"I think the public do understand that prison isn't addressing the underlying issues for those people who are committing minor offences but can't get the help that they need to stop that cycle."
Of 1,076 men incarcerated in Mountjoy Prison in the first week of September, 433 were on a waiting list to receive treatment for their addiction – about 40 percent of the prison’s population, according to the Irish Prison Service.
That's a big increase from this time last year, when 242 of the 975 men in custody in Mountjoy – 25 percent – were on that same list, according to IPS figures.
Separately, the new figures, released in response to a request under the Freedom of Information Act, show there are currently 635 men – 60 percent of the prison population – on a separate waiting list to see a psychologist for general counselling.
Across the entire prison estate, 2,745 people out of 5,552 in custody – nearly 50 percent – are waiting to speak to a psychologist.
When John O'Connor arrived in Mountjoy to serve his sentence in 2019, a court had already ordered that he see a psychologist.
He said the assessment that followed was so daunting that he could not bring himself to tell the truth about his mental health.
"There were three big men, and they were so intimidating that even though I suffered with my mental health, I couldn't be honest with them," he said. "I think they were doctors, but they were three burly old men, they frightened the life out of me."
He says he found the staff he was dealing with were not “trauma-informed”. It is often said that this means shifting the focus from “What's wrong with you?” to “What happened to you?”
At that time, O’Connor was also addicted to heroin. This is not unusual in prison.
An estimated 80 percent of people incarcerated across the prison estate have a substance addiction, a spokesperson for the prison service said on Wednesday.
O'Connor said he never came across the addiction services which are run by Merchants Quay Ireland in the prison. "I didn't even know they were going in there, and that's the truth."
Instead, he put himself through withdrawal when he arrived. He says he knew he would end up in drug debt otherwise, and that the debt could also fall on his loved ones outside prison.
"So then when you get out, you're not really recovered from the heroin. You're still in addiction mode," O'Connor said. He went "straight back into addiction" after his release, he said.
These days, O'Connor, now in recovery, works full-time as a peer-support worker with UISCE, the national advocacy group for people who use drugs, founded in 1992.
As the share of people in custody on the waiting list for addiction support in Mountjoy has jumped from 25 percent to 40 percent in just over a year, the Irish Prison Service points to overcrowding as a driver.
And overcrowding has got worse over the past year. IPS figures show Mountjoy was at 119 percent of bed capacity for men a year ago, and is at 129 percent now.
The IPS doesn’t have the ability to turn off the tap, the spokesperson said.
It "is required to accept into custody all persons committed to prison by the Courts and has no role in determining the number of people sent to custody at any given time", they said.
Accordingly, “significant work” has been undertaken in recent years to increase capacity across the prison estate, they said.
However, according to Saoirse Brady, executive director of the Irish Penal Reform Trust (IPRT), “no other jurisdiction has ever built its way out of a crisis like this”.
And not to mention, the extra prison spaces cost a lot of money to build, she says, and they can't be built overnight.
“Even if you expedite the planning process and all of that, it is still, you know, months potentially years before those come on stream,” she says.
And it currently costs the state €103,000 a year to keep one person in prison, she says.
Brady points to remand – when a person is held in custody while awaiting a court appearance, trial, or sentencing hearing, rather than serving a convicted sentence – as one issue that could be fixed.
“Affordability of bail is a huge issue for people,” she says.
“We hear from the Dóchas Centre [the female prison at Mountjoy] that people can't afford 20 or 30 euros bail, and you know, people can often find that hard to believe,” she says. “And if someone can’t pay it, they’re in prison.”
New laws will let judges hand down up to 480 hours of community service, rising from a maximum of 240, in place of sentences of up to two years, Brady says.
Judges will also have to explain why they chose custody, she says.
Brady welcomes the changes, but says people will need support to complete those hours while holding down jobs or caring for family.
The public appears to agree that change is needed, she says.
According to IPRT public opinion polling from late 2024, 63 percent said people with an addiction who commit minor offences should be treated in dedicated healthcare settings rather than sent to prison.
"The number was 73 percent when we asked the same question about mental healthcare," she says.
"I think the public do understand that prison isn't addressing the underlying issues for those people who are committing minor offences but can't get the help that they need to stop that cycle," she says.
"People can talk about additional prison spaces," she says, "but ultimately that is not going to solve this problem."
IPRT will publish its latest Progress in the Penal System (PIPS) report next week, and, says Brady, this year’s report will have a particular focus on mental healthcare in prisons.
Brady says that the Midlands Prison, which saw a spate of overdoses last week, shows how stark the situation has become.
At the time it was holding 1,119 people against a capacity of 892, she says – and 76 people were sleeping on mattresses on the floor.
Last year, she says, Midlands had one addiction counsellor for every 513 prisoners.
The latest FOI figures show that, in the first week of September, there were 44 people on a waiting list for addiction support and 625 people on list to see a psychologist for counselling.
"We know that there has been recruitment of more addiction counsellors to bring it up to the allocated number that they're meant to have, but that's still nowhere near enough," she says.
Given the IPS’s belief that 80 percent of prisoners have an addiction, Brady says that "having one or two addiction counsellors for each prison just isn't enough”.
Specialist addiction nurses who left the prison service were never replaced, she says.
While the IPS says other healthcare staff can meet the need, Brady says she and the IPRT disagree, pointing to overdoses and active drug use inside prisons.
Brady says she believes addiction rates are even higher amongst women than men.
While Mountjoy has a dedicated addiction service for men – Merchants Quay Ireland’s TARP programme – there is nothing equivalent for women, she says.
The Treatment and Recovery Programme (TARP) lasts eight weeks, Karl Duque, its coordinator, said last year.
It is intensive, he said, with nine participants per cycle.
