The Impact of Dual Diagnosis
When services treat the addiction and the mental illness separately — or not at all — the consequences spill into our prisons, our homelessness services and the public purse. The human cost is greater still.
A cycle of treatment, then prison, then offence, then prison
According to Mental Health UK, an estimated 16% of jail and prison inmates have a dual diagnosis. There are no figures for Irish prisons, nor are there services available to people with a dual diagnosis once they are inside.
Providing separate mental health and addiction services is already costly. Costs rise even higher when the same people recycle through the healthcare and criminal justice systems again and again. Without more integrated treatment programmes, the cycle continues.
| Figure | Number | Source |
|---|---|---|
| Committals to prison (2008) | 13,557 | Irish Prison Service Annual Report 2008 |
| Estimated % with a dual diagnosis | 16% | National Co-morbidity Survey / Mental Health UK |
| People in prison with a dual diagnosis | 2,169 | Calculated figure |
| Average cost of a prison space (2008) | €92,717 | Irish Prison Service Annual Report 2008 |
| Cost of imprisoning them for one year | €201,103,173 | €92,717 × 2,169 |
In one year alone, over €200 million is being spent — far more than the cost of providing an effective dual diagnosis service. This excludes the cost to society of repeated crime and the impact on its victims.
Far more likely to lose their home
There is little Irish research linking dual diagnosis and homelessness, but research from abroad estimates that around 50% of homeless adults have a dual diagnosis.
People with a dual diagnosis are much more likely to become homeless, because the combination often leads to a poorer overall ability to manage one’s own life. (National Alliance for Mental Illness, USA)
Counting people who are without homes at any given point is difficult because of the transient nature of homelessness. Services working in the area believe the published government figures — based only on those who have contacted local authorities — are significantly lower than the real number.
More expensive to ignore than to fix
The financial argument points in the same direction as the human one. Recycling people through healthcare, criminal justice and homelessness services — without ever treating the whole person — costs far more than providing integrated dual diagnosis care would.
Every figure on this page understates the true picture, because none of them can capture the cost to families, communities and the people themselves.
Without integrated treatment, the cycle of treatment, then prison, then offence, then prison, then treatment will simply continue.
This is why we campaign
Dual Diagnosis Ireland exists to change how the system treats people who fall between two services. Your support helps us keep making the case.