Assignment: Referral for HSE Addiction Services – Case-Based Assessment for Mary’s Complex Needs

Purpose

To support a formal referral for further intervention from HSE Addiction Services for Mary.

Word Count: Minimum 1,800 words

Audience: HSE Addiction Services + interagency professionals

Focus: Comprehensive case-based assessment to justify coordinated intervention

Tone: Professional, factual, evidence-based, and aligned with CORU Standards

1. Executive Summary (Approx. 150–180 words)

Purpose: Provide a concise summary for HSE professionals.

• State the referral purpose: “This report has been prepared to support a referral for comprehensive addiction assessment and multi-disciplinary intervention by the HSE Addiction Services for Mary, a 36-year-old mother experiencing alcohol and process addictions.”
• Briefly outline presenting issues, current risks, current supports, and need for further intervention.
• Summarise the rationale for HSE involvement, referencing social care and public health principles.

2. Background and Presenting Concerns (Approx. 200–250 words)

Purpose: Establish a clear factual profile of the service user and presenting issues.

• Demographic info: age, family composition, housing, socioeconomic status.
• Addictions: daily alcohol use, online gambling, compulsive digital media use.
• Family context: two children, strained relationship with partner, child welfare concerns.
• Previous and current engagement: Family Support Worker, GP, social worker.
• Immediate concerns: neglect indicators, school attendance, emotional instability, ambivalence toward help.
• Cite case notes and observations if available.

3. Analysis of Contributing Factors (Approx. 450 words)

Purpose: Use theory and evidence to explain Mary’s addiction pathways.

• Biological/Neurobiological factors: Alcohol dependency, neural reward systems, co-occurring stress.
• Psychological factors: Unresolved grief, chronic stress, maladaptive coping, emotional numbing.
• Social and Structural factors: Economic instability, domestic conflict, isolation, intergenerational trauma, gendered barriers to accessing care.

Embed concepts from:

• Biopsychosocial model
• Ecological systems theory
• Trauma-informed practice

Highlight how these determinants support the case for a multi-layered intervention through HSE.

4. Risk and Impact Assessment (Approx. 450 words)

Purpose: Clearly identify individual, familial, and community-level risks.

• Mary’s functioning: parenting ability, mental health (low mood, disrupted sleep), safety at home.
• Impact on children: emotional dysregulation, inconsistent caregiving, school disruption.
• Environmental impact: community disengagement, tenancy risk, financial hardship.
• Risks of escalation: Potential for eviction, child protection escalation, overdose or dual diagnosis development.

Reference CORU proficiencies on safety and duty of care (e.g., Domains 1.6, 3.1, 3.10, 5.7). Justify the urgency for structured, specialist intervention from addiction services, including dual diagnosis assessment.

5. Intervention Recommendations (Approx. 450 words)

Purpose: Outline suitable HSE and allied interventions for Mary based on evidence and practice frameworks.

Recommended Services:

• Comprehensive HSE Addiction Services referral for:
  • Substance use assessment (alcohol and gambling)
  • Dual diagnosis screening
  • Harm reduction programme participation
  • Structured aftercare and relapse prevention support
  • Motivational Interviewing-based intervention: to enhance Mary’s readiness for change (SOAR model; Transtheoretical stages).
  • Family-focused support: including parenting skills, child-focused interventions.
  • Interdisciplinary collaboration: HSE addiction team, social care, child protection (Tusla), mental health liaison.

Supportive Rationale:

• Evidence-based intervention for poly-addiction is most effective when coordinated across services.
• Mary’s ambivalence and complex presentation require trauma-informed, integrated care pathways.

Cite HSE addiction care pathways, CORU Domain 2 (teamwork), Domain 5 (evidence-informed practice).

6. Ethical and Legal Considerations (Approx. 200 words)

Purpose: Identify ethical concerns supporting intervention urgency.

• Child safeguarding vs. parental autonomy (Children First Act, 2015).
• Confidentiality boundaries in context of child welfare and inter-agency planning.
• Informed consent and Mary’s capacity for engagement.
• The ethical obligation of duty of care and non-maleficence (CORU Code of Professional Conduct).

Reflect briefly on the social justice aspect of supporting women with addiction through gender-responsive care.

7. Socio-Political and Policy Context (Approx. 180 words)

Purpose: Demonstrate awareness of wider systemic influences.

• National Drugs Strategy – Reducing Harm, Supporting Recovery (2017–2025): multi-agency response to addiction.
• Harm Reduction Frameworks: low-threshold services, women-specific supports.
• Societal stigma around female addiction, media addiction, and parenting.

Connect Mary’s case to structural inequality and the right to equitable care access (CORU 5.2, 5.3, 5.15).

8. Conclusion (Approx. 90–100 words)

Reiterate:

• The complexity of Mary’s presentation.
• Her willingness to engage and potential for recovery.
• The necessity of coordinated trauma-informed, HSE-led intervention.
• The critical role of social care in advocating for system-level responses.

9. References

Follow Harvard UL format.

Suggested sources:

• HSE National Drugs Strategy (2017–2025)
• Maté, G. (2018) In the Realm of Hungry Ghosts
• WHO (2022) Turning Down the Alcohol Flow
• CORU (2017) Standards of Proficiency for Social Care Workers
• Peer-reviewed articles from www.drugsandalcohol.ie, EBSCO, and journals on addiction and trauma.