Mountjoy hosts the programme, but participants may be sent from other prisons around the country on recommendation from counsellors.
Passerose Mantoy, CEO of Chrysalis Community Drug Project, has worked in addiction services in Dublin's north inner-city for 26 years.
She said that when mental health staff levels are low, long counselling waiting lists are unavoidable when the work is done properly.
"If they are good practitioners, they're not going to rush their work," she said.
Many service users carry "layers and layers of trauma" and may need years of therapy, so places are slow to free up, she says.
She also questions whether everyone on prison waiting lists is suited to "general counselling".
“It's not actually always appropriate for the needs that they have at a particular time,” she says.
Many people who ask for "counselling" actually need practical support navigating things like housing, education, finance or their physical and mental health, she says.
Those needs must be met first before you can tackle counselling, she says.
Counselling that digs into past trauma also needs a level of stability first, she says.
You need to be in a good place before starting counselling, she says. “And to be in a good place, you need obviously to tackle things that are more practical and more urgent.”
"Normally when they use drugs, it's like self-medication,” she says. “It's very often a way to ease the pain.”
If painful memories come to the surface before someone is ready, "they are likely then to go back to what they know as their coping mechanism".
Mantoy draws a clear line between general counselling and addiction counselling.
Addiction counselling focuses on triggers, relapse prevention and harm reduction, and she described it as more urgent for people in active addiction.
Also, while people wait for their turn to see a psychologist, she says, prisons should link them with peer workers, chaplains, and other groups.
Indeed, the IPS spokesperson said, other therapeutic supports available in prisons include “chaplaincy, the Samaritans Listeners Scheme and 24 hour telephone line, Rape Crisis Centre counselling and domestic violence support programmes in both female prisons, Occupational Therapy, Narcotics Anonymous, Alcoholics Anonymous, Recovery College, parenting programmes and addiction psycho-education via Prison Education Centres, and Traveller-specific therapy supports”.
Mantoy stresses that while waiting lists for both addiction supports and psychological counselling are bad within the prison system, the same is sadly true outside prisons, in the community.
Both Mantoy and Brady say short sentences can make things worse.
Brady says prisoners serving a few months "are never going to get to the top of the waiting list to see that addiction counsellor before they're out again".
About three in four people entering prison have been there before. "That tells you that it's not working," she says.
Theft and drug-related crimes dominate the most recent reoffending figures from the Central Statistics Office, with international research pointing to a link between the committing of those crimes and addiction.
Mantoy argues that long-term general counselling should not begin at all for people on short sentences.
Many service users already struggle with abandonment and rejection, she says.
Opening up to a counsellor, only to be released months later, means the work "is not closed properly".
Starting again with a new therapist outside can be retraumatising, she says.
Mantoy points to a positive new pilot programme which is aiming to bridge the gap between services in prison and those outside in the community to strengthen the “continuum of care” – the Prison Links Health Navigator Service.
"The Prison Links Health Navigator Service is currently running as a new pilot in Mountjoy and the Dóchas prisons,” criminologist Megan Coghlan from Maynooth University, who is currently working on the pilot’s final report, said on Wednesday.
“It has been running since 2025 and an evaluation is underway to assess the impact of the service and the implementation of the service looking at how it might be rolled out to other prisons,” she said. “This evaluation is due to be finished at the end of October 2026 with findings to be shared after."
Mantoy says that before a person is released, the Prison Links Health Navigator Service arranges things like their methadone, follows up housing applications, and hands them over to a community key worker.
However, she says, plans can easily fall apart when someone leaves prison into homelessness.
"If they're homeless, you don't know where they will end up," she says.
Services like the Chrysalis Community Drug Project are funded for specific areas, she says. A last-minute move to emergency accommodation elsewhere in Dublin can break the chain of care.
Overdoses often happen soon after release, "because they have no structure in place, and everything falls apart very quickly".
Experts have said that buprenorphine-based products like Buvidal, for some people but not everyone, may be a better option than methadone as it doesn’t require the same frequency of doses.
The slow-release injection leaves the person in a very steady and comfortable state for up to a month.
This can be very beneficial for people leaving prison, said Dublin GP Dr Deirdre Dowdall, in January.
When people in recovery leave prison, they can be vulnerable to relapse, she says.
Because the Buvidal injection lasts for weeks, it gives people some elbow room to re-engage with services in the community.
Mantoy says that trauma-informed practice should be embraced across the prison estate.
But, she notes, applying it properly means reviewing everything, "from the environment, from the language you use, from the process that you use, from the assessment tool that you use".
For prisons, that would mean in-depth training for staff at every level, followed by a proper audit. "Not like an online thing over two hours," she says. "You want the staff from the top down to have that training ... from the governor all the way down."
The same applies to understanding and dealing with neurodiversity among prisoners.
People with undiagnosed ADHD or autism are increasingly recognised as over-represented among people in addiction and in the justice system, she says.
Real trauma-informed training needs "a champion within the prison to really roll it out", she says. "There's no point doing half the team and not the rest."
She warns against box-ticking. Services must "embrace the language" and put it into practice, which takes time, money and a willingness to change the culture.
Doing that in prisons is a huge challenge, she says, because the system "is not really about rehabilitation. It's really punishment, which obviously is totally against the trauma-informed idea."
Better understanding would lead to better responses, she says.
If staff understood why people behave the way they do, "perhaps the response would be a more compassionate response, or at least more acceptance".
John O'Connor, the formerly incarcerated person now a peer-support worker with UISCE, says he stands as an example of what can happen when the right supports are in place for someone at the right time.
"I'm out on the street now, doing outreach work," he says. "We work in collaboration with Merchants Quay at the minute, the safe injection facility."
"So, I'm doing good. I'm doing good for a change," he says.
Funded by the Local Democracy Reporting Scheme.
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