Dual Diagnosis

The term “dual diagnosis” is used to describe a person who presents with a concurrent mental health disorder and a substance use disorder (SUD).

Dual Diagnosis is not uncommon; research suggests that up to half of those attending Community Mental Health Teams have co-morbid substance use disorder. Dual Diagnosis is defined in different ways across countries, and Dual Diagnosis services cater to varying groups of service users depending on the scope of the definition for the implementation of Dual Diagnosis services.

An initial National Working Group for the HSE Dual Diagnosis National Clinical Programme was established between 2016 and 2018. In 2021, a new Clinical Lead was appointed and a second National working group was established to further progress the development of the HSE Dual Diagnosis National Clinical Programme. As part of the process of drafting the Model of Care, this group explored the experiences of people with lived experience of Dual Diagnosis, including both service users and carers.

In the HSE, Dual Diagnosis services will be a tertiary level service providing support to Community Mental Health Teams, Community Child and Adolescent Mental Health Teams, acute inpatient psychiatric units for both adults and adolescents, HSE addiction services (HSE Social Inclusion), community, voluntary and HSE-funded organisations, including Section 39 agencies. As envisaged in the Sharing the Vision recommendation for Dual Diagnosis, an integrated approach will be implemented by the Dual Diagnosis services. In addition, a collaborative approach will be taken, involving HSE addiction services, HSE Community Mental Health Teams, the HSE National Office for Suicide Prevention (responsible for implementation of the National Strategy for Suicide and Self-Harm: Connecting for Life), HSE Health and Wellbeing, HSE Mental Health Engagement and Recovery, Liaison Psychiatry services, maternity services, community and voluntary agencies and regional universities. Resources such as staff, training and premises will be shared between the service partners, primarily under the Clinical Governance of HSE Mental Health and in some cases under the shared Clinical Governance with HSE addiction services.

The Model of Care for Dual Diagnosis was approved by the HSE Chief Clinical Officer forum and endorsed by the College of Psychiatrists of Ireland. The Model of Care was launched on 23rd May 2023 by Minister Mary ButlerTD, Minister of State for Mental Health & Older People and Minister Hildegarde Naughton TD, Government Chief Whip & Minister of State with responsibility for Public Health, Wellbeing and Drug Strategy.

Contact details for the HSE Dual Diagnosis National Clinical Programme:

National Clinical Lead:  Dr. Narayanan Subramanian

National Programme Manager: Ms. Anita Whyte

Email: ncpdd@hse.ie