Deputy Violet-Anne Wynne: At the outset I want to acknowledge and congratulate the amazing team at FASD Ireland on its fantastic work and for reaching the recent milestone of the first anniversary of the FASD hub national helpline, which allowed it to provide support to more than 800 people living with foetal alcohol spectrum disorder, their families, and professionals across the State. I also acknowledge the commitment of the Minister of State, Deputy Rabbitte, to FASD Ireland. She has worked closely with the organisation and has made it her business to support it. She visited County Clare to meet its representatives on a number of occasions, which is to be commended. Foetal alcohol spectrum disorder, known as FASD, is Ireland's silent epidemic and is caused by prenatal alcohol exposure. FASD is lifelong brain damage for which there is no cure or treatment and according to the Journal of the American Medical Association in 2017, Ireland has the third highest prevalence of people living with FASD in the world at 4.75%, behind Croatia at 5.3% and South Africa at 11.1%. This is the most credible report carried out to date and one that has been referred to many times in Ireland since publication. There has not yet been an Ireland-specific prevalence survey to verify these numbers since that report seven years ago. However, following the two years of Covid-19 lockdown, in September 2022 the HSE alcohol and mental health and well-being programme announced that the prevalence of FASD may have increased to as high as 7.4% of the population, which would equate to around 379,000 living with FASD in Ireland today.

Astonishingly, most people in Ireland are not even aware of what FASD is and only 1% of those living with the condition in Ireland have been able to obtain a diagnosis, for which they had to go overseas. Alarmingly, Ireland is the only country in the developed world that does not recognise FASD as a neurodevelopmental disability. The HSE does not currently have any statutory guidelines for diagnosis, there are no specialist clinicians or diagnosis pathway and few support services for people living with the condition. FASD Ireland, which is based in my own constituency of Clare, is a national organisation providing essential support, advocacy and education to those living with foetal alcohol spectrum disorder, their families, and professionals. We know from recent research by Dr. Katy Tobin at Trinity College Dublin that 25% of young people living with FASD in Ireland left formal education at the age of 14. That dreadful statistic could be considered a contributory factor and it informs the latest research from Dr. David Junior Gilbert of Salford University who found that people living with FASD are 19 times more likely to be involved with the criminal justice system in comparison to individuals without FASD.

That number is stark. Tusla recognises that up to two thirds of care-experienced children live with FASD and consequentially most will need supported living or face extreme challenges after leaving care. Children's disability network teams and CAMHS currently do not have statutory guidelines or the clinical experience to diagnose FASD. They are trying their best, providing revolving door support for comorbid conditions for the many children and young adults living with FASD. In addition, tragically, CAMHS supports terminate for these young people upon reaching the age of 18, with no handover to adult mental health services, as FASD is neither recognised nor supported by the service.

I am aware of the publication of the HSE national service plan which, on page 38, mentions that a foetal alcohol project will be undertaken using a multi-healthcare sector approach. The Minister of State acknowledged this in the Chamber in March, in response to the motion on supporting people with disabilities and carers. Will she outline what her Department intends to do to ensure FASD is a recognised disability in Ireland?

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