Lynn Ruane
University of Dublin · Independent · Ireland
“The chairperson of the board of the Courts Service, Ms Justice Aileen Donnelly, said that the rise in drugs cases of a less serious kind had increased the workload of the lower courts.”
“I remember I could barely write when I started studying addiction. I was 16 when I applied for an addiction studies course. They would not let me on it because they said I was too young and it was for adults. I fought and fought. I did not know how to write an essay. I had not engaged in school since I was about 12.”
“The world is watching how Ireland has done the most extensive interrogation of drugs policy ever seen, and is waiting in hope to see what we do next to make sure that we move with the evidence. It is not just opinion.”
“I join Senator McDowell in thanking all the people we should thank for the efficient and smooth running of these Houses. He ran through them all. Even if we have had a few ding-dongs over rulings on amendments and stuff, other than that, things have moved well, as they always do. I thank the staff across both Houses.”
“There are not many things I will claim some level of expertise in, but this is one where I will claim it. I have been obsessed with it since I was about 16. I look forward to coming back in the new year, and not just for 90 minutes. We need a substantial time to discuss this report, whether three hours, four hours or six hours.”
“It will contain all incidents of prohibited AI practices under Article 5 of the AI Act; all serious incidents of high-risk AI systems in the State, reported under Article 73; high-risk AI systems that are employed in critical infrastructure; and any other AI-related incidents or notifications in the State required to be reported under the…”
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“I am not participating in something that actually is against everything we have done in this Chamber for years. We are now optional on the two-and-one. That means if I come to those doors, I should be treated the same as anybody else and allowed in to vote. Some of us have missed voting on our own amendments because we did not get through the doors at the last second. Before the Chair has even opened his or her mouth, we have been refused at those doors. It is not fair, it is not transparent, it is too loose and it is not okay. I will not sit down and participate in the vote on my amendment being called under such conditions.”
“I have respect for the House. That is why I am in my chair on time when the bells ring. Okay? I do that because I have respect for the House. If I get locked outside, I do not get to vote because I have respect for the House and the rules this House has abided by for exactly the ten years I have been here. So I do have respect for the House.”
“I will not resume my seat. I am sorry but you are an impartial, non-voting Member. Even if you were not in your seat to take the vote at the time, those doors should be locked to voting Members after the period that is called. The Acting Chairperson at the time actually instructed that the doors be closed, but, still, more people opened the doors and walked in.”
“The sitting was suspended for ten minutes and now the Leas-Chathaoirleach has come back and taken the Chair without there having been any conversation on the substantive issue at hand. Is that what I am hearing?”
“-----in terms of how much time we can come in to vote in this room. It has always been four and four and two and one, and it was called from the Chair. You may suspend the House because I am not allowing the vote.”
“So what you are telling us now is that what is called from the Chair when a vote happens does not stand. If you are not in the room on time, or if people decide that they want to linger outside and then come in at the last second - I am here ten years and we have always abided by the time. So there is precedent right now. What is being set from the Chair is a dangerous precedent-----”
“We would like a commentary on what just happened. I am not going to a vote until we have a decision that is made that clearly says that Standing Orders - two and one does not matter anymore, so four and four. Are we saying we can knock on the door after eight minutes and demand that we are let in?”
“I move amendment No. 19: In page 17, between lines 13 and 14, to insert the following: “(3) Where an application for declaration has been made before or during a trial of action and costs, a judge must not strike out a claim and appeal under section 34E if the claimant satisfies the judge that— (a) the claim is likely to prevail at trail, and (b) the harm suffered or likely to be suffered by the claimant as a result of the defendant’s expression is sufficiently serious that the public interest in permitting the proceeding to continue outweighs the public interest in dismissing the case before trial.”. Vótáil.”
“I move amendment No. 18: In page 16, between lines 20 and 21, to insert the following: “34EA. (1) Where a defendant in defamation proceedings relating to his or her engagement in public participation makes an application referred to in section 34E(1), he or she may also make an application, on notice to the plaintiff in those proceedings, for a declaration by the court that the proceedings or part thereof amount to abusive court proceedings against public participation. (2) Unless a judge orders otherwise, the claimant is not permitted to amend his or her pleadings in the proceeding— (a) in order to prevent an order under this Act dismissing the proceeding, or (b) if the proceeding is dismissed under the Act, in order to continue the proceeding.”. My colleague, Senator Higgins, and I have already spoken to the amendment. I will press it.”
