was carried out by Ms Maeve Martin, a psychologist in the south east, on primary school children and their mental health. The results showed that we have poor mental health among school-going children. I accept the point made about young children. Parents have a great deal to answer for in that they are afraid that if they tell children about drugs or sex they will become rampant on the drug and sex scene rather than equipping them with the information so that they can make positive choices. That is the case in particular for poorer children in society.
Ms Josephine O’Mara: The assessment is comprehensive. A person comes for an assessment preferably with a family member because we treat the whole family. As Deputy Conway indicated, there are different types of family. The ideal situation is to have the family involved but that is not always possible and in some cases the person will be accompanied by a probation officer or social worker. The individual can be seen as the bad child in the family. That is why it is so important to treat the family - to take a holistic approach and then to treat the whole family so that everyone can get well and move forward.
It is difficult to assess someone with an ongoing chemical dependency problem and to deal with the person there and then. That is why we have a pre-admission programme. When someone is assessed I ask all agencies involved for a report, be they social workers, probation officers or psychiatrists. In itself it is difficult to get all the information together and to deal with a frightened young person sitting on a chair to whom one applies a label of being chemically dependent.
As a result of all that is going on we have developed a new pre-admission unit, the detox unit. When someone is presented with an ongoing, complex addiction problem it is difficult to then offer him or her a place on a programme because if he or she is coming from an environment where there is no hope he or she can never come into the programme. An offer of admission is nearly like a wall which they cannot get over. I may get all the reports I have requested from the agencies but the person concerned cannot stop using drugs because he or she is going back to an environment where there is peer pressure or a lack of support and communication or unemployment within the family unit. That is why detoxification is important.
There are not many detoxification beds here especially for 15 to 18 year olds. I may offer a person a bed in the Aislinn centre but he or she may not be able to access it. The new unit is already having great success. People are able to get clean in a safe environment. If one’s body is physically prepared for treatment then one’s mind is a bit clearer and one can take part in our programme. This is really important.
Ms Breda Cahill: I will revert to Senator Colm Burke’s query on funding. We operate on a year-to-year basis in this regard. However, what I would dearly love and what I ask members to consider today is the possibility of the Government putting in place funding on a three to five-year basis. As managers, it is impossible to plan when we do not know our allocation nor what cuts will be effected. It is normally February or March when we are told what the funding will be. At present, we are party to service level agreements and I ask for this matter to be considered. I refer to facilities such as the Aislinn centre, which is a voluntary organisation run by many volunteers. Taking into account the numbers of people waiting to go into it, to plan properly, we would need to be sure of sustainable funding over a three to five-year period.
Mr. Ruairí McKiernan: There are similar issues in respect of service level agreements and it is something of a nightmare to try to navigate the infrastructures. The Health Service Executive management will state that it simply does not know its budgets and one must empathise, in that it is operating within a macro-level crisis. However, the issue is that the HSE has invested €500,000 in us over the past three years and we are at risk of going under within the next 12 months, with the consequential loss of all that investment in the relationship, intellectual property, goodwill and so on. Consequently, it makes good economic and rational sense to have some kind of longer-term funding, which can be subject to quarterly and annual reviews and so forth. Another point in respect of funding for the youth sector is that in recent years, I have tried to at least access the mechanisms for applying for youth sector funding but it is extremely unclear. The process appears to be behind closed doors and simply is not transparent and we do not even know how to apply. We rely heavily on the HSE, whereas we would like to access youth sector funding.
On Deputy Conway’s comment on the number of young people in distress, repeated surveys and research findings show that up to one quarter of young people are in mental ill health or distress at any time. This is pretty high if, for instance, one considers it in the context of a classroom. I will keep hammering home the point that we must go to the underlying factors. While there are cultural and psychological factors, there also are economic factors and in recent years, we have been implementing a particular economic and social model that is not very healthy. While the evidence is hitting us in the face, we really must begin to address fundamentally whether we live in an economy or a society. I suggest we live in a society first and foremost and that the economy should serve us.
Chairman: I sincerely thank the delegations for their attendance and congratulate them on the quality of their presentations and the manner in which they have addressed this issue on a humanitarian level. Mr. Ruairí McKiernan is correct to note that we are dealing with people and members’ business is about people. Undoubtedly, there are underlying factors as to the reasons people are turning to alcohol and drugs and I refer to the perspective of those members who have been involved in different groups. For example, I am familiar with Fellowship House in Cork, which deals with adults and which seeks to have a step-down facility. I worry that we do not even have a step-down facility for adults in society to continue the good work being done by the Aislinn centre and by Mr. McKiernan, because a vacuum certainly is created and there is no one to step in to fill that vacuum. People who are vulnerable or who are in recovery or in the steps to get into recovery need support, as well as supports around them.
Today’s meeting has provided a valuable insight into how members as legislators and public representatives can address these issues. This does not simply pertain to illegal drug use, although Mr. Ruairí McKiernan is correct to state that we have a heroin epidemic that must be tackled now head-on. In addition, I refer to the issue of the manner in which different agencies interact. There is a need for a joined-up approach between the HSE, the Department of the Environment, Community and Local Government and the different youth groups, whereby it can be made easy for the delegates to deal with those agencies. All of us as representatives would welcome if the Health Service Executive could examine how it proceeds with service agreements with groups such as those present and the voluntary groups which are dependent on funding. Unfortunately, we are in an economic recession and we all accept that funding will be reduced. As a consequence and as part of its reform package to reduce the number of ministerial appointments, the Government has not appointed a Minister of State with responsibility for a drugs strategy.
It is important, therefore, that we all work together in this area. I was impressed by Mr. Raymond McKenna’s point about imagining if this problem affected our families. I compliment Mr. Ruairí McKiernan for tapping into what has become a core constituent of Irish life, social media and networking. More young people are using social media websites to communicate and to even let their emotions run free.
I thank the delegations for attending the committee. This is part of a series of meetings which will culminate in a session with the Minister of State, Deputy Shortall, and members of the national drug strategy unit. There is an issue with alcohol use here. The President, Mrs. Mary McAleese, spoke about having a national conversation on it. I am glad it has been included in the national drug strategy because alcohol can often be a gateway drug. The southern regional drugs task force highlighted how alcohol was the main addictive substance for 46% of young people under 20 years of age accessing community-based addiction initiatives in the southern region. In the United States the minimum drinking age is 21; in Ireland it is 18. I hope over the coming months the committee will have serious discussions about this and other matters such as below-cost selling and that there will be constructive outcomes as a result.
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