There are no accurate figures on the cost of not providing a dual diagnosis service in Ireland. Based on our experience which is also backed up by research we believe it costs more to have separate mental health and addiction services than to have an integrated service. Because there is no systematic measurement of whether addiction or mental health services have actually helped people, people just keep relapsing, needing more treatment or worse as Mary’s story shows. They die.
So it should actually be possible to reduce the costs of service provision whilst improving services. This would also have a positive impact on homelessness and the number of people in prison.
We’ve estimated the costs of keeping people with a severe dual diagnosis in prison is approximately €200 million just in prison costs alone in 2008. Click here for details
In England some high standard cost/benefits estimates have been prepared.
For example Turning Point and the London School of Economics showed that for for every £1 invested in an integrated service, a return of £4.07 is achieved. This takes into account the effects of aftercare, and measures core impacts, defined as: increased participation in employment, reduced crime, improved health, including lower rates of blood-borne viruses and more stable housing.
Cambridge City Council introduced a pilot dual diagnosis service. They tracked the services -hospitals, refuges, courts, police etc, used by just one person and proved use of services had declined by £140,000.
Of course not all people with a dual diagnosis are homeless or offenders, but surely even in a time of cutbacks it makes sense to change services so helping people properly when they first encounter difficulties whilst also reducing costs?