“We have counselling services, suicide prevention services and rape crisis services that will not deal with people because they have substance misuse. It is happening actively. We need to actually place the substance front and centre and not ignore all other types of addiction. The problem is it is substance use that is in the way of people receiving care. That is just the reality of the situation. I would ask for a bit more openness and understanding in that regard because people are actually dead. None of us got defensive. The Minister of State got defensive. The rest of us are putting people in holes in the ground and the Minister of State is the one getting defensive. I would suggest she reconsider that.”
“I ask the Minister of State for a bit more openness because nobody is insulting all the other stuff - I certainly am not - in relation to service provision. I am not coming at it from that angle. I am looking for something to be included. I have not once criticised anything that was happening or anything that the Minister of State was working on. I am asking for a positive inclusion of a cohort of people who are being completely failed by all mental health systems in Ireland in relation to substance use. It is very particular, and that is not to ignore in any shape or form other types of addiction, but they present differently and doctors and psychiatrists feel that they can engage with them differently. I have problems with many other services that will not engage.”
“Whether it is sex, gambling or whatever type of behaviour, they generally present differently. It is true that, in presenting differently, they can access mainstream services more easily than somebody who may be drunk or had a bag of heroin an hour before they asked for assistance with mental health issues. It is very different and that is why I am saying there is a gap in awareness, in understanding it intimately, because for most of the people who have died, substance misuse and mental health issues were co-occurring conditions. When looking at dual diagnosis, the statistics show it is substance use, so it matters. The Bill may not preclude them but the problem is practice has precluded them, and unless we take an active measure to include them, then they can continue to be turned away in practice.”
“Nobody is turned away if they have gambling and mental health issues. That does not happen because it is very specifically "substance use" that sees people being turned away, as they are seen as affected. From all the years I worked with people who gambled, the reason it was one of the most dangerous addictions was that it did not knock people out. Gamblers do not fall asleep and have a little respite. Other substances are different. Doctors do not like dealing with somebody affected physically. They do not like them showing up if they are goofing off in the assessment. They do not like them showing off if they are in withdrawals and they are jumpy. It is very different. The type of addiction actually matters in dual diagnosis. I am telling the Minister of State that from 25 years' experience of working in addiction.”
“-----when we are talking about addiction. She is giving an example of dual diagnosis but then saying she has services for dual diagnosis. Therefore, her Department must be able to define it. If Keltoi is a service for dual diagnosis, then the Minister of State understands exactly what dual diagnosis is. What I am suggesting would not make the Bill confusing at all; it would align with all the work being done on the ground. I am quite confused by what has been said.”
“The Minister of State used Keltoi as an example. That is actually an addiction service with a specialty in trauma. It is an amazing service. The Minister of State is saying she is going to have a day centre there for people with a dual diagnosis. Is she stating that people will be arriving there not with an addiction but with a mental health issue and an intellectual disability?”
“In the case in question, it has only ever been referred to in the context of addiction and mental health issues. In addition to wanting to understand everything else, I would like to understand what the Minister of State means when she says that the clinical supervisors now in place have nothing to do with addiction and that, instead, according to her understanding, are concerned with dual diagnosis. If I have a child whose mental health issues and intellectual disability exist side by side, and there is no substance use, is that child representative of those whom the Minister of State says the clinical supervisors are working with in respect of dual diagnosis? That is not how it is understood, even by the clinical supervisors I have met in the HSE who were put in place six or seven years ago before the advent of service provision.”
“Is the Minister of State saying that the dual diagnosis staff employed by the HSE in the past few years, one of whose names I have in my head because I have met the staff often, do not understand their job as she does? We meet dual diagnosis staff all the time in relation to the work we do in here or our work on drugs policy, and we note that they all understand the service as involving no wrong door and believe we need to develop dual diagnosis services. That is in the context of addiction and mental health. Is the Minister of State saying the dual diagnosis services that have been introduced are not related to addiction and mental health and that they relate to something else? This is where I am confused. Many of us have been told over the years that work is being done on dual diagnosis.”
