English: Well, as our report states: 'An issue that kept being raised was the difficulty for rough sleepers to access integrated substance misuse and mental health services' and 'we have concerns on the level of integrated support for rough sleepers with co-occurring disorders.' Although we noted that: 'There may be some small pockets of integrated services such as the work of the Community Care Collaborative in Wrexham', referred to by the Chair, 'these appear to be the exception and not the norm.' Briefing us on her research into priority need and rough-sleeping, Dr Helen Taylor from Cardiff Metropolitan University, told us that just making someone a priority would not address the issues that they were experiencing. She said that it won't solve the problems - giving them somewhere to live and giving them help; they have to want to do it. You have to give them that chance. Dr Taylor also told us that many spoke of their experience in schools, which did not know how to deal with their conditions and behaviours. In accepting our first recommendation, the Welsh Government stated that it has 'established a Welsh Government Co-occurring Substance Misuse/Mental Health Deep Dive to consider progress in the development of co-occurring mental health and substance misuse and the challenges that remain.' Perhaps it could tell us in plain language what that means, how and when this will report, when things will be done differently, and how performance will be monitored. The Welsh Government only accepts in principle our recommendation 4 calling on it to take 'a lead role in working with organisations across sectors to drive forward the necessary cultural change', and dodges our statement that it should 'update the Committee on the actions it has taken and timescales for future actions to deliver this recommendation at six, nine and twelve months.' And we thought long and hard about that, and that was an important recommendation for us. It instead states that: 'Implementing the Housing Support Grant will be the key mechanism through which we will achieve this objective.' Despite this, as we've heard, the Welsh Government played fast and loose with this grant in its draft budget by giving it a cash-flat settlement - a cut in real terms - with Cymorth Cymru, Community Housing Cymru and Welsh Women's Aid warning that services preventing homelessness and supporting independent living have now reached tipping point. As a supported-living service provider in north Wales told me, and I'll say it again, the consequences will be increased pressures on the NHS, A&E and blue-light services, adding that this, combined with the Welsh Government's planned redistribution of housing support grant, will be 'devastating to north Wales'. The Welsh Government accepts our recommendation 7, and says that it is currently undertaking further work to understand the barriers faced by rough-sleepers with co-occurring disorders and neurodiverse conditions, and that this, 'will form part of developing future services which better meet the needs of vulnerable individuals.' Several witnesses with experience of rough-sleeping referred to their own Asperger's or autism or that of loved ones. What has the Welsh Government been doing all these years, despite being told repeatedly that, too often, autistic people are being treated as the problem by public sector officials at senior levels, who have failed to establish and meet their communication and sensory processing needs? In accepting our recommendation 9, the Welsh Government states that it remains committed to ensuring that residential rehabilitation and in-patient detoxification services are available and that it allocates £1 million ring-fenced annual funding to area planning boards for the provision of these tier 4 services and that it is currently tendering for a contract for an all-Wales substance misuse residential rehabilitation framework, which will provide a list of approved residential rehabilitation and detoxification service providers. What they don't say is that it's still unclear whether the £1 million is ring-fenced; that their previous framework, which resulted in referrals to non-framework units outside Wales, has expired; that, following damning reports, a previous Welsh Government stated that it was taking forward work on three units in Wales, but two of these have since closed; or that the latest ONS figures show that Wales saw an 84 per cent increase in drug-related deaths over the previous decade and that, across England and Wales, Wales comes second only to the north-east of England for the highest mortality rate for drug-related deaths. As the Wallich's chief executive told us, 'we definitely need to improve access to tier 4, but, at the moment, my services can't get people through the assessment.' As the chief executive of Kaleidoscope told us, tier 4 is chronically underfunded and there's very little funding for anyone with a drugs issue to get into a tier 4 service.