“The Minister of State, through her work and efforts to provide dual diagnosis services, and the Department must have defined what they understood dual diagnosis to be. Otherwise, they would be coming up against the same issue on a practical level in the community. They would say they had dual diagnosis. If, however, a mother arrived with a child with an intellectual disability and a mental health issue, would there be clinical provision in the community?”
“She said that if somebody was presenting with a dual diagnosis but it was addiction, they would not be presenting with dual diagnosis. Then there was the conflation of dual diagnosis with intellectual disability, which is not actually defined, as Senator Ryan said, in terms of the World Health Organization. Then the Minister of State spoke about the services that are being provided for dual diagnosis. When the Minister of State says she is providing a service for dual diagnosis, is she saying that service is for people with intellectual disabilities and mental health issues or are she and her Department defining mental health issues as addiction, thereby recognising it through service provision but engaging in conflation when it comes to the legislation?”
“This definition, from Sinn Féin and Senator Clonan, matched with my amendments that are in this as well in regard to dual diagnosis, clearly defines it and defines why it is needed. We do not have people contacting our office every day or in our personal lives saying there is a problem in Ireland with dual diagnosis in relation to intellectual disability and mental health and that people are dying, throwing themselves off bridges or knifing people as a result. That is not an issue. That is not being raised as a concern. What is being raised as a concern is addiction and mental health and the lack of care there. There is even a lack of coherence in what the Minister of State said that I was not quite following.”
“James's when I was in the inner city with the homeless, with many people who were there for six or ten hours and, when they displayed an uncomfortableness because of a dual diagnosis, whether there was an alcohol issue or whatever, and the substance piece kicked in, the mental health professionals who were assessing them, when they realised they had a substance misuse issue, sent them away. They did not signpost them anywhere else or do anything else - no follow-up or anything. They sent them out of the room. People have literally walked out of accident and emergency departments and killed themselves because of this. That is the reality and what is still happening in this country today.”
“Of course, anyone will welcome the different initiatives and clinical programmes the Minister of State is speaking to in terms of dual diagnosis, but the problem is, legislatively, we need to opt in people because they are being refused care for dual diagnosis. If we do not explicitly name them in the Bill and their right to care under this Bill, it means they can be continued to be turned away. It is happening daily and weekly, where people are being turned away because of substance use. I have sat in many a psychiatric ward, especially in Tallaght in my work as a drug worker, and in St.”
“We need to resist confusing dual diagnosis with other types of co-morbidities or other types of stuff where there are two diagnoses. We know what we are referring to when we are talking about addiction and mental health. The problem is, we do not have a situation where people are dying regularly because they have other types of co-morbidities. There is a very specific issue here on the ground in practice where people are not cared for when they present with the two. If somebody just had an addiction issue, nobody is suggesting they would be cared for for any other reason. We are quite particularly talking about the two, and people are dying. People are living lives they do not want to be living because of the lack of care for dual diagnosis.”
“I have been trying to find a way to deal with dual diagnosis for a decade, and it is in front of us now. I ask the Minister of State to really consider how we can do that between now and Report Stage.”
“We think the Minister of State can begin to address that in this Bill, because if she does not, so many parts of this will not apply to people who are experiencing substance misuse. People will continue to die and people will lose family members. They will continue to have their own children not want to be around them because they are caught in that cycle. It is one of the biggest destroyers of people's lives in my community when they are unable to get supports. I am begging the Minister of State to really look at this. People who understand dual diagnosis have been looking for care and a positive response in this regard for a long time. The Minister of State has the opportunity to do that in this Bill. I will have been elected for ten years as of next year.”
“We will hear speeches for years about addiction being a mental health issue, yet when you go and say you have an addiction, the services will say that is not for them. If we had really good psychiatry, psychology, therapy, counselling, and whatever psychosocial supports are needed for someone presenting with dual diagnosis, an individual who works in that area should be able to say he or she knows what to do with that person and how to address this. When they send people away, there is something wrong with that in terms of the professional training that they get, that they cannot actually come up with a tailored programme, response and intervention for someone to actually be able to support someone with dual diagnosis. There is something seriously wrong there.”
“I will probably never be employed in drug services again when I do. I kept my service open for three full days, through the night, to try to keep that person safe. I had to sit with her in that building until we could finally try to get her to a regulated space where she could calm and understand that what she thought was happening was not happening. I am not qualified to do that. If anything had happened, I would have been held accountable on all sorts of levels, but I could not turn that person away because I understood addiction and what was happening. I am not a medical practitioner, however. The problem is, as Senator Ryan pointed out, that services on the ground are trying to respond to something they are not equipped to do. There need to be co-created care plans relating to addiction and mental health.”
“I could keep going with them. When I worked in addiction services, I was around the age of 20 when I first really started understanding dual diagnosis. A girl arrived from the inner city. My service was not based in the inner city or for the inner city. She was told that if she came to my service, she would likely not be turned away. Somebody else had obviously been engaged with us from that particular community and told her to come. She had voices in her head telling her to do something she really did not want to do. She also thought she had lost one of her family members in this hallucination and she was frantic. It was all wrapped up in dual diagnosis. I could not get that person any help. I had to defy my board of management and defy and break every boundary. I can say it now, thankfully.”
“People ended up in hostels and on the streets, unable to access that so-called community care that was meant to exist when we decided we would no longer institutionalise people. Some of the results of people not getting care go beyond self-harm, to the harm of others or within the home. I have worked with men who have attacked their mothers. Those men will be vilified if something serious happens to someone, but some of them have begged and begged for help for the voices inside their head. They were turned away because they were using substances and they actually physically hurt the people they love the most. If this Bill does not address dual diagnosis, we are ignoring the core drivers of some of the most serious things that happen in our society where dual diagnosis has been present. They are the most extreme cases.”
“In my lifetime, I responded to somebody who slit their throat because they did not get the help that we tried to get them for months leading up to it. They survived and I still could not get them help. They slit their throat and still could not get help. On occasions, I have dropped people at St. James's Hospital who were turned away and walked out. One man threw himself in front of a taxi and died when he was turned away from St. James's Hospital because of dual diagnosis. The streets have become asylums. Ireland said it addressed the problem of institutions when it closed them down, but it did not put in the supports, care, dual diagnosis planning and everything that was needed.”
“People who are really kind in nature and experiencing dual diagnosis, and doing things under psychosis that their real, natural self would never do, are never able to recover from the shame of that and are then using drugs to deal with the shame of behaviours associated with mental health, whether that be violent outbursts, issues within the home, or running around the estate, knocking on people's doors, embarrassing the family, and doing things that they just cannot control. Right now, many of my friends have dual diagnosis. They try so hard not to drink or take drugs, so that they do not get the dual diagnosis, and then they go for help, and it is a constant circle. I am sorry for being graphic but I think I need to be to illustrate why the Minister of State needs to address dual diagnosis, so that people are not turned away.”
“It may have been through suicide due to untreated dual diagnosis because everywhere they went and asked for help they were told by an addiction practitioner that they needed to sort their mental health before the practitioner could address the addiction or by a mental health practitioner that they needed to sort their substance use before he or she could deal with their mental health. On some occasions, these people, both in my work and personal life, experienced various forms of mental health issues, including psychosis and schizophrenia alongside addiction.”
“I concur with everything my colleague said. I have a knot in my stomach all day even thinking about talking about dual diagnosis. When I first was elected, the first thing I brought to this House was conversations on dual diagnosis. I had briefings in the audiovisual room. Mainly, my experience of dual diagnosis has been through two avenues. One of them is working in addiction services since I was 17 years old, for the last 20-odd years, and working in the homeless services, again, since I was 17 years of age;. The other is through the friends I loved and have lost due to dual diagnosis. Dual diagnosis will never be put down as the cause of death on someone's death certificate but there are many ways in which my friends died over the years.”