Welsh: Wel, fel y dywed ein hadroddiad: 'Mater a oedd yn cael ei godi dro ar ôl tro oedd yr anhawster i bobl sy'n cysgu ar y stryd gael mynediad at wasanaethau camddefnyddio sylweddau ac iechyd meddwl integredig' ac 'mae gennym bryderon ynghylch lefel y gefnogaeth integredig i bobl sy'n cysgu ar y stryd ac sydd ag anhwylderau sy'n cyd-ddigwydd.' Er i ni nodi: 'Efallai y bydd rhai pocedi bach o wasanaethau integredig fel gwaith y Gydweithfa Gofal Cymunedol yn Wrecsam', y cyfeiriwyd ato gan y Cadeirydd, 'ymddengys mai eithriad yw'r rhain ac nid y norm.' Wrth ein briffio ar ei hymchwil i angen blaenoriaethol a chysgu allan, dywedodd Dr Helen Taylor o Brifysgol Metropolitan Caerdydd wrthym na fyddai gwneud rhywun yn flaenoriaeth ynddo'i hun yn mynd i'r afael â'r problemau yr oeddent yn eu dioddef. Dywedodd na fyddai'n datrys y problemau - rhoi rhywle iddynt fyw a rhoi cymorth iddynt; mae'n rhaid iddynt fod eisiau ei wneud. Rhaid ichi roi'r cyfle hwnnw iddynt. Dywedodd Dr Taylor wrthym hefyd fod llawer yn sôn am eu profiad mewn ysgolion, nad oeddent yn gwybod sut i ymdrin â'u cyflyrau a'u hymddygiad. Wrth dderbyn ein hargymhelliad cyntaf, dywedodd Llywodraeth Cymru ei bod wedi 'sefydlu ymchwiliad at wraidd Camddefnyddio Sylweddau/Iechyd Meddwl i ystyried cynnydd o ran datblygu gwasanaethau iechyd meddwl a chamddefnyddio sylweddau sy'n cyd-ddigwydd, a'r heriau sy'n parhau.' Efallai y gallai ddweud wrthym mewn iaith glir beth y mae hynny'n ei olygu, sut a phryd y bydd hwn yn adrodd, pa bryd y gwneir pethau'n wahanol, a sut y caiff perfformiad ei fonitro. Mewn egwyddor yn unig y mae Llywodraeth Cymru yn derbyn ein hargymhelliad 4 sy'n galw arni i fabwysiadu 'rôl arweiniol wrth weithio gyda sefydliadau ar draws sectorau i fwrw ymlaen â'r newid diwylliannol angenrheidiol', ac mae'n osgoi ein datganiad y dylai 'ddiweddaru'r Pwyllgor ar y camau y mae wedi'u cymryd a'r amserlenni ar gyfer camau yn y dyfodol i gyflawni'r argymhelliad hwn ar ôl chwech, naw a deuddeg mis.' Ac fe fuom yn meddwl yn hir ac yn galed am hynny, ac roedd hwnnw'n argymhelliad pwysig inni. Mae'n dweud, yn lle hynny: 'Rhoi'r Grant Cymorth Tai ar waith fydd y prif fecanwaith a fydd yn ein helpu i gyflawni'r amcan hwn.' Er gwaethaf hyn, fel y clywsom, fe fu Llywodraeth Cymru yn anghyfrifol gyda'r grant hwn yn ei chyllideb ddrafft drwy roi setliad arian gwastad iddo - toriad mewn termau real - gyda Cymorth Cymru, Cartrefi Cymunedol Cymru a Cymorth i Fenywod Cymru yn rhybuddio bod gwasanaethau sy'n atal digartrefedd a chefnogi byw'n annibynnol bellach wedi cyrraedd pwynt tyngedfennol. Fel y dywedodd darparwr gwasanaeth byw â chymorth yng ngogledd Cymru wrthyf, ac fe'i dywedaf eto, y canlyniadau fydd mwy o bwysau ar y GIG, adrannau damweiniau ac achosion brys a golau glas, gan ychwanegu y bydd hyn, ynghyd â bwriad Llywodraeth Cymru i ailddosbarthu grant cymorth tai, yn 'ddinistriol i ogledd Cymru'. Mae Llywodraeth Cymru yn derbyn ein hargymhelliad 7, ac yn dweud ei bod yn gwneud gwaith pellach ar hyn o bryd i ddeall y rhwystrau a wynebir gan rai sy'n cysgu allan ag anhwylderau sy'n cyd-ddigwydd a chyflyrau niwroamrywiol, ac y bydd hyn, 'yn rhan o ddatblygu gwasanaethau at y dyfodol, a rheiny'n wasanaethau sy'n diwallu anghenion unigolion sy'n agored i niwed yn well.' Cyfeiriodd sawl tyst â phrofiad o gysgu allan at eu syndrom Asperger neu eu hawtistiaeth eu hunain neu rywun annwyl. Beth y mae Llywodraeth Cymru wedi bod yn ei wneud yr holl flynyddoedd hyn, er iddi glywed dro ar ôl tro fod pobl awtistig yn rhy aml yn cael eu trin fel problem gan swyddogion y sector cyhoeddus ar lefelau uwch sydd wedi methu sefydlu a diwallu eu hanghenion cyfathrebu a phrosesu synhwyraidd? Wrth dderbyn ein hargymhelliad 9, mae Llywodraeth Cymru yn datgan ei bod yn parhau'n ymrwymedig i sicrhau bod gwasanaethau adsefydlu preswyl a dadwenwyno ar gyfer cleifion mewnol ar gael a'i bod yn dyrannu £1 filiwn o gyllid blynyddol wedi'i glustnodi i fyrddau cynllunio ardal ar gyfer darparu'r gwasanaethau haen 4 hyn a'i bod ar hyn o bryd yn tendro am gontract ar gyfer fframwaith adsefydlu preswyl ar gyfer camddefnyddio sylweddau i Gymru gyfan, a fydd yn darparu rhestr o ddarparwyr gwasanaethau adsefydlu preswyl a dadwenyno cymeradwy. Yr hyn nad ydynt yn ei ddweud yw ei bod yn aneglur o hyd a yw'r £1 filiwn wedi'i glustnodi; fod eu fframwaith blaenorol, a arweiniodd at atgyfeiriadau at unedau nad oeddent yn rhai fframwaith y tu allan i Gymru, wedi dod i ben; fod Llywodraeth Cymru flaenorol wedi datgan, yn dilyn adroddiadau damniol, ei bod yn bwrw ymlaen â gwaith ar dair uned yng Nghymru, ond bod dwy o'r rhain wedi cau ers hynny; neu fod ffigurau diweddaraf y Swyddfa Ystadegau Gwladol yn dangos bod Cymru wedi gweld cynnydd o 84 y cant yn nifer y marwolaethau cysylltiedig â chyffuriau dros y degawd diwethaf ac ar draws Cymru a Lloegr, gogledd-ddwyrain Lloegr yn unig sydd â chyfradd farwolaethau uwch o farwolaethau cysylltiedig â chyffuriau. Fel y dywedodd prif weithredwr Wallich wrthym, yn bendant mae angen inni wella mynediad at haen 4, ond ar hyn o bryd, ni all fy ngwasanaethau gael pobl drwy'r asesiad. Fel y dywedodd prif weithredwr Kaleidoscope wrthym, mae haen 4 wedi'i danariannu'n eithafol ac ychydig iawn o gyllid sydd ar gael i unrhyw un sydd â phroblem gyffuriau allu cael gwasanaeth haen 4.