“In the commission's setting of regulations in this regard, we need to be able to have an accurate indicator of how often sedatives are used in relation to behaviour. This is to ensure we do not say they are cases of chemical restraint but we actually catch a lot of the invisible numbers of when sedatives are given and noted on records as a person being given a sedative. The records do not give any reason or insight as to why the person was given a sedative. It may be assumed by other people that the sedative was given because the person wanted to go asleep but that may not actually be the case. It is much more subtle. Is there a way that the full picture can be captured?”
“The only reason I became so aware of this and that I read other investigations into nursing homes in Ireland to see if it was common practice was that I questioned why an individual was clearly groggy on several occasions and the staff naively told me - they did not see anything wrong with the answer they gave - that it was because he kept singing at night. My mind was blown. I monitored this over a period, did my own research and read a research paper. I forget the name of the author but I will remember it in time. The research was done in Ireland on the use of chemical restraint among older people. We are going to end up with older people who have intersections with different types of dementia, Alzheimer's disease, etc., may be in particular care settings, and may also intersect with capacity assessments.”
“Sometimes it is really subtle and heavy sedatives are given to an individual. Somebody visiting the next day may say the person is very groggy and ask whether they had a difficult night. When the visitor is told the person had a difficult night, they will not ask any further questions. It is not always noted that there has been a risk assessment and a report done. It is very subtle but it happens in nursing homes. Dementia intersects with older mental health. People end up on particular wards and when sedatives are given, it is noted that a sedative was given, not that the person was given a sedative because they were walking the corridors at night. That is no reason to give a sedative unless the person consents and it is part of their care plan.”
“I welcome the Minister of State's statement that the use of chemical restraint has reduced. I wonder what a health professional, whether a doctor or whoever else, who is in charge of an individual considers to be a chemical restraint. In some cases, it may be very obvious that chemical restraint is being used and it is noted as that because there is a very clear risk to the person's well-being or to other people or there is an outward physical manifestation that causes a risk, maybe in the person's environment, and a chemical restraint is used because, for whatever reason, it is deemed to be in the best interest of the individual and the people around him or her. In many cases, it is much more subtle than that. In many cases, it is not noted on records as chemical restraint or pharmacological restraint.”
“It makes me even more concerned to think about the degree to which they might be used in enclosed facilities where people are detained involuntarily or where there is even less access for families to pick up on it. The fact that I have seen it used in older age care makes me extremely concerned about it in this Bill. Having a broader definition of it is really necessary so that we protect vulnerable people in this situation. Someone's behaviour is not always a mental health issue and we do not need to control other people's behaviours just because they may be seen as a disruption to someone's shift. In my experience, that is how it has been used.”
“I support this amendment. It is outside the space of this Bill but chemical restraint is widely used, even with regard to people's age and mental health, so it can affect people who end up in nursing homes or long-term wards in hospitals. I have my own experience of somebody being medicated because they were singing at night. When we look at this in terms of the medical constraint of a person's behaviour, it was being used in that situation because the nurses did not want the other people to be woken up by somebody singing. The singing was the person's regulation of their fear and anxiety. It kept them calm. Chemicals are used at an alarming rate to control people in hospitals.”
“I am glad to hear parental consent is still involved if a child is in a place of detention, when capacity is questioned or if the child needs an assessment. If it is challenged in court, is the child involuntarily detained while the matter is in court or does that pause the capacity assessment until the court deals with the issue? I wish to ensure the child is not treated or detained under a certain thing while the case is being heard in court. I am wondering what order that goes in.”
“Notwithstanding the technical nature of the amendment, we need to understand the technical part as Senator Boyhan said. I seek clarification on a number of points. There are children aged 16 and 17 in Oberstown. If such a child's capacity is in question, who is responsible for deciding whether that child requires an assessment of capacity? Would it be the parent of the child, who might be quite active? Would it be the place of detention of a 16- or 17-year-old? Who is involved in the picture when somebody is in a residential setting?”
“It is a group that I would like us to start thinking and talking about when we talk about people who are living with a disability. Like I said, there are extra layers of marginalisation and it is often a group that we do not pick up on. I just thought about it when Senator McCarthy was speaking about addiction.”
“I welcome the Bill and am happy to support Senator Clonan. Senator McCarthy raised the areas of marginalisation and addiction. Something we need to consider is marginalisations within marginalisations within marginalisations. We do have a growing and ageing population of people who were drastically impacted by the heroin epidemics of the eighties and nineties and have acquired disabilities over time. They are often unseen when it comes to disability advocacy. We have people in our prison and homeless systems who have acquired disabilities through intravenous drug use and through certain conditions where their bodies have begun to break down. They have ended up in wheelchairs and had limbs amputated. Their rights are eroded in every way, never mind them getting an assessment and then having the right to care.”
“She was watching for the postman and terrified she would have to tell her child that they were in trouble with rent arrears, with the lack of safety that would have caused for the child and shame for the mother. She is still watching the post because these proceedings will not take place until next year. Therefore, I would love to receive some feedback in the next week or two about how we can address this. There is probably a simple solution.”
“My hope is that it is an anomaly. My thoughts were that it is an automated system that does not pick up the differences, but it is from the law agent in the council. I do not have the other one in front of me that is from South Dublin County Council, where there was a similar situation. The person who was a child occupier was then banned from going on the housing list when they were in school and obviously could not pay rent. It is clear that an anomaly is happening. I am hopeful this can be addressed simply, without having to look at legislation because it is not part of the legislation. I hope the Minister of State and I can follow up in the next week or two to figure out a simple solution to this. Thankfully, in this situation, the mother got to the letter first, but she was distraught at the thought more letters might come.”
“What I am hoping is that an automation system has spat these out and sent them to everyone in a house and that we can send some sort of ministerial direction to the local authorities to make sure the message is loud and clear that a child occupier who is under 18 should never receive one of these in the post. No family should be shamed and potentially criminalised for struggling. We want to deal with intergenerational poverty, inequality and all of those things, and this is definitely not the way to do it.”
“The 18-year-old went to put themselves on the housing list at 18 - they had just left school - and the local authority told them they could not go on the housing list, that they were now barred for two years because they broke their tenancy agreement. This was a child occupier. A child occupier was banned from going on the housing list because their parents could not deal with the cost-of-living crisis they were in being able to keep up with their rent. One of those families had been in the home for 42 years. It makes absolutely zero sense. I am hoping the Minister of State is going to tell me it is an automation system and that it is not a human making this decision to send a child to court or ask a child to attend court or force a mother to have to explain to that child the difficult situation they are in.”
“Why are we making a spectacle of families in the courts where the children have to sit by and watch? It makes absolutely no sense as to why we would be effectively creating a potential criminal sanction for child occupiers. They have no responsibility. How can a ten-year-old pay the rent? They are on the rent, of course, because they live there in terms of how many people live in the house, but the only person responsible for making sure that the tenancy is paid and the rent is up to date, or to come up with a new rent agreement, is the leaseholder or parent. That situation was in relation to a ten-year-old. Another situation was in relation to a 17-year-old. This person turned 18 and the parents were put out on the street.”
“[it gives the date] in District Court No. 23, Four Courts, Inns Quay, Dublin 7. We recommend that you, as the occupant of the property, attend court on this date. We are literally sending requests for children to come to court. A mother, if she has anybody to seek support from, may say that she is not bringing her child to that. However, if the child opens it, then the child is asking, "Am I in trouble? Am I poor? Can mammy not afford the rent? Are we going to be homeless?" Then the child brings the letter to the mammy, who has probably been trying to shield the child from the struggles they are experiencing within the home in terms of being able to pay the bills, and she is then forced and shamed into having to explain to the child the struggle they are in in terms of rent arrears. What if the mother brings the child to court?”
“However, what has come to my attention in supporting some of those families who are facing court proceedings in relation to rent arrears is that rather than, obviously, wrapping the supports around them, children are receiving court summonses from Dublin City Council and South Dublin County Council in relation to the rent of their parents being behind. Can you imagine being ten years old, some letters come through the door, your name is on that post, and you pick that up and open it. What it says on that letter, that is effectively penalising, criminalising and shaming the child, is: Dear ... [so-and-so; I will remove the name], As an occupant of the property ... [again, I will remove the address], we wish to inform you that there is matter before the courts in relation to the above premises. The matter will be before the court on